Cancer, one of the important health problems of our age, threatens human life biologically, psychologically and economically. In order to reduce or eliminate all these threats, different treatment methods have been developed from past to present. Chemotherapy drugs, which are one of the treatment methods, prevent the uncontrolled proliferation of cancer cells by dispersing throughout the body through the blood circulation. Chemotherapy is administered alone or in combination with additional treatment, depending on the individual's condition. The main aim is to reduce symptoms and improve the quality of life, as well as to treat patients.
Effects of Chemotherapy on Nutrition
The most important issue that affects and supports the treatment of cancer patients is nutrition. Malnutrition, which refers to inadequate and malnutrition, slows down the treatment process of the individual and can cause severe consequences. Malnutrition is a fairly common symptom in individuals with cancer and is a consequence of both the presence of the tumor and anti-cancer treatments. For this reason, early diagnosis of malnutrition in cancer patients, regular screening and detailed evaluation are very important. Despite all this, only less than 30% of cancer patients use nutritional assessment or dieting in studies. Many cancer individuals experience unintentional weight loss due to malnutrition, chemotherapy drugs, and tumor cell activity. This condition is called cancer cachexia, and the degree of cachexia varies depending on the location, extent of the tumor, and the stage of the disease. Involuntary weight loss of more than 10% of the initial weight is observed in approximately 15% of patients at the time of diagnosis. Correct and timely nutritional care is very important during and after active treatment. Therefore, nutrition plays a central role in cancer management, in addition to anti-cancer treatments. Nutritional therapy should not be ignored because it prevents cancer cachexia and shortens the length of hospital stay. When nutritional therapy is a part of early treatment, it helps to improve the malnutrition risk and general condition of cancer patients. Maximizing the recovery phase is achieved only by preserving muscle mass and function and preventing involuntary weight loss during the cancer treatment process. ır.
Individuals receiving chemotherapy experience many side effects that disrupt daily life. Although these side effects vary depending on chemotherapy drugs, they are generally in the form of loss of appetite, nausea-vomiting, weakness, pain, fatigue, taste changes in the mouth, hair loss and anemia. these side effects are compelling. Therefore, it is very important for patients and health professionals to manage the process in cooperation. With the decrease in saliva secretion in the mouth, changes in taste and smell, difficulty in swallowing, oral ulcers (mucositis) and dental caries are encountered. Changes in taste and smell are seen in 45-80% of cancer patients and are caused by chemotherapy regimens, especially in smokers and smokers, and in patients with head and neck cancer. Taste changes in cancer patients manifest as increased or decreased sensitivity to one or more of the five basic tastes (sweet, sour, salty, bitter, umami). It also includes varying sensory experiences of certain foods and smells. Although it has been reported that taste changes due to chemotherapy occur at an early stage and come and go intermittently during the treatment process, they may also remain constant throughout chemotherapy. These changes affect the individual's food preferences and lead to a decrease in food intake. Nausea and vomiting are among the most serious and disturbing symptoms and occur in approximately 38-80% of patients. Risk factors that may play a role in the individual as a result of nausea and vomiting are fluid and electrolyte imbalance, weight loss, dehydration (excessive fluid loss) and malnutrition. Of course, it is possible to control the side effects that affect all these body balance.
Nutrition in the Chemotherapy Process
The correct application of nutritional therapy during the chemotherapy process can prevent unintentional weight loss, reduce nausea and vomiting and damage the oral mucosa. It helps to minimize. In addition to these, the course of the disease can be changed with appropriate nutritional therapy.
- One of the most important issues that cancer patients undergoing chemotherapy should pay attention to is fresh vegetables and fruits. Unwashed raw vegetables and fruits pose a risk. In addition, the consumption of moldy, damaged skin and direct contact with the soil is risky. Thin-skinned fruits (kiwi, apple, peach, etc.) are not recommended; Instead of these, fruits with thick skin (banana, orange, tangerine etc.) should be preferred. Consumption of dried fruits, cereals containing dried fruit and frozen soft fruits (raspberry, strawberry, etc.) is not recommended for cancer patients. Compote can be easily consumed. It is important that vegetables are cooked well.
- Pasteurized milk and its products should be consumed; Unpasteurized milk and products (street milk), home-made yoghurts, and ice creams sold in the open should not be preferred. Consumption of kefir and similar probiotic/prebiotic-containing products should be restricted. Hard, cooked, packaged, processed (curd, cottage) cheeses can be consumed.
- Raw or cracked eggs and sauces prepared with raw eggs (cream, mayonnaise, etc.) are in an extremely risky position. Eggs should be cooked well.
- Since undercooked meats, sushi, sausage, salami, sausage, shellfish contain microorganisms that negatively affect immunity, these foods should be avoided. Meat, chicken and fish should be consumed well cooked; When there is difficulty in meat consumption, turkey or chicken meat should be preferred. Bay leaves and lemon can be used to improve the smell and taste of fish. In addition, it has been reported that thyme, mint, rosemary and basil are more compatible with the tastes of oncological patients.
- Restrictions should be made on the intake of unheated nuts and delicatessen products, honey, instant soup and ready-made biscuits. Unroasted packaged nuts can be consumed.
- Another issue that is often overlooked is the consumption of tap, stream or natural water. Bottled water should be consumed instead. Since it will facilitate the entry of microorganisms that may affect the body immunity to the body, every water source offered under the name of "natural" should not be preferred.
- Hot food and i Room temperature or cold food and drinks may be preferred, as drinks may cause discomfort. Information should be given to avoid excessive salty, sweet, spicy and fatty foods. For this reason, attention should be paid to the consumption of salty foods such as pickles, pickles, olives, and fried products.
Nutrition after Chemotherapy
It should not be forgotten that body resistance is open to potential risks during the post-chemotherapy process. Important points applied in nutrition therapy are also valid after chemotherapy. In particular, ways that can be applied to alleviate the discomfort caused by the side effects are sought. For example, since an empty stomach can trigger the feeling of nausea, it is recommended that patients be fed in small portions and frequently. Drinking liquids between meals rather than during meals also prevents nausea. It is ensured that the liquids taken are consumed gradually. For this reason, drinks can be drunk with a straw. Individuals who are uncomfortable with the metallic taste left in the mouth by metal spoons as a result of taste changes are recommended to use plastic spoons and forks. Chewing gum and sucking on ice pieces can moisten the inside of the mouth by stimulating salivation and relieve the pain. Since the taste left in the mouth after a meal seriously affects food intake, mouth cleaning can be provided by gargling. In cases where there is difficulty in chewing and swallowing, the food can be cooked until soft or consumed as a puree. Soft foods such as omelette and pudding can be preferred.
General Recommendations to be Applied
- Wooden tools such as wooden chopping boards should not be used as they are risky.
- Frozen products should be consumed within 24 hours or freshly bought and cooked.
- Cooked foods should be consumed immediately, leftover meals should not be reheated and consumed.
- Spices should not be added to cooked meals, if spices are to be added, they should be added during cooking.
- Raw and cooked foods should be stored in separate places.
- Pay attention to oral hygiene, avoiding smoking and alcohol.
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