Chapek Michael A, Martindale Robert G
Portland, Oregon, USA.
Division of Gastrointestinal and General Surgery, Oregon Health Sciences University, Portland, Oregon, USA.
JPEN J Parenter Enteral Nutr. 2021 Nov;45(S2):33-40. doi: 10.1002/jpen.2259.
Despite significant advances in oncologic treatment, cancer-associated metabolic derangements largely remain poorly understood and are often neglected in cancer care. Cancer cachexia and metabolic changes exhibited by neoplastic cells pose formidable barriers to improving outcomes and quality of life. Although cancer has traditionally been viewed as a proliferative disease caused by genetic mutations, newer perspectives suggest that it is primarily a metabolic disease. This paper discusses the etiology of cachexia and sarcopenia and nutrition interventions that can address these wasting disorders. The role of inflammation in cancer and the methods for preventing and resolving inflammation with nutrition intervention are also explored. Several nutrition recommendations aimed at overcoming cachexia, resolving inflammation, and improving cancer outcomes are provided based on current literature. This manuscript selected only a few areas on which to focus and is not all-inclusive of the expansive literature available on the topic of cachexia.
尽管肿瘤治疗取得了重大进展,但癌症相关的代谢紊乱在很大程度上仍未得到充分理解,并且在癌症护理中常常被忽视。癌症恶病质和肿瘤细胞表现出的代谢变化对改善治疗效果和生活质量构成了巨大障碍。虽然癌症传统上被视为由基因突变引起的增殖性疾病,但新的观点表明它主要是一种代谢性疾病。本文讨论了恶病质和肌肉减少症的病因以及可以解决这些消耗性疾病的营养干预措施。还探讨了炎症在癌症中的作用以及通过营养干预预防和解决炎症的方法。基于当前文献,提供了一些旨在克服恶病质、解决炎症和改善癌症治疗效果的营养建议。本手稿仅选择了几个重点关注的领域,并未涵盖有关恶病质这一广泛主题的所有文献。