Cancers of the colon and rectum together are second most common tumor type worldwide. The prognosis for the survival
after disease progression is usually poor (1). Cancer anorexia-cachexia syndrome is highly prevalent among patients with
colorectal cancer, and has a large impact on morbidity and mortality, and on patient quality of life. Early intervention with
nutritional supplementation has been shown to halt malnutrition, and may improve outcome in some patients (2).
The etiology of cancer-associated malnutrition appears to be related to the pathological loss of inhibitory control of catabolic
pathways, whose increased activities are not counterbalanced by the increased central and peripheral anabolic drive (3).
The goals of nutritional support in patients with colorectal cancer are to improve nutritional status to allow initiation and
completion of active anticancer therapies (chemotherapy and or radiotherapy) and improve quality of life (3, 4).
Cancer growth and dissemination but also cancer treatments, including surgery, chemotherapy, and radiation therapy,
interfere with taste, ingestion, swallowing, and digest food which leads to hypophagia. Also, chemotherapy agents may cause
nausea and diarrhea (3, 4). Although many new agents are on the market to combat these symptoms, prevalence of colorectal
cancer is still high (1).
We studied the influence of nutritional support (counseling, nutritional supplements, megestrol acetate) on physical status
and symptoms in patients with colorectal cancer during chemotherapy. The study was designed to investigate whether dietary
counseling or oral nutrition commercial supplements during chemotherapy and/or BSC affected nutritional status and influence
survival status prevalence in patients with colorectal cancer.
Results: Three hundred and eighty-eight colorectal cancer patients were included in the study. Nottingham Screening Tool
Questionnaire, Appetite Loss Scale and Karnofsky Performance Status were taken to evaluate the nutritive status of patients.
Group I consisted of 215 patients who were monitored prospectively and were given nutritional support and in this group weight
gain of 1,5 kg (0,6.2,8 kg) and appetite improvement was observed in patients with colorectal cancer. In both groups Karnofsky
Performance Status didn?t change significantly reflecting the impact of the disease itself.
Nutritional counseling, supplemental feeding and pharmacological support do temporarily stop weight loss and
improve appetite, QoL and social life, but this improvement has no implications on patients KPS and course of their disease.
Conclusion: These results encourage further studies with more specific nutritional supplementation in patients with
colorectal cancer and probably in gastrointestinal oncology.
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