RESUMO
OPINION STATEMENT: Despite extensive research that has identified new risk factors, genetic mutations, and therapeutic options, pancreatic ductal adenocarcinoma continues to be a leading cause of cancer related death. Patients with pancreatic cancer, along with their clinicians, must balance realistic hope alongside a life-threatening diagnosis. As the search for treatments to reduce the morbidity and mortality continues, symptom management and quality of life remain the focus of our efforts. In addition to side effects of cancer-directed therapy, patients are at risk for malnutrition, pain, and fatigue. These factors are often overlooked in practice, so a multidisciplinary team is critical in optimizing the care of patients.
Assuntos
Adenocarcinoma/terapia , Carcinoma Ductal Pancreático/terapia , Manejo da Dor , Dor/epidemiologia , Adenocarcinoma/complicações , Adenocarcinoma/epidemiologia , Adenocarcinoma/genética , Carcinoma Ductal Pancreático/complicações , Carcinoma Ductal Pancreático/epidemiologia , Carcinoma Ductal Pancreático/genética , Fadiga/complicações , Fadiga/epidemiologia , Fadiga/genética , Fadiga/terapia , Humanos , Mutação/genética , Dor/patologia , Cuidados Paliativos , Qualidade de VidaRESUMO
Head and neck cancer (HNC) patients often face multiple nutritional challenges before, during, and after treatment due to the close proximity of the cancer to organs that are vital for normal eating function. Common treatment-related side effects, such as dysphagia, odynophagia, dysgeusia, xerostomia, thick saliva, mucositis, nausea, and vomiting, all further impair the patient's ability to maintain adequate oral intake. Malnutrition and unintentional weight loss in HNC patients during and after treatment are associated with poorer treatment outcomes, increased morbidity and mortality, and poor quality of life, even in overweight and obese patients whose Body Mass Index (BMI) is not suggestive of malnutrition. The main nutrition goal for HNC patients is thus to maximize nutrition intake either orally or through nutrition support therapy in order to prevent or limit weight loss, preserve lean body mass, minimize treatment delays and unplanned hospitalizations, and improve treatment outcomes. This chapter will discuss nutrition interventions to manage common symptoms before, during, and after treatment for HNC. Guidelines will be provided for patients that require enteral nutrition or less commonly, parenteral nutrition.