Niedożywienie dotyczy dużej części pacjentów onkologicznych. Prawidłowe postępowanie żywieniowe warunkuje skuteczność i powodzenie leczenia u tych chorych. Ze względu na znaczenie tego zagadnienia, dzięki współpracy towarzystw naukowych: Polskiego Towarzystwa Chirurgii Onkologicznej (PTChO), Polskiego Towarzystwa Onkologicznego (PTO), Polskiego Towarzystwa Onkologii Klinicznej (PTOK) oraz Polskiego Towarzystwa Żywienia Dojelitowego, Pozajelitowego i Metabolizmu (POLSPEN), zostały opracowane standardy leczenia żywieniowego w onkologii. Wstępem do leczenia żywieniowego jest prawidłowa identyfikacja niedożywionych pacjentów. W Polsce hospitalizowani chorzy są poddawani badaniu przesiewowemu w kierunku niedożywienia. Interwencja żywieniowa powinna być dostosowana do sytuacji klinicznej. Polega ona na poradnictwie dietetycznym, stosowaniu doustnych diet przemysłowych (oral nutritional support), żywienia dojelitowego lub żywienia pozajelitowego w warunkach szpitalnych i domowych, z uwzględnieniem sytuacji szczególnych. Clinical nutrition in oncology: Polish recommendations Malnutrition affects a large part of patients with malignant neoplasm. Proper nutritional treatment determines the effectiveness and success of therapy in these patients. Given the importance of this issue, thanks to the collaboration of scientific societies: Polish Society of Surgical Oncology (PTChO), Polish Society of Oncology (PTO), Polish Society of Clinical Oncology (PTOK) and Polish Society for Parenteral, Enteral Nutrition and Metabolism (POLSPEN) standards for nutritional therapy in oncology have been set. An introduction to nutritional therapy is the correct identification of malnourished patients. In Poland, hospitalized patients are subject to screening towards malnutrition. Nutrition

Lycopene is a nutraceutical with health-promoting and anti-cancer activities, but due to a lack of evidence, there are no recommendations regarding its use and dosage. This review aimed to evaluate the benefits of lycopene supplementation in cancer prevention and treatment based on the results of in vivo studies. We identified 72 human and animal studies that were then analysed for endpoints such as cancer incidence, improvement in treatment outcomes, and the mechanisms of lycopene action. We concluded that the results of most of the reviewed in vivo studies confirmed the anti-cancer activities of lycopene. Most of the studies concerned prostate cancer, reflecting the number of in vitro studies. The reported mechanisms of lycopene action in vivo included regulation of oxidative and inflammatory processes, induction of apoptosis, and inhibition of cell division, angiogenesis, and metastasis formation. The predominance of particular mechanisms seemed to depend on tumour organ localisation and the local storage capacity of lycopene. Finally, there is a need to look for predictive factors to identify a population that may benefit from lycopene supplementation. The potential candidates appear to be race, single nucleotide polymorphisms in carotene-cleaving enzymes, some genetic abbreviations, and insulin-like growth factor-dependent and inflammatory diseases.

The treatment of locally advanced head and neck cancer (HNC) is based on extensive resections followed by concurrent chemoradiotherapy (CRT) with platinum derivatives or concurrent radiotherapy with cetuximab (bioradiotherapy; BRT). Malnutrition, which occurs in up to 60% of patients before treatment commencement, severely increases the risk of CRT/BRT drug dose reductions and the incidence of treatment-related adverse events. A prospective observational study was performed regarding the influence of nutritional care on nutritional status, compliance with the treatment‘s planned regimen, and the incidence of treatment-related complications in patients with advanced HNC during CRT and BRT. The study population encompassed 153 patients compared with a retrospective control group of 72 patients treated before nutritional care was included in the standard of oncological care. Patients enrolled in the nutritional care programme received significantly higher doses of platinum derivatives or cetuximab than patients in the control group. A significant difference between the compared populations was observed in patients below 70 years of age (92.8% of the study population), after prior surgery, and with initial weight loss lower than 10%. Nutritional care reduced final weight loss and prevented a decline within the laboratory markers of nutritional status. Weight loss was comparable in both modes of treatment—CRT and BRT. The incidence of treatment-related complications was significantly higher in patients without nutritional support in the subgroups of patients under 70 years of age and after primary surgery. Nutritional care before and during CRT and BRT in patients with HNC is a determinant of therapeutic benefit, defined as preventing down-dosing, weight loss, and the incidence of complications. Platinum derivatives and cetuximab had comparable influence on weight loss.

Nutritional intervention is an essential part of cancer treatments. Research and clinical evidence in cancer have shown that nutritional support can reduce length of hospitalisation, diminish treatment-related toxicity, and improve nutrient intake, quality of life, and physical function. Nutritional intervention can improve outcomes and help patients in the successful completion of oncological treatments by preventing malnutrition. Malnutrition is a very common hallmark in patients with cancers. Almost one-fourth of cancer patients are at risk of dying because of the consequences of malnutrition, rather than cancer itself. Patients with digestive cancers are at higher risk of suffering malnutrition due to the gastrointestinal impairment caused by their disease. They are at high nutritional risk by definition, yet the majority of them have insufficient or null access to nutritional intervention.Inadequate resources are dedicated to implementing nutritional services in Europe. Universal access to nutritional support for digestive cancer patients is not a reality in many European countries. To change this situation, health systems should invest in qualified staff to reinforce or create nutritional teams’ experts in digestive cancer treatments. We aim to share the patient community’s perspective on the status and the importance of nutritional intervention. This is an advocacy manuscript presenting data on the topic and analysing the current situations and the challenges for nutrition in digestive cancers. It highlights the importance of integrative nutrition in the treatment of digestive cancers and advocates for equitable and universal access to nutritional intervention for all patients.

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