PERSONIFICATION OF NUTRITIVE TREATMENT PROGRAMS IN THE STRUCTURE OF PALLIATIVE AID TO PATIENTS OF THE ONCOLOGICAL PROFILE

Abstract

The aim is to develop recommendations for the use of nutritional schemes for palliative care for cancer patients. Material and methods. The severity of the condition, the degree of protein-energy deficiency and organ deficiency (according to the method of alimentary-vollemic diagnosis), the degree of nutritional risk, the stage of the process, the assessment of the intensity of intoxication, the state of the immune system and genomic prognosis were assessed in cancer patients. Criteria for assessment of homeostasis in all patients with oncopathology are divided into 3 main groups: 1) patients who could performed radical surgery and/or comprehensive treatment; 2) patients receiving at the time of providing support to various regimens; 3) patients requiring only palliative care. With this gradation, the use of information, literature data and own observations, we proposed for each group a specialized nutritional program. Results and discussion. Patients in need of palliative care were diagnosed with asthenia, early satiety, progressive weight loss, anorexia, tissue protein deficiency, the growth of pro-inflammatory cytokines and tumor-specific cachexia factors. For such patients, a program is proposed that includes a diet, sipping with the use of a caliper; In the case of probe alimentation, partially disintegrated formulations are recommended (for example, nutrihim). In severe patients, the nutritional effect was enhanced by progestogen preparations (megas, ondasetron), anti-catabolic agents (indomethacin, ibuprofen, EPA), anabolics (retabolil). Conclusions. The composition of the sipping rations should include nutrients that affect the molecular mechanisms of survival, apoptosis of tumor cells, proliferation, angiogenesis and invasion of tumor cells.