Initial assessment and monitoring of the nutritional status of lung cancer patients

Kaheksija je kompleksan metabolički sindrom povezan s postojanjem bolesti, karakteriziran gubitkom mišićne mase, sa ili bez gubitka masnog tkiva. Iz kliničke je prakse dobro poznat nepovoljan učinak kaheksije na liječenje i klinički ishod bolesnika koji boluju od zloćudnih novotvorina. Usprkos činjenici da kaheksija ima nepovoljan učinak na liječenje, a time i prognozu, ona često ostaje nedijagnosticirana i neadekvatno tretirana. Važno je procjenjivati i redovito pratiti nutritivni status oboljelih, pratiti i bilježiti popratne pojave te u skladu s tim i postupati. Za procjenu nutritivnog statusa i praćenje simptoma i popratnih pojava bolesti i diferentnog onkološkog liječenja oboljelih od raka pluća osmišljena je Sastavnica sestrinske liste koja je i uvedena na Kliniku za plućne bolesti Jordanovac KBC Zagreb kao obvezna dokumentacija za praćenje bolesnika. Cilj ovoga rada je utvrditi važnost procjene nutritivnog statusa bolesnika s rakom pluća i potaknuti kasnija istraživanja i promjene u svakodnevnoj kliničkoj praksi kako bi se pravovremeno uočilo i prepoznalo postojanje rizika pothranjenosti bolesnika, omogućila bolja procjena mogućeg ishoda terapije te na taj način interveniralo i na tijek bolesti. Inicijalna procjena i praćenje nutritivnog statusa mora biti obvezan i neodvojiv dio skrbi oboljelih od raka pluća.Cachexia is a complex metabolic syndrome based on the illness itself, characterized with the loss of muscles tissue with or without the loss of fat tissue. The negative effect of cachexia on the treatment result of cancer patients is well known from clinical practice. Despite the fact that cachexia has negative effect on treatment outcomes including prognosis, it often remains not diagnosed and not adequately treated. It is very important to evaluate and carefully monitor the nutritive status of patients and adverse effects of therapy in order to be able to react in time. As a tool to evaluate the nutritive state and symptoms of the disease as well as adverse effects of therapy of lung cancer patient a new sheet in the patient nurse diary was developed and implemented in the Clinic for Pulmonary Diseases Jordanovac, Clinical Hospital Centre Zagreb. This new sheet which follows the nutritive state and symptoms of disease and adverse effects of therapy is now mandatory. The purpose of this paper is to evaluate the importance of nutritive state of lung cancer patients and to facilitate further investigation and modification in everyday clinical practice in order to recognize in time the potential risk of malnutrition, enable better evaluation of possible therapy outcome, in order to modify the disease outcome. The initial assessment and continuous monitoring of the nutritive state of a ling cancer patient should be mandatory part of a patient care