Nutritional Intervention: Important Aspect Of Treatment In Children With Cancer

Adequate nutrition during cancer plays a significant role in several clinical outcome, such assusceptibility to infections, wound healing, tolerance and response to chemotherapy, biochemicalimbalances, quality of life, and cost of care. But, the importance of nutrition in children withmalignancies is still an undervalued topic within pediatric oncology. The importance of our work isto reinforce and indicate that malnutrition in children with cancer should not be accepted at anystage of the disease or tolerated as a predictable process. Aim of our paper is the closecollaboration, the exchange of knowledge and expertise between pediatric oncologists and anutritional specialist, as well as the comprehension of the mechanisms during cancer cachexia andmalnutrition. We provide a critical review of the current state of research and new knowledgerelated to nutritional management in childhood cancer. Also we discuss screening methods,including the use of subjective global assessment. Different parts of nutritional assessment includemedical history; physical examination; biochemical and hematological data ,anthropometricmeasurements; and food and nutrition history. We review medical tests and procedures todetermine nutritional status, including nitrogen balance, delayed cutaneous hypersensitivity,prognostic nutritional index, creatinine height index, maldigestion and malabsorption tests,indirect calorimetry and dual x-ray absorptiometry. The importance of nutrition in children withcancer is an underestimated topic within pediatric oncology. There are new, inexpensive, andnoninvasive techniques for the evaluation of the nutritional status providing evidence for thequality of nutritional interventions for children with a high risk of malnutrition and a tendency forbody fat accumulation. Nutritional strategies should be considered and integrated as afundamental feature of pediatric oncology with the same diligence as one does for other supportivecare measures to prevent chronic illness and adverse late effects caused by malnutrition in thispopulation. One of the main objectives in this field is the early detection of children withpreexisting malnutrition and a high risk of substrate depletion before cancer therapies startemploying standardized methodologies. In short, it is essential to establish individualized andpatient-centered nutrition therapy for a child with cancer, focusing on proactive, ongoingassessments with early and continuing preventive measures in place.