Factors Involved in the Development of Malnutrition in Children with Cancer

Öz

Childhood cancers are a group of diseases that occur between birth and 19 years of age, are characterised by uncontrolled division of abnormal cells, are not limited to the tissue in which they occur, but can spread to different parts of the body and cause death when left untreated with very serious damage. Children with cancer can be cured with early diagnosis and appropriate treatment methods. In addition, chemotherapy, radiotherapy and/or surgical treatment may cause physical, psychosocial and neurocognitive problems and symptoms affecting various body systems. Metabolic effects that change during the course of the disease, changes in energy requirements, psychological processes that change depending on the location and size of the tumour and the patient's emotional state can negatively affect many physiological and psychological processes, especially the nutritional status of the patient. Due to all these factors, it is inevitable that children with cancer will experience health problems such as diarrhoea, mucositis, nausea, vomiting, dysphagia, taste and smell disorders, reflux, intestinal obstructions, bleeding, malabsorption, hypermetabolism, increased catabolic process, anorexia and/or cachexia, which will cause malnutrition in the long term. Nutrition is of great importance in the treatment of cancer. Inadequate nutrient intake due to late diagnosis or uncorrectable health problems, taking too much or unbalanced amounts of nutrients can cause serious malnutrition in the patient. For this reason, disease and nutrition follow-up of the patient from the diagnosis is of great importance. In the light of the guidelines, implementation of the appropriate treatment protocol with teamwork is very important in terms of improving the quality of life and providing recovery in children with cancer. Literature search for this article prepared as a review; Google Scholar, Pubmed and Science Direct databases were used. Human studies; It was aimed to investigate the factors causing malnutrition in children with cancer and the general effects of these factors from many different sources, including meta-analyses, cohort studies, retrospective studies, and generally accepted articles were included in the review.

Anahtar Kelimeler

• Malnutrition
• Child with cancer
• Nutrition
• Treatment

Kanserli Çocukta Malnütrisyon Gelişmesinde Rol Oynayan Faktörler

Öz

Çocukluk çağı kanserleri, doğum ile 19 yaş arasında ortaya çıkan, anormal hücrelerin kontrolsüz bölünmesiyle karakterize, oluştuğu dokuyla sınırla kalmayıp vücudun farklı bölgelerine de yayılabilen ve çok ciddi zararlarla birlikte tedavi edilemediğinde ölüme sebebiyet veren bir hastalık grubudur. Kanserli çocuklar, erken tanı ve uygun tedavi yöntemleriyle iyileştirilebilmektedir. Ayrıca hastaya uygulanan kemoterapi, radyoterapi ve/veya cerrahi tedavi çeşitli vücut sistemlerini etkileyen fiziksel, psikososyal ve nörobilişsel sorunlara ve semptomlara sebebiyet verebilmektedir. Hastalığın seyri boyunca değişen metabolik etkiler, enerji gereksiniminin değişmesi, tümörün yerine ve boyutuna ve hastanın duygu durumuna bağlı değişen psikolojik süreçleri de başta hastanın beslenme durumu olmak üzere birçok fizyolojik ve psikolojik süreci olumsuz yönde etkileyebilmektedir. Tüm bu faktörler sebebiyle kanserli çocuklarda ishal, mukozit, bulantı, kusma, yutma güçlüğü, tat ve koku bozuklukları, reflü, bağırsak tıkanıklıkları, kanamalar, malabsorpsiyonlar, hipermetabolizma, katabolik sürecin artışı, anoreksi ve/veya kaşeksi gibi uzun vadede malnütrisyona sebebiyet verecek sağlık problemlerinin yaşanması kaçınılmaz olmaktadır. Kanserin tedavisinde beslenmenin önemi çok büyüktür. Geç teşhis veya düzeltilemeyen bu sağlık problemlerinden kaynaklı yeterli besin alınamaması, alınması gerekenden çok fazla veya dengesiz oranlarda besin alınması hastada ciddi oranda malnütrisyona sebebiyet verebilmektedir. Bunun için hastanın tanıdan itibaren hastalık ve beslenme takibi büyük önem arz etmektedir. Kılavuzlar ışığında, ekip çalışması ile uygun tedavi protokolünün uygulanması kanserli çocuklarda yaşam kalitesini artırıp, iyileşme sağlanması açısından çok önemlidir. Derleme olarak hazırlanan bu makale için literatür taraması; Google Akademik, Pubmed ve Science Direct veri tabanları kullanılarak yapılan çalışmalar taranmıştır. İnsan çalışmaları; meta-analizler, kohort çalışmaları, retrospektif çalışmalar da dahil olmak üzere birçok türde farklı kaynaktan kanserli çocuklarda malnütrisyona sebep olan etmenler ve bu etmenlerin genel etkilerinin araştırılması amaçlanmış olup konuya ilişkin yapılan çalışmalarda genel kabul görmüş makaleler derlemeye dahil edilmiştir.

Anahtar Kelimeler

• Malnütrisyon
• Kanserli çocuk
• Beslenme
• Tedavi

Kaynakça

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