Nutrition and Pediatric Oncology

Nutrition and Pediatric Oncology

Nutrition deficiency among cancer-ridden children is a major deterrent in the way of their recovery. Estimates by Indian Cancer Society indicates that each year, 50,000 children and adolescents in the age group 0 to 19 years will be diagnosed with cancer in India. Paediatric oncologists believe that an early diagnosis and treatment of cancer in children has a favourable chance of being cured. A strong nutritional care program, however, is undeniably, the need of the hour.

The data available with the Indian Council for Medical Research (ICMR) reveals that cancer in children comprises of 5.5 percent cases of the total cancer cases in India. Death due to cancer in children remains the top-ten causes in the age-group 5-14 years. The low and middle-income group countries struggling with food-insecurity and malnourishment are prone to a high risk of cases of cancer in children.

Over the years, nutrition has become a key component of paediatric cancer care. The government has launched steps to strengthen the food-security system which emphasise on the nutrition value. There has been a Conscious attempt at a global level to facilitate high-quality research and training in paediatric oncology and nutrition, thus boosting the cancer care support system. It is imperative to integrate nutrition studies in paediatric oncology care and not treat it as a secondary to the approach.

When to see a paediatric-Oncologist?
The warning signs indicating the onset of cancer in a child can be identified by an unexplainable prolonged fever, fatigue, pain in joints, change in taste, unusual lump or swelling in lymph nodes, frequent headaches; nausea or vision changes. While the cancer in children is rare, the lack of nutrition deters its chances of cure in such cases.

Why is nutrition important in paediatric-onco care?
A malnourished child seeking cancer treatment is less likely to meet the stage of recovery which makes it pertinent for the paediatric oncologists to closely work with the clinical nutritionists and evaluate a child’s nutritional status.

Malnourishment in a cancer-ridden child can range from mild to severe. The rising susceptibility of children falling under the grip of cancer, calls for personalized nutrition care that is germane to arrest an increased risk of mortality and the treatment-induced deficiencies.
An early evaluation of the nutrition status can help an oncologist chart a holistic intervention by including a nutritionist who will appropriate the diet-intake to supplement and manage symptoms and the side-effects. Moreover, a nutrient-deficient-child maybe further prone to stunting, which is both, mentally and physically damaging. In India, 35 percent of children are stunted, making them vulnerable to long-lasting chronic diseases such as diabetes, obesity and hypertension.
An adequate amount of nutrition in the body can prevent delay in the cancer treatment, address the distress caused during treatment, lower the risk of infection, prevent a relapse and improve the quality of life.

Effect of nutrition deficiency on the cancer treatment
Cancer and its treatment can affect eating habits, taste, smell and appetite, thereby impacting the ability of the body to meet the nutritional needs. A body’s use of carbohydrates, proteins and fat may be affected during the treatment. For instance, it may feel that the individual seeking treatment is consuming enough food, but there has not been a visible impact on the body.
During the treatment, the body requires additional energy and supply of nutrients to heal and repair. A registered nutritionist comes in handy, as they counsel the patient and the family to focus on the nutrition value in the meals. Based on an evaluation, the nutritionist may prescribe the intake of the certain nutrition, as required. Eating meals that are high in protein, calories, protein and micro-nutrients is vital.
It is not only the symptoms that cause nutrition deficiency; the side-effects of the cancer treatment can, too, induce malnourishment. Chemotherapy and Hormone therapy; Radiation therapy; surgery to the head, neck, esophagus, stomach and intestine; Immunotherapy, Stem Cell Transplant may individually affect the nutrition in the body and may require special nutrition needs.
Besides focusing on the nutritional value, the treatment also uses food-therapy to comfort the individual.

Special Nutrition supplements
Cancer treatment makes it difficult for the children to eat, making it important for the family to engage a nutritionist that may suggest the intake of supplements along with the meal. A nutritionist may prescribe Vitamin C, Probiotics, Melatonin to boost the recovery from the treatment. The nutritionists can also provide supplements to stimulate the appetite as and when required.

Vitamin C helps the body strengthen the immune system and fight the infection. It is responsible for keeping tissues healthy and healing of the wounds. Intake of fruits and vegetables rich in Vitamin C in small proportions can help the body deal with the treatment. Similarly, Probiotics can also be included in the diet. They are the live microorganisms that help with the efficient bowel movement and digestion.Studies suggests that consuming probiotics during radiation and the chemotherapy can help prevent stomach related issues, which is, often, a side-effect. Another supplement can be included in Melatonin that is produced by the pineal gland in the brain. Melatonin is generally responsible for the sleep cycle and also helps in the chemotherapy and the radiation therapy.

Nutrition and post-cancer care

Nutrition intake post treatment plays a major role in the recovery of a child and the family needs to be a lot more attentive to the diet needs. Even after the child is cured, it is recommended that a nutritionist remains engaged to chart a long-term diet plan to prevent a relapse. Paediatric oncologists say that a child cured from cancer can live a normal childhood but it becomes paramount that its nutrition status is monitored closely. The cancer requires a prolonged treatment and causes immense weakness in the body. Going back to school and resume regular activities can take time; however, a good nutrition diet can ease the process and strengthen the immunity system gradually. The family and the child can attend regular counseling sessions along with the regular check-ups on the health and the diet.

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