RSS-Feed abonnieren
DOI: 10.1055/a-1741-5329
Ernährungsmedizinischer Bedarf und reale Versorgung von Brustkrebspatientinnen
Nutritional Medical Needs and the Actual Care of Breast Cancer PatientsZusammenfassung
Einleitung Für die Primärtherapie und Rezidivprävention des Mammakarzinoms sind der Ernährungsstatus und mögliche Effekte von Nahrungsergänzungsmitteln von großer klinischer Relevanz. Ziel der vorliegenden Untersuchung war die Beantwortung der Frage, ob es eine Diskrepanz zwischen dem ernährungsmedizinischen Bedarf von Brustkrebspatientinnen und der realen Versorgungssituation gibt.
Methoden Von Dezember 2019 bis März 2020 wurden Brustkrebspatientinnen mittels eines Online-Fragebogens zu den persönlichen Erfahrungen während ihrer onkologischen Therapie befragt. Die erhobenen Daten wurden statistisch ausgewertet und kritisch diskutiert.
Ergebnisse Von den befragten Brustkrebspatientinnen (n=166) gaben 64,5% an, keine Ernährungsberatung erhalten zu haben, wobei sich von diesen Frauen 71,8% eine Ernährungsberatung gewünscht hätten. 56% der Frauen gaben an, keinerlei Beratung bezüglich der Einnahme von Nahrungsergänzungsmitteln erhalten zu haben; gleichzeitig hatten aber 80,8% der Frauen während ihrer onkologischen Therapie Nahrungsergänzungsmittel eingenommen. 83,7% der Frauen informierten sich selbstständig über mögliche therapiebegleitende Ernährungstherapien, wobei die Informationen mit 71,2% am häufigsten von Internetseiten und Online-Foren stammten.
Diskussion Die Ergebnisse zeigen eine erhebliche Diskrepanz zwischen ernährungsmedizinischem Bedarf und realer Beratungssituation von Frauen mit Brustkrebs. Trotz des mehrheitlich artikulierten Bedarfs einer individuellen Ernährungsberatung wird diese in der Regel nicht angeboten. Die strukturelle Implementierung einer qualifizierten Ernährungsberatung für alle Brustkrebspatientinnen wäre dringend notwendig, um durch einen optimierten Ernährungsstatus die Wirksamkeit und Verträglichkeit der onkologischen Therapie zu verbessern und potenziell gefährliche Wechselwirkungen mit Nahrungsergänzungsmitteln zu vermeiden.
Abstract
Introduction For the primary therapy and recurrence prevention of breast cancer, the nutritional status and possible effects of nutritional supplements are of great clinical relevance. The aim of the present study was to answer the question of whether there is a discrepancy between the nutritional needs of breast cancer patients and the actual care situation.
Methods From December 2019 to March 2020, breast cancer patients were surveyed via an online questionnaire about their personal experiences during their oncological therapy. The collected data were statistically analysed and critically discussed.
Results Of the breast cancer patients surveyed (n=166), 64.5% stated that they had not received any nutritional counselling, although 71.8% of these women would have liked to receive nutritional counselling. 56% of the women stated that they had not received any advice regarding the intake of dietary supplements; at the same time, however, 80.8% of the women had taken dietary supplements during their oncological therapy. 83.7% of the women informed themselves about possible concomitant nutritional therapies, whereby the information (71.2%) most frequently came from websites and online forums.
Conclusion The results show a considerable discrepancy between nutritional medical need and the actual care situation of women with breast cancer. Despite the majority articulated need for individual nutritional counselling, this is usually not offered. The structural implementation of qualified nutritional counselling for all breast cancer patients would be urgently necessary to improve the effectiveness and tolerability of oncological therapy through an optimised nutritional status and to avoid potentially dangerous interactions with dietary supplements.
Publikationsverlauf
Eingereicht: 17. September 2021
Angenommen: 13. Januar 2022
Artikel online veröffentlicht:
15. August 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart,
Germany
-
Literatur
-
1
National Cancer Institute, Surveillance, Epidemiology, and End
Results (SEER).
Cancer Stat Facts: Female Breast Cancer (2020). Im Internet: https://seer.cancer.gov/statfacts/html/breast.html Stand: 05.06.2021
-
2
World Cancer Research Fund/American Institute for
Cancer Research (WCRF/AICR).
Continuous Update Project (CUP), Third Expert Report: Diet, nutrition, physical
activity and breast cancer (2018). Im Internet: www.wcrf.org/dietandcancer Stand: 06.06.2021
- 3 Dandamudi A, Tommie J, Nommsen-Rivers L. et al. Dietary Patterns and Breast Cancer Risk: A Systematic Review. Anticancer Res 2018; 38: 3209-3222
- 4 Toledo E, Salas-Salvadó J, Donat-Vargas C. et al. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial. JAMA Intern Med 2015; 175: 1752-1760
- 5 Muscaritoli M, Arends J, Bachmann P. et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr 2021; 40: 2898-2913
-
6
Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft,
Deutsche Krebshilfe, AWMF).
S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des
Mammakarzinoms, Version 4.3, AWMF Registrierungsnummer: 032-045OL (2020). Im
Internet: http://www.leitlinienprogramm-onkologie.de/leitlinien/mammakarzinom/ Stand: 06.05.2021
- 7 Runowicz CD, Leach CR, Henry NL. et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol 2016; 34: 611-635
- 8 Arends J, Bertz H, Bischoff SC. et al. S3-Guideline of the German Society for Nutritional Medicine (DGEM) in Cooperation with the DGHO, the ASORS and the AKE. Aktuel Ernahrungsmed 2015; 40: e1-e74
- 9 Velicer CM, Ulrich CM. Vitamin and mineral supplement use among US adults after cancer diagnosis: a systematic review. J Clin Oncol 2008; 26: 665-673
- 10 Harvie M. Nutritional supplements and cancer: potential benefits and proven harms. Am Soc Clin Oncol Educ Book 2014; e478-e486
- 11 Ambrosone CB, Zirpoli GR, Hutson AD. et al. Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221). J Clin Oncol 2020; 38: 804-814
- 12 Chu C, Deng J, Man Y. et al. Green Tea Extracts Epigallocatechin-3-gallate for Different Treatments. Biomed Res Int 2017; 2017: 5615647
- 13 Le Gal K, Ibrahim MX, Weil C. et al. Antioxidants can increase melanoma metastasis in mice. Sci Transl Med 2015; 7: 308re8
- 14 Smollich M, Podlogar J. Wechselwirkungen zwischen Arzneimitteln und Lebensmitteln. 2. überarbeitete und erweiterte Aufl. Stuttgart: Wissenschaftliche Verlagsgesellschaft Stuttgart; 2020
- 15 Keum N, Lee DH, Greenwood DC. et al. Vitamin D supplementation and total cancer incidence and mortality: a meta-analysis of randomized controlled trials. Ann Oncol 2019; 30: 733-743
- 16 Keaver L, Yiannakou I, Folta SC. et al. Perceptions of Oncology Providers and Cancer Survivors on the Role of Nutrition in Cancer Care and Their Views on the „NutriCare“ Program. Nutrients 2020; 12: 1277
- 17 Geirsdottir OG, Thorsdottir I. Nutritional status of cancer patients in chemotherapy; dietary intake, nitrogen balance and screening. Food Nutr Res 2008; 52
- 18 Van Veen MR, Winkels RM, Janssen SHM. et al. Nutritional Information Provision to Cancer Patients and Their Relatives Can Promote Dietary Behaviour Changes Independent of Nutritional Information Needs. Nutr Cancer 2018; 70: 483-489
- 19 Halilova KI, Pisu M, Azuero A. et al. Healthy lifestyle discussions between healthcare providers and older cancer survivors: Data from 12 cancer centers in the Southeastern United States. Cancer Med 2019; 8: 7123-7132
- 20 Schuetz P, Fehr R, Baechli V. et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321
-
21
AGO Breast Committee.
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer.
Recommendations 2021. Im Internet: www.ago-online.deStand: 08.09.2021
-
22
World Cancer Research Fund/American Institute for
Cancer Research (WCRF/AICR).
Continuous Update Project Expert Report 2018. Survivors of breast and other
cancer (2018). Im Internet: https://www.wcrf.org/wp-content/uploads/2021/02/Cancer-Survivors.pdf Stand: 08.09.2021
- 23 Piepoli MF, Hoes AW, Agewall S. et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37: 2315-2381
- 24 Arends J, Bachmann P, Baracos V. et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017; 36: 11-48
- 25 Mattsson S, Olsson EMG, Johansson B. et al. Health-Related Internet Use in People With Cancer: Results From a Cross-Sectional Study in Two Outpatient Clinics in Sweden. J Med Internet Res 2017; 19: e163
- 26 Nagler RH, Gray SW, Romantan A. et al. Differences in information seeking among breast, prostate, and colorectal cancer patients: results from a population-based survey. Patient Educ Couns 2010; 81 Suppl: S54-S62
- 27 Greenlee H, Kwan ML, Kushi LH. et al. Antioxidant supplement use after breast cancer diagnosis and mortality in the Life After Cancer Epidemiology (LACE) cohort. Cancer 2012; 118: 2048-2058
- 28 Ronis MJJ, Pedersen KB, Watt J. Adverse Effects of Nutraceuticals and Dietary Supplements. Annu Rev Pharmacol Toxicol 2018; 58: 583-601
- 29 Zirpoli GR, Brennan PM, Hong CC. et al. Supplement use during an intergroup clinical trial for breast cancer (S0221). Breast Cancer Res Treat 2013; 137: 903-913
- 30 Friese CR, Harrison JM, Janz NK. et al. Treatment-associated toxicities reported by patients with early-stage invasive breast cancer. Cancer 2017; 123: 1925-1934
- 31 Abdollahi R, Najafi S, Razmpoosh E. et al. The Effect of Dietary Intervention Along with Nutritional Education on Reducing the Gastrointestinal Side Effects Caused by Chemotherapy Among Women with Breast Cancer. Nutr Cancer 2019; 71: 922-930
- 32 Carayol M, Ninot G, Senesse P. et al. Short- and long-term impact of adapted physical activity and diet counselling during adjuvant breast cancer therapy: the “APAD1” randomized controlled trial. BMC Cancer 2019; 19: 737
- 33 De Souza APS, da Silva LC, Trussardi Fayh AP. Nutritional Intervention Contributes to the Improvement of Symptoms Related to Quality of Life in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Randomized Clinical Trial. Nutrients 2021; 13: 289
- 34 Von Grundherr J, Koch B, Grimm D. et al. Impact of taste and smell training on taste disorders during chemotherapy – TASTE trial. Cancer Manag Res 2019; 11: 4493-4504
-
35
Bundesärztekammer.
Strukturierte curriculare Fortbildung
„Ernährungsmedizin“ (2018). Im Internet: https://www.bundesaerztekammer.de/fileadmin/user_upload/downloads/pdf-Ordner/Weiterbildung/_Muster-Kursbuecher/20210608_MKB_Ernaehrungsmedizin.pdf Stand: 08.09.2021