Clinical Nutrition in Oncology and Palliative Care — Treatise on Physiopathological and Therapeutic Specialization

Clinical Nutrition · Clinical Specialties

How it begins

A detailed and rigorous scientific compendium of nutritional therapy and metabolic immunomodulation in cancer patients. It addresses everything from the cellular and metabolic bases of tumor cachexia and myosteatosis to perioperative optimization using ERAS protocols, the approach to specific digestive complications depending on the location of the tumor, the selection of enteral formulas and…

What it covers

1. Oncological Cachexia vs. Simple Starvation: Proinflammatory Mediators
2. Alterations in the Intermediate Metabolism of Macronutrients
3. · Carbohydrate Metabolism and the Warburg Effect
4. · Lipid Metabolism and Adipose Browning
5. · Protein Metabolism and the Ubiquitin-Proteasome Pathway
6. Oncological Sarcopenia, Myosteatosis and Myelopenia
7. · Myosteatosis: Qualitative Muscle Dysfunction
8. · Sarcopenia and Myelopenia: The Muscle-Bone Marrow Axis
9. Nutritional Screening and Diagnosis Tools: GLIM Criteria
10. · Validated Screening Tools
11. · Patient-Generated Subjective Global Assessment (VGS-GP)
12. High Precision Body Composition Assessment Methods
13. · Bioelectrical Impedance Analysis (BIA) and Vector Analysis (BIVA)
14. · Computed Tomography (CT) at L3 Level: The Clinical Gold Standard
15. · Hand Dynamometry (Handgrip Strength)
16. Inflammatory and Nutritional Biomarkers: The Modified Glasgow Score (mGPS)
17. · Kinetics and Limitations of Visceral Proteins
18. · The Modified Glasgow Score (mGPS): The Inflammatory Prognostic Standard
19. Determination and Optimization of Energy and Protein Requirements
20. · Measurement versus Estimation of Energy Expenditure
21. · Optimization of Protein Contribution in Sarcopenia
22. Immunonutrition and Pharmaconutrition: Omega-3 Fatty Acids, Arginine and Glutamine
23. · Eicosapentaenoic Acid (EPA) and DHA: Inflammation Modulators
24. · Arginine and Glutamine: Conditionally Essential Amino Acids
25. Micronutrients, Vitamins and Antioxidants: Evidence and Controversies
26. · Vitamin D (25-Hydroxyvitamin D): Beyond Bone Metabolism
27. · Zinc and Selenium: Antiradical Cofactors
28. Toxicities of Chemotherapy, Targeted Therapies and Immunotherapy
29. · Pathophysiology of Mucositis of the Gastrointestinal Tract
30. · Chemotherapy-Induced Nausea and Vomiting (CINV)
31. · Immune Checkpoint Inhibitor (ICI)-Induced Colitis
32. Radiation Enteritis and Impact of Head, Neck and Pelvis Radiotherapy
33. · Pathophysiology of Gastrointestinal Actinic Lesion
34. · Actinic Dysphagia and Preservation of Swallowing
35. Perioperative Management and Accelerated Recovery Protocols (ERAS)
36. · Nutritional Pillars of the ERAS Protocol
37. Enteral Nutrition: Indications, Access Routes and Formula Selection
38. · Accesses for Enteral Nutrition
39. · Stratification and Selection of Enteral Formulas
40. · Clinical Complications of Enteral Nutrition
41. Parenteral Nutrition: Indications and Monitoring of Vascular Access
42. · Absolute Clinical Indications in Oncology
43. · Access Routes and Relationship with the Osmolarity of the Formula
44. Pathophysiology and Prevention of Refeeding Syndrome
45. · Cellular Pathophysiology of Metabolic Transition
46. · Safe Prevention and Repletion Protocol
47. Head and Neck Cancer: Mechanical Dysphagia and Prophylactic Gastrostomy
48. · Pathophysiology of Mechanical Oropharyngeal Dysphagia
49. · Clinical Controversy: Prophylactic vs. Reactive Gastrostomy (PEG)
50. · Modification of Viscosities and Caloric Density
51. Upper Gastrointestinal Tumors: Esophageal and Gastric
52. · Pathophysiology of Dumping Syndrome (Rapid Gastric Emptying)
53. · Nutritional Strategies to Control Dumping
54. · Afferent Loop Syndrome
55. Pancreatic and Hepatobiliary Tumors: Exocrine Pancreatic Insufficiency
56. · Pathophysiology of Exocrine Pancreatic Insufficiency (EPI)
57. Colorectal Cancer and Pelvic Tumors: Management of High Debt Ostomies
58. · Pathophysiology of the High Debt Ostomy (HOA)
59. · High Debt Ostomy Management Protocol
60. Transition from Active Nutritional Support to Palliative End-of-Life Care
61. · Physiology of the Agony Phase and Cessation of Ingestion
62. · The Futility of Artificial Nutritional Support (ANS) in Agony
63. Physiopathological Management of Symptoms of Nutritional Impact at the End of Life
64. · 1. Terminal Xerostomia (Dry Mouth)
65. · 2. Nausea and Vomiting due to Gastroparesis and Partial Intestinal Obstruction
66. · 3. Opioid Induced Constipation (OIC)
67. Hydration in the Terminal Patient: Myths, Realities and Hypodermoclysis
68. · Myths and Realities of Dehydration at the End of Life
69. · Hypodermoclysis: A Palliative Comfort Technique
70. Pharmacology of Orexigenic Agents and Metabolic Modulators
71. Systematic Clinical Algorithm for Oncological Nutritional Support