Ernährung von Tumorpatienten

Kernaussagen

Bei Patienten mit aktiver Tumorerkrankung entwickelt sich sehr häufig eine Mangelernährung. Der Gewichtsverlust ist mit einer reduzierten Lebensqualität und Leistungsfähigkeit sowie mit einer eingeschränkten Toleranz für antitumorale Therapien assoziiert. Gastrointestinale Störungen, quälende Schmerzzustände, psychosoziale Belastungen sowie Änderungen des metabolischen Milieus mit einer oft nachweisbaren tumorassoziierten systemischen Inflammationsreaktion führen zu Appetitverlust, verminderter Nahrungs- und Energieaufnahme, Fatigue, reduzierter Mobilität und weiterem Muskel- und Gewichtsverlust.

• Alle Tumorpatienten müssen regelmäßig auf einen drohenden Gewichtsverlust (Mangelernährung) sowie auf die Entwicklung einer prognostisch ungünstigen tumorassoziierten systemischen Inflammationsreaktion (Kachexie) untersucht werden.

• Zu einer effektiven Ernährungsbetreuung gehört neben der kompetenten Behandlung gastrointestinaler Störungen, chronischer Schmerzen und psychosozialer Belastungen ein Trainingsprogramm zur Muskelstärkung.

• Patienten mit aktiver Tumorerkrankung sollten regelmäßig und professionell zur Einnahme einer akzeptierten, verträglichen und bedarfsgerechten Kost beraten werden.

• Medikamentöse Ansätze zur Appetitsteigerung (Steroide, Gestagene) sowie zur Dämpfung einer chronischen systemischen Inflammation (nicht steroidale Antirheumatika, n-3-Fettsäuren) können die Ernährungstherapie unterstützen.

• Die individuell erforderliche Energie- und Nährstoffzufuhr sollte durchgehend sichergestellt werden, falls erforderlich mithilfe von Trinknahrungen und supplementären künstlichen Ernährungsformen über enterale Sonden und intravenöse Katheter (z. B. über ein liegendes Portsystem).

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