Nursing Interventions IN THE Patient WITH Tumoral Caquexia PDF

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TRANSFORMATIONAL LEADERSHIP IN NURSING....

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NURSING INTERVENTIONS IN THE PATIENT WITH TUMORAL CAQUEXIA Cancer is a disease with a high incidence, being 228,482. "One in two men and one in three women will have cancer in their lifetime." The most common tumor is colorectal, followed by prostate, lung and breast (Figure 1). Mortality varies according to the type of tumor, but also according to sex, since in men the tumor that causes the most deaths is lung and in women it is breast. It is the leading cause of death in men and the second in women, producing around 100,000 deaths per year (1). For the fight against cancer there are treatments such as chemotherapy and radiotherapy, which can have nutritional consequences, because they increase the probability of malnutrition and cachexia due to the symptoms they cause. Some of these symptoms are nausea, vomiting, and an altered taste sensation, which can affect the ability to ingest, digest, or absorb nutrients (2). As a consequence of this situation, malnutrition is present in the majority of patients diagnosed with cancer. Its prevalence increases when the disease is already advanced, occurring in 80-90% of cases (3). It negatively influences the prognosis of the patient, and its prevalence depends on the type and location of the tumor, the stage of the disease, the treatment and the nutritional assessment tool applied (4). The main manifestation of malnutrition is tumor cachexia. The

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Cancer cachexia is a complex metabolic syndrome characterized by a loss of muscle mass and body weight, leading to progressive functional decline that cannot be completely reversed by conventional nutritional support (5). It is associated with a poorer response to cancer treatments, increased treatment side effects and toxicity, and high psychological distress for both patients and their families (6). Cachexia negatively influences the quality of life of patients, since some of the manifestations of this disease are: fatigue, muscle weakness, decreased motor capacity and functional status (Figure 2). This causes inability to perform activities of daily living (2). It affects about 80% of patients with advanced cancer, therefore, it is an important cause of global morbidity and mortality. At least about 20% of these patients die from cachexia (7,8). It is observed more frequently in patients with solid cancerous tumors of the pancreas, lung, and gastrointestinal system, with a lower prevalence in patients with breast cancer and hematological malignancies (2). The prevalence of weight loss in patients with pancreatic cancer is (83%), stomach (83%), esophagus (79%) and lung (60%) (9). with a lower prevalence in patients with breast cancer and hematological malignancies (2). The prevalence of weight loss in patients with pancreatic cancer is (83%), stomach (83%), esophagus (79%) and lung (60%) (9). with a lower prevalence in patients with breast cancer and hematological malignancies (2). The prevalence of weight loss in patients with pancreatic cancer is (83%), stomach (83%), esophagus (79%) and lung (60%) (9). Cachexia can be divided into three stages: precachexia, cachexia, and refractory cachexia. In the prechexia stage, the patient experiences early clinical and metabolic manifestations that can develop, where previously involuntary weight loss occurs (11). The definition of precachexia remains somewhat imprecise, despite this, there are several factors that help to identify the state of precachexia: underlying chronic disease, chronic or recurrent inflammatory response,

involuntary weight loss of 5% or less of usual body weight during the last 6 months, anorexia or symptoms related to anorexia but all of the above must be present (5). The possibility of advancing to the next stage of cachexia depends on factors such as the type and stage of cancer, the development of systemic inflammation, minimal food intake, and poor response to cancer treatment (11). Cachexia can be confirmed by nutritional evaluation using a combination of anthropometric examinations and clinical tests, such as body weight, skin fold thickness, and mean arm circumference (2). But it can also be confirmed by the criteria established for the diagnosis of cachexia: 

Unintended weight loss of> 5% in a patient with a tumor in the past six months.

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The weight loss> 2% in a patient with a body mass index of...