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A conference in the Chamber of Deputies looks at the problem and calls for a "call for action" for doctors and politicians: PDTA and ad hoc laws are needed
![badistance-seniors [19659003] Rome, 4 July 2018 - Despite its high frequency and the two serious consequences, malnutrition in cancer patients is still a largely underestimated, unrecognized and very rarely adequately treated problem. </p>
<p> For this reason, the meeting took place in the Chamber of Deputies. seen at the same table clinicians, patients and representatives of institutions to evaluate the actions necessary to attribute to nutritional therapy its decisive role: to improve the results of cancer patients and avoid preventable deaths. </p>
<p> Organizational models are needed to ensure patients adequate, timely, effective and safe nutritional interventions. The data permanently provided by the scientific literature make this intervention obligatory. In fact, the problem of malnutrition is irrelevant because it causes preventable deaths with correct medical strategies. </p>
<p> Italy lacks a national law that regulates and guarantees uniform access to artificial and clinical nutritional treatments at home during the period of acute care and palliative care </p>
<p> "It is therefore appropriate to Evaluate and predict the inclusion of nutritional screening and malnutrition treatment, also but not only, in PDTAs (Diagnostic-Therapeutic Care Paths) of various diseases ". Maurizio Muscaritoli, Professor of Internal Medicine at the Sapienza University of Rome and President SINUC – Italian Society of Clinical Nutrition and Metabolism </p>
<p> The PreMiO study (Prevalence of malnutrition in oncology) showed that the weight loss is already present at the time of first oncological visit. Of the 2,000 patients enrolled, 51% had a nutritional deficit and 64% of those badessed had lost 1 to 10 kg in the previous six months. </p>
<p> Malnutrition is determined by both an increase in metabolism by cancer cells that consume energy reserves, which reduce appetite, ability to perceive tastes, swallowing, being nauseous and widespread malabsorption of nutrients. <br /> Malnutrition in oncology still represents an unrecognized need, due to unacceptable differences in care </p>
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Prof. Maurizio Muscaritoli
"We ask for the policy that nutritional remedies be part of good clinical practice, even with the possibility of sanctions for those who do not guarantee the patients proper care, by badogy with what has been done in law 38 which guarantees access to treatments for pain – continues Prof. Muscaritoli – we also need governance tools to address the chronic absence of nutritionists and dieticians doctors in all companies health care, and especially where cancer patients are treated, to which must be added the establishment of regional networks requiring close interaction with the territory, general practitioners and the hospital. "
To illustrate the pillars and objectives of nutritional guidelines in cancer patients initialed by the Ministry of Health At the Conference of the Regions in December 2017, the doctor was called. Giuseppe Ruocco, Secretary General of the Ministry of Health, who stressed that "the document values different aspects: from the use of nutritional screening and specific nutritional needs to diagnosis, during the therapeutic process, to follow-up; the proposal of a model of organizational response through an integrated journey involving hospital, day surgery and territorial networks, promotes continuity of care by the MMG – General Practitioners and PLS – Pediatrics of Free Choice up to the definition of home care and artificial nutrition; and finally, training and information courses for health professionals. Conscientious and correct use of knowledge related to adequate nutrition screening and integrated clinical nutrition approaches, as exemplified in the Guidelines, can have a positive impact, contributing to a positive impact on outcomes, quality of life for these patients and expenses.
"Malnutrition can negatively affect the effectiveness of surgical and medical therapies in oncology (and not only). Preventing the progression of weight loss reduces the toxicity of drugs, improves the sensitivity of cells to receive the treatments, decreases the frequency and duration of hospitalizations and postoperative complications "says Prof. Paolo Marchetti, professor of medical oncology at the Sapienza University of Rome
Cancer can cause a state of the art. inflammation and an acceleration of metabolism.Intense inflammatory response leads to weight loss, appetite, muscle mbad, generalized deterioration called cachexia
"To this are added metabolic alterations and a generalized inflammatory state – said Dr. Giuseppe Aprile, director of the Oncology Cluster of Vicenza and national counselor AIOM – Italian Association Medical Oncology – The cachectic syndrome, which affects about half of patients with advanced disease, determines the possible loss of effectiveness of anticancer treatments, increased side effects and impacts negatively affect the quality of life of patients.
Receiving appropriate nutritional treatment should be considered a right provided by competent clinical nutrition personnel who also provide correct, understandable and scientifically sound information. This is the position of Cittadinanzattiva – Court of the patient expressed by its national coordinator Tonino Aceti: "Malnutrition must be identified quickly, treated quickly and must not contribute to increase the already unbearable inequalities that characterize our public health service. It is useful to measure it and evaluate it from the point of view up to the follow-up. It is necessary to include nutritional therapies in the context of concurrent care and to inform patients about its benefits. It is also very important to sensitize health workers (doctors and nurses) about malnutrition by offering ad hoc training programs. "
" Nutrition is an emergency for cancer patients and malnutrition can die. Patient badociations like ours – concludes Claudia Santangelo, president of the badociation Vivere senza Stomaco – trust the actual application of the guidelines signed on December 15, 2017 with the agreement of the regions of the # 39; State. Thank you to the authors of the document and to the prof. Maurizio Muscaritoli who worked to ensure that nutrition in cancer patients is good nutrition and not malnutrition. "
IN BRIEF PREMIUM STUDIO
The Italian study PreMiO has for the first time focus on the nutritional status of patients at the first visit to oncology. badyzed had nearly 2,000 patients visited in 22 national oncology units, highlighting unprecedented data on the relationship between different types of cancer and nutritional status.
[19659004] PreMiO, acronym for Prevalence of malnutrition in oncology, was published in the prestigious journal Oncotarget and showed unquestionably that malnutrition, anorexia, loss of appetite and weight are common among cancer patients in the early stages of the disease, already visible at the first visit to oncology.On the sample examined, 51.1% had a variable degree of nutritional deficiency, including 42.4 % et at risk of malnutrition and 9% were already malnourished.
Involuntary weight loss is another indicator of undernutrition or risk. At the first visit to medical oncology, 64% of patients had weight loss in the previous 6 months: 28.4% lost more than 10% of body weight, 36.2% lost 5-10% , and 35.4% lost less than 5%. The effective weight loss ranged from 1 to 10 kg
In the most severe forms of malnutrition, the risk of death increases by 2 to 5 times, which can be avoided by timely and adequate interventions.
