2020 Volume 23 Issue 2 Pages 97-103
Maintenance of a satisfactory nutritional state is an important factor for cancer treatment, as management of nutrition in cancer patients supports chemotherapy, radiation therapy, and surgery, comprising the major modalities of cancer treatment. On the other hand, adverse events resulting from each treatment can negatively affect the patients by reducing their quality of life and potentially preventing cancer treatment. Thus, to perform cancer treatment effectively and safely, registered dietitians closely monitor the nutritional state of each patient and carefully arrange their daily oral diet, thereby preventing a decline in oral intake as much as possible. Among patients with hematological diseases, those who undergo hematopoietic stem cell transplantation (HSCT) become immunosuppressive and develop severe complications during the long-term inpatient treatment. Between November and December in 2016, among patients in the hematology ward whose disease conditions were stable, we interviewed a total of 22 with a history of difficulty in oral ingestion. Adverse events affecting oral ingestion frequently noted during inpatient treatment included anorexia, nausea, and mucositis, but the patients exhibited a wide range of symptoms. They often ate fruit and noodles that were brought by family members. We thus constructed an “interchangeable diet” table to inform that fruit and noodles, instead of rice, can be provided in the hospital diet. Furthermore, we developed a “recovery diet” program for patients who are unable to maintain an oral diet. Currently, we meet HSCT patients at their bedside to provide instruction for nutrition and diet on the day of admission to the hospital (usually to the clean room) and on the day of discharge. During inpatient treatment, we visit the patient once a week to arrange their oral diet according to their condition. In the future, we aim to not only promote instruction in the hematology ward, but also to provide all HSCT patients with instruction for nutrition and diet in the outpatient setting to resolve difficulties and distress, which they may experience after discharge, in order for them to not have to deal with problems alone.
