Patologie della Prostata: Prostatite, Tumore, Ipertrofia benigna
The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has nutrizione in prostata to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence nutrizione in prostata progression.
In this regard, there has been a recent emphasis in the literature on nutrizione in prostata and cancer as an important factor in both quality of life and in the pathophysiology of cancer.
Hence, the primary purpose of this paper is to review the current data on diet and nutrition as it pertains to a wide range of nutrizione in prostata patients in the palliative care setting. In cancer care models, the primary goals of palliative care are to relieve suffering and improve quality of life across the cancer illness trajectory.
As the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider lifestyle behaviors that can positively affect health outcomes and cancer progression for those who have responded to oncological interventions.
In that regard, there has been a recent emphasis in the literature on nutrition and cancer as an important factor in both quality of life and in the pathophysiology of cancer. Hence, the primary purpose of this paper is to review the current data on diet and nutrition as it pertains to a wide range of nutrizione in prostata with cancer in nutrizione in prostata palliative care setting.
If the patient deteriorated, the standard nutritional strategy became more focused on quality of life QOL and relief of symptoms, rather than active nutritional interventions aimed at nutrizione in prostata outcome. At this stage of the cancer illness, the expectation was short survival time, and the major goal was to minimize cachexia. As a broader number and range of patients come under the purview of this expanded palliative model, recent research has suggested that it may be more appropriate to develop a specific nutritional strategy which can help improve the overall health and well-being of cancer patients, including those in the traditionally defined palliative care setting.
In fact, when making nutrizione in prostata about nutritional support, one must consider diagnosis, prognosis, current status and symptoms, pathways of disease progression, treatment and possible side effects, patient comfort and peer and social support, socioeconomic status, cultural and religious views, and ethical and legal issues. Hence, the primary purpose of this paper is to introduce the concept of diet as a potential survivorship intervention as opposed to sustenance only.
Our goal is to synthesize the known knowledge in a way that might assist clinicians while making nutritional recommendations to. Using these strategies and based upon the most current data available, appropriate, individualized approaches to palliative care diet and nutrition can be established for a wide spectrum of patients with cancer.
The diagnosis of cancer often powerfully motivates survivors to alter their lifestyle habits, so healthcare providers need to be aware of what changes patients are likely and willing to make in order to determine the most appropriate recommendations [ 1 ]. This review nutrizione in prostata explore the relevant data and make recommendations for dietary and nutrizione in prostata considerations in the palliative care setting. It should be stated at the outset that this paper pertains broadly to all types of cancer.
However, we also recognize that there may be differences in the nutritional approach to patients with different types of cancers. Thus, patients with lymphoma may have different requirements or benefit differently nutrizione in prostata various supplements than patients with sarcoma.
At the present moment, we do not feel that there is sufficient data to help with these distinctions. In addition, this paper pertains primarily to adult patients rather than children. While some of the concepts below would certainly pertain to pediatric patients and an overall analysis of nutrition in children would be extremely valuable, space does not permit an additional review and analysis of this area of palliative care. Nutrition should be a priority early in palliative care.
Food has a primary role in life for everyone including people with advanced illness. Adequate nutrition is essential, not only to meet physiological requirements, but also because it has additional psychological, spiritual, social, and cultural benefits for patients and nutrizione in prostata.
Strategically addressing these additional aspects is of high importance in the palliative setting. The hypothesis that increased energy expenditure leads to weight loss experienced by patients with cancer has been supported in the literature [ 23 ]. However, other studies showed that the effect of cancer on energy expenditure is variable and complex [ 4 ]. Thus, patients with cancer can be in a physiologically nutrizione in prostata, hypometabolic, or eumetabolic state.
The particular state of an individual patient is not fully explained by differences in tumor type, tumor burden, nutritional status, or duration of disease. However, tumor type has been found to be more predictive. For instance, gastric, pancreatic, and biliary cancers are typically more hypermetabolic than nongastrointestinal cancers. The lack of a clear relationship between clinical status and metabolic status makes it hard to generalize caloric recommendations. Therefore, recommendations for nutrition and physical activity for persons who are living with advanced cancer are likely best made based on their individual needs and clinical issues.
These guidelines mirror others that emphasize high-calorie, high-energy meals in small portions [ 6 ], and such an approach may not only satisfy caloric requirements but also positively impact secondary problems related to sugar consumption, nutrizione in prostata resistance, inflammation, and others. Diet may also have a role in alleviating treatment-related symptoms.
For example, opiates to relieve pain commonly cause constipation, but this side effect may be lessened by a diet high in fluid and fiber. In addition, some medications are included in the ACS guidelines which cite the use of nonsteroidal anti-inflammatory drugs or omega-3 fatty acid supplements that may help stabilize nutrizione in prostata improve body weight, along nutrizione in prostata nutritional and functional status [ 7 — 9 ].
The notion of palliative care traditionally evoked a cachectic picture. However, many patients are overweight at the time of diagnosis or become so after treatment [ 10 ]. Women diagnosed with early-stage breast cancer might improve overall prognosis and survival by adopting more healthful dietary patterns [ 11 ].
Health care professionals should encourage weight management at all phases of the cancer care continuum as a means to potentially avoid adverse sequelae, as well as to improve overall health and possibly survival [ 12 ]. Comprehensive approaches that involve dietary and behavior modification and increased aerobic and strength training exercise have shown promise in either preventing nutrizione in prostata fat gain or promoting weight fat loss, reducing biomarkers associated with inflammation and comorbidity and improving nutrizione in prostata behaviors, functional status, and QOL in this high-risk patient population [ 13 ].
Hence, optimal body mass index and body metrics should be pursued in an appropriate manner based upon the status of the nutrizione in prostata, whether cachectic or overweight. The health care team should be intimately involved in addressing the specific caloric needs of each cancer patient throughout the clinical course, nutrizione in prostata in terms of the number of calories required and the quality of those calories.
Eating foods that contain high nutrizione in prostata of excess sugars is an unhealthy diet even in the palliative care setting. For example, a high intake of refined carbohydrates has been associated with cancer in general [ 14 ] and more specifically with prostate cancer [ 15 ]. Fructose intake, which is also associated with obesity, has been shown to be used preferentially by pancreatic cancer cells to grow [ 16 ] and cancer of the small intestine [ 17 ].
Diabetes mellitus also has been linked to cancer [ 18 nutrizione in prostata, 19 ]. Red and processed meat consumption has consistently gained a reputation as a contributor to disease, including cancer. Data is emerging that red and processed meats may influence disease recurrence and mortality as well, for example, for colorectal cancer survivors.
Evidence shows that consumption of red meat can activate cancer genes in the colon [ 20 ] such as the MDM2 and ubiquitin genes as well as the WNT gene signaling pathway which is involved in epithelial proliferation and differentiation. Such genetic modulation can facilitate cellular progression to colon cancer [ 2122 ].
Prospective observational studies have shown that increased exercise after diagnosis and avoidance of a Western pattern diet high intake of red and processed meats and refined grains nutrizione in prostata associated with a reduced risk of cancer recurrence and improved overall survival in early-stage colorectal cancer after standard therapy [ 23 ]. The data also suggests that red meat, in particular, is pro-inflammatory and procarcinogenic.
For example, the European Nutrizione in prostata Investigation into Cancer and Nutrition-Potsdam study of 2, men and women found that the consumption of red meat was significantly associated with higher levels of the inflammatory markers GGT and hs-CRP when adjusted for potential confounding factors related to nutrizione in prostata and diet [ 24 ]. Another study showed that when people were given a 7-day dietary red meat intervention, fecal water genotoxicity significantly increased in response to nutrizione in prostata red meat intake [ 20 ].
The authors reported that genes significantly correlating with the increase in fecal water genotoxicity were involved nutrizione in prostata biological pathways indicative of genotoxic effects. These effects included modifications in DNA damage nutrizione in prostata, the cell cycle, and apoptosis pathways.
Thus, nutrizione in prostata meat should be minimized or eliminated from the diet of palliative care patients. However, it is important to nutrizione in prostata that patients continue to receive nutrients commonly found nutrizione in prostata meats such as iron, vitamin B, and essential amino acids.
Thus, care should be taken to provide nutrizione in prostata when necessary to augment these requirements. A mouse study demonstrated that a high animal fat diet could actually induce tumor growth and progression, including epithelial-mesenchymal transition EMT and inflammation [ 21 ]. This study also showed the molecular mechanisms. Changes occurred through activation of mitogen-activated protein kinase and phosphatidylinositolkinase signaling pathways. A dietary analysis of patients with bladder cancer compared a variety of dietary factors to those of 1, non-cancer patients [ 25 ].
The results showed that processed nutrizione in prostata intake was positively associated with bladder cancer with a significant odds ratio OR of 1. In this study, the intake nutrizione in prostata fruits or vegetables had no correlation with bladder cancer, but higher levels of vitamin B12 intake were found to be protective individuals in the highest, compared with nutrizione in prostata lowest, quartile of vitamin B12 intake had a lower nutrizione in prostata of bladder cancer with an OR of 0.
In an analysis of patients with early stage breast cancer from the Life After Cancer Epidemiology Study [ 11 ] researchers compared 1, patients diagnosed with early stage breast cancer. Two dietary patterns were identified: prudent high intakes of fruits, vegetables, whole grains, and poultry and Western high intakes of red and processed meats and refined grains.
The results showed that increased adherence to a prudent dietary pattern was associated with a statistically significant decreased risk of overall death and also nutrizione in prostata from nonbreast cancer causes.
The authors reported that increasing consumption of a Western dietary pattern was related to an increased risk of overall death and also death from nonbreast cancer causes. Interestingly, neither dietary pattern was associated with the risk of breast cancer recurrence or death from breast cancer [ 11 ].
Further, the observations were generally not modified by physical nutrizione in prostata, being overweight, or smoking. Thus, more research is needed to elucidate these issues in the broader context of patients with cancer. Overall, the cumulative data suggests that refined carbohydrate and red meat consumption should be avoided or significantly reduced in the diet of patients with cancer as there are many other healthier sources of caloric intake.
Achievement and maintenance of a healthy body composition via a plant-based diet high in fruits, vegetables, and whole grains and low in saturated fats and red or processed meats should be the guidelines imparted to patients from their health care providers.
As it has become increasingly apparent that cancers use inflammatory pathways for growth and metastases, the concept nutrizione in prostata utilizing anti-inflammatory diets has received more attention. The literature indeed shows more studies exploring the link between cancer and inflammation [ 26 ]. Inflammation itself is associated with high levels of oxidative stress that can damage most of the body's tissues and genetic material which ultimately can lead to cancer formation [ 27 ].
In integrative medicine, there is a long tradition of utilizing anti-inflammatory diets to attenuate the negative effects of inflammation and oxidative stress. Ancient cultures also developed and used anti-inflammatory diets, such as in Ayurvedic a system of traditional medicine native to the Indian subcontinent that stresses plant nutrizione in prostata treatment nutrizione in prostata, which are now investigated using modern criteria [ 28 ].
Mounting evidence suggests that chronic inflammation mediates most chronic diseases, including cancer, and causes a great deal of morbidity and ultimately mortality. For instance, nutrizione in prostata called triterpenes are particularly adept at suppressing inflammatory pathways linked to cancer.
The mechanism of action is most likely related to the suppression of different cytokines, in addition to prostaglandin E 2particularly from activated macrophages [ 30 ]. These triterpenes include avicins, betulinic acid, boswellic acid, celastrol, diosgenin, madecassic acid, maslinic acid, momordin, saikosaponins, Platycodonpristimerin, ursolic acid, and withanolide.
These can be obtained from botanical medicines and diet [ 31 ]. It is known that a major risk factor for sporadic colon cancer is a high animal fat Western diet, which has been linked to a cancer-prone, proinflammatory state [ 32 ]. Diets with an emphasis on fresh fruits and vegetables are associated with lower cancer incidence [ 33 ].
Diet has the potential to encourage colon cancer development, but on the other hand, recent evidence demonstrates that certain natural dietary products such as beans [ 34 ] and apples [ 35 ] can halt colon cancer development and progression via epigenetic regulation.
Another study suggested that unfavorable diet-promoted nutrizione in prostata dysregulation may contribute to inflammation-driven diseases, such as cancer, via inappropriate silencing of genes necessary to inhibit cancer nutrizione in prostata [ 36 ]. An interesting animal study explored whether compound K, a metabolite of American ginseng, could help reduce inflammation and also the risk of cancer in mice with xenograft colon cancer [ 37 ].
The results showed that ginseng significantly inhibited colonic inflammation and tumor growth. The epidermal growth factor receptor EGFR cascade was upregulated in colon cancer, but administration of ginseng significantly reduced EGFR activation. Nutrizione in prostata addition, the authors reported that nutrizione in prostata ginseng altered colonic microbial diversity and that compound K significantly nutrizione in prostata tumor xenograft growth.
Some of the more nutrizione in prostata available supplemental agents that can be taken both as part of food and as commercial products include the following. These compounds have both anti-inflammatory and antioxidant activity.