The role of nutritional support in non-small-cell lung cancer treatment

Scientific discoveries from recent years, along with rapid progress in clinical nutrition, are gradually changing the views of physicians around the world regarding the role of nutritional support in the treatment of patients with cancer. Nutritional support in the modern context is considered not only as part of basic care but also as a serious therapeutic tool in the treatment and rehabilitation of patients with cancer. The effectiveness of additional substrate provision in reducing the number of complications during specific treatment, as well as the ability of nutritional therapy to improve patients’ quality of life, has been proven.

The present review is devoted to the problem of nutritional supplementation in patients with non-small-cell lung cancer.

According to the current international clinical guidelines, the primary treatment for non-small-cell lung cancer is surgery, included as part of combination treatment, which aggravates nutritional status disorders. Against the background of metabolic disorders characteristic of the malignant process, anorexia-cachexia syndrome develops, accompanied by weight loss, which is extremely difficult to reverse. The metabolic response caused by surgical injury significantly accelerates catabolic processes and blocks anabolic ones, sharply increasing the patient's need for macronutrients and especially for protein, which, in the absence of exogenous intake, is “extracted” from muscle tissue. For the assimilation of this protein, an energy supply (carbohydrates and fats) is necessary, most of which is also derived from the patient's own tissues. With progressive weight loss in the preoperative period, protein and fat reserves in the postoperative period are not sufficient.

The relationship between malnutrition and adverse treatment outcomes dictates the need for routine determination of nutritional status and correction of existing disorders in all patients with lung cancer. Nevertheless, most clinicians pay insufficient attention to the problem of nutritional status disorders in patients with non-small-cell lung cancer.

To describe the necessity and safety of nutritional therapy in patients with non-small-cell lung cancer, an analysis of publications on the topic was carried out with a preliminary search in the medical databases PubMed and Medline. The data obtained show convincingly that patients with non-small-cell lung cancer often have anorexia-cachexia syndrome. In the perioperative period, nutritional support for non-small-cell lung cancer improves the immediate and long-term results of surgical treatment.

Currently, nutritional therapy should be considered as an integral component of any anticancer treatment, as it contributes to the improvement of therapeutic results.