頭頸部癌症例における心療と栄養治療について

MENTAL AND NUTRITIONAL THERAPY FOR CANCER OF THE HEAD AND NECK

　I．はじめに

　癌と栄養の関係については，従来より主に発癌や予防などの面より検討されてきたが，手術や照射，化学療法などの効果は全身の栄養状態で左右されるので，最近は治療の面からも重要視されている。

　筆者らは，頭頸部癌症例に対して集学治療の一環として栄養治療を行い，積極的に患者の全身栄養状態の改善に努めている。そこで今回，筆者らが行っている栄養治療を報告し，あわせてその意義について考察してみた。

　In cancer patients, an immediate cause of cachectic prostration, deterioration of nutritive conditions and weight loss, is malnutrition, which is a consequence of deficiency of voluntary food intake. The causative factors of this malnutrition are anxiety or fear of cancer, decrease of appetite caused by want of exercise, the difficulty of opening mouth, chewing, swallowing causedby existence of tumor, the influence of surgery, irradiation and chemotherapy.

　The general nutritional condition of the patients would affect cancer treatment to a great extent. Therefore, the patients must always be kept in good nutritional condition. Being in good condition mentally and nutritionally is an important factor in cancer treatment.

　Every effort has been made to rid the patients of their fear of cancer, and also to afford them a right understanding of the importance of adequate food intake and physical exercise for the sake of recovery. While paying attention to their daily diet, checking calories of food intake, administration of complete nutriments, etc., the Patient's entire nutritive conditions have been kept under close medical observation.

　These nutritive treatments were fairly effective for the patients, especially for the aged who had lost weight. Some improvement has been found in immunological findings, in serum protein and other haematological findings. Most of the patients have been kept nutritionally as well as mentally in good condition.