Factors that Increase the Risk of Malnutrition

The cause of malnutrition in cancer patients is multifactorial, generally the causes are grouped into two categories namely : 

• The reduced of food intake and malabsorption.
• Disruption of metabolic processes

Bruera classifying the cause of cachexia in cancer patients as following :

•  Psychological factors and central nervous system (unwillingness to eat, disturbance soy sauce taste perception, psychological stress).
•  Tumor effect (mechanical obstruction, the use of substrate / nutrient by the tumor, the production of cytokines by tumor cells, lipid-mobilizing factors).
•  Effects who associated with therapy (chemotherapy, radiation, surgery, nausea, stomatitis, xerostomia, pain, ileus).
•  Effects who associated with the patient (an increase resting energy expenditure, impaired metabolism, cytokine production by macrophages, autonomic dysfunction, decreased gastric emptying.

  

The reduced of food intake and Malabsorption.

 Tumor effect

The direct effects: 

Tumors of the GI tract such as tumors of the tongue, pharynx, esophagus and stomach that causes obstruction or tumor from outside the gastrointestinal tract that cause obstruction antaralain head neck tumors, pancreas, liver or other tumors that metastasize to the abdominal. Impaired digestion and absorption pankres for example in cancer, lymphoma small intestine, colon tumor vilous. 

Indirect effects (remote effect). 

 The tumor can cause anorexia without directly involving the gastrointestinal tract. It occurs due to a decrease in sense of taste, the quality of smell, disturbance neuroendocrine, disorders of the hypothalamic appetite control center resulting in impaired control of food intake.