A few days ago, at the invitation of my colleagues in our hospital, I went to another big hospital to consult a patient with advanced gastric cancer, male, 52 years old, found gastric cancer 4 months ago, and underwent most gastric surgery (this is not gastric cancer Radical surgery, because the metastasis was found at that time, so no total gastric resection surgery), postoperative chemotherapy. Two weeks ago, the peritoneal implant was found and extensively transferred, and was admitted to the hospital again. The main treatment drug is currently an anti-cancer drug imported from Japan (Gen Luming). My task is to guide patients on diet and nutrition.

　　He has a good appetite, but eats very little, because the anti-cancer drugs he uses have a large side effect of gastrointestinal mucosa necrosis. In order to avoid irritation of the gastrointestinal mucosa, the clinician ordered him to mainly eat rice oil (The thin layer floating on the surface after cooking rice porridge, the main ingredient is still starch, mixed with a small amount of protein and fat), rotten noodles and other residue-free liquid food. His nutritional intake is extremely poor. Although some amino acids and glucose are infused intravenously, he has no fat emulsion (it cannot be used because of intolerance), so his energy and nutrition are seriously inadequate. The patient weighed 150 pounds before being admitted to the hospital for the first time, and 130 pounds when he started chemotherapy after discharge from the hospital. He currently weighs less than 110 pounds. Like most patients with advanced cancer, he is already very thin.

　　 The top priority is to control weight, at least to avoid further weight loss, it would be better if you can increase some weight. In the later stages of life, when all clinical treatments cannot reverse or control the development of the disease, weight becomes a key factor in determining the length of life. The heavy-weight people have a longer survival time, and the light-weight people have a shorter survival time. No matter what you eat, you should aim to maintain or increase the weight of the patient, otherwise it must be hospice of failure.

　　 Obviously, it is impossible to eat more energy by eating rice oil and rotten noodles, and it is not possible to benefit the weight. The patient is actually in a state of severe hunger-although due to illness He didn’t feel very hungry, but his body was really hungry-the patient’s appetite was fair, and he should be encouraged to consume more energy-rich foods such as eggs, milk, meat, bread Wait (subject to his desire to eat, and fine processing). The residue in these foods is also very small. Compared with rice oil and rotten noodles, they are not mechanically stimulating to the gastrointestinal mucosa, but they can provide energy and nutrition far beyond rice oil and rotten noodles. Life is helpful.

　　 Due to the side effects of gastrectomy and chemotherapy, he felt bloating after meals and the food was not easy to digest. It is estimated that it has a great relationship with the lack of stomach acid. You can drink a little sour drinks after each meal, such as orange juice, apple cider vinegar, vinegar, etc., to help food digestion. Vitamin C effervescent tablets are very sour, which not only helps food digestion, but also has a nutritional effect, it is more recommended.

　　 There are still a few details, so I won’t be verbose here. In short, the diet of patients with advanced cancer must take weight maintenance as the goal and principle, and the intake of adequate and highly nutritious foods such as meat, eggs, milk and food is very important.

When 　　 left, I asked him to pull my hand with all his strength, and found that his muscles (although they were very few) had good strength. From this I think he can persist for a longer time. Good luck to him.