查看犬血管肉瘤的治疗：2000 年及以后的源代码

== 饮食调整 (Dietary Modifications) ==

最近，兽医癌症患者的营养方面受到了很多关注[77-84]。许多代谢异常与肿瘤有关。用于描述这些异常的副肿瘤综合征是癌症恶病质，其特征是尽管摄入了足够的营养，但体重减轻。碳水化合物、脂质和蛋白质代谢都会对癌症患者产生不利影响。

Recently, a great deal of attention has been directed toward nutritional aspects of the veterinary cancer patient.77–84 Numerous metabolic abnormalities have been associated with neoplasia. The paraneoplastic syndrome used to describe these abnormalities is cancer cachexia, which is characterized by weight loss despite adequate nutritional intake. Carbohydrate, lipid, and protein metabolism are all adversely affected in cancer patients.


癌症相关代谢异常的临床影响导致使用饮食操纵来试图减轻癌症恶病质。简单碳水化合物含量低的饮食，适量的高生物利用度蛋白质来源，补充 omega-3 脂肪酸和特定氨基酸，如精氨酸、甘氨酸、谷氨酰胺和半胱氨酸，可能对一些癌症患者有益[77]。癌症饮食管理的关键组成部分之一是利用脂肪来源作为主要的膳食能量成分， 注意脂肪酸的类型和比例与饮食[77,84]。高脂肪饮食可能对癌症患者有 2 个主要的有益影响[77,78,80,84]。首先，肿瘤似乎在使用脂肪作为能量来源方面效率低下，与正常体细胞相比，'''富含脂肪衍生卡路里的饮食可能会有效地“饿死”肿瘤细胞'''[77,80,84]。其次，特别是 '''omega-3 脂肪酸已被证明具有抗血管生成特性'''，并在动物模型中抑制肿瘤发展[78]。二十碳五烯酸是一种 omega-3 脂肪酸，在实验性肿瘤模型中具有杀瘤作用而不会损害正常细胞[78]。最近的一项双盲随机研究评估了富含多不饱和 omega-3 脂肪酸和精氨酸的特殊饮食对代谢参数的影响[77]。在特殊饮食的患者中注意到乳酸水平降低，与对照动物相比，这些狗的无病间隔和生存时间明显更长[79]，此后开发了一种可比较的商业饮食，旨在提高犬癌患者的生存时间和生活质量（希尔肿瘤饮食 Hill’s Neoplasia [ND]）[b]。虽然ND饮食是为患有淋巴瘤的狗设计的，它在其他肿瘤中的使用似乎是合理的[85]。因为患有HSA的动物已被证明会发展为癌症恶病质，因此饮食疗法可能是一种可行的治疗方式。目前，一项兽医研究正在检查饮食操纵对患有 HSA 的狗的影响（Ogilvie，个人交流）。

The clinical impact of cancer-associated metabolic abnormalities has led to the use of dietary manipulation in an attempt to lessen cancer cachexia. A diet low in simple carbohydrates with a moderate amount of a highly bioavailable protein source supplemented with omega-3 fatty acids and specific amino acids such as arginine, glycine, glutamine, and cysteine may be beneficial to some cancer patients.77 One of the key components to the dietary management of cancer is the utilization of a fat source as the major dietary energy component, with attention to the type and ratio of fatty acids with the diet.77,84 High-fat diets may have 2 major beneficial effects in cancer patients.77,78,80,84 First, tumors seem to be inefficient in using fat as an energy source, and a diet that is high in fat-derived calories may effectively ‘‘starve’’ neoplastic cells compared to normal body cells.77,80,84 Second, omega-3 fatty acids in particular have been shown to possess antiangiogenic properties, and inhibit tumor development in animal models.78 Eicosapentaenoic acid, an omega-3 fatty acid, has tumorcidal effects without damaging normal cells in experimental tumor models.78 A recent double-blind, randomized study evaluated the effect of a specialized diet high in polyunsaturated omega-3 fatty acids and arginine on metabolic parameters, chemical indices of inflammation, quality of life, and disease-free interval and survival time of dogs with lymphoma.77 Decreased levels of lactic acid were noted in patients on the special diet and these dogs had significantly longer disease-free interval and survival times compared to control animals.79 A comparable commercial diet has since been developed that is designed to enhance survival time and quality of life in canine cancer patients (Hill’s Neoplasia Diet [ND]).b Although the ND diet was designed for dogs with lymphoma, its use in other neoplasia seems plausible.85 Because animals with HSA have been shown to develop cancer cachexia, it stands to reason that dietary therapy may be a viable modality of treatment. Currently, a veterinary study is examining the effect of dietary manipulations on dogs with HSA (Ogilvie, personal communication).

<pre>
根据 2015-2020 年美国人膳食指南，建议每周食用 8 至 12 盎司 (oz) 的海鲜，以获得必要的 omega-3。

美国心脏协会 (AHA) 建议每周至少食用两份鱼，以降低患心血管疾病的风险。

鱼油胶囊可能含有磷虾油或鱼肝油，但也有素食选择（藻油来自藻类）。

大多数人从他们吃的植物性食物（坚果和种子）中获得足够的 ALA。

但孕妇可能会对这些指南持谨慎态度，因为某些鱼类中存在汞的风险。

在这种情况下，孕妇仍应以每周至少 8 盎司（但少于 12 盎司）为目标，以帮助婴儿的认知和视力发育。

一定要选择汞含量较低的鱼，例如野生鲑鱼、鲱鱼、沙丁鱼、鳟鱼和大西洋或太平洋鲭鱼（但不要选择甲基汞含量高的鲭鱼）。

大多数鱼油或 omega-3 补充剂都含有 EPA 和 DHA，它们来自动物来源，[比来自植物来源的 ALA] 更具生物利用度说。

这些包括鱼类和其他海鲜，尤其是冷水、油性品种，如鲑鱼、金枪鱼、鲭鱼、鲱鱼、凤尾鱼和沙丁鱼。

核桃、奇亚籽和亚麻籽，以及它们的油和其他植物油（如菜籽油）也是 omega-3 的良好来源。

市场上的许多食品都添加了 omega-3。

当您寻找鸡蛋、牛奶、酸奶、果汁和豆浆制成的饮料时，请查看标签。

母乳和大多数婴儿配方奶粉都含有 ALA、EPA 和 DHA。
</pre>

<br>