Asuhan Gizi Terstandar pada Pasien Malignant Neoplasm of the Ascending Colon dan Anemia in Neoplastic Disease dengan FOLFIRI Chemotherapy

Abstract

Colon cancer is one of the leading causes of morbidity and mortality worldwide. Loss of appetite, nausea, and chemotherapy-related side effects often reduce dietary intake, thereby increasing the risk of malnutrition. Appropriate nutritional care is essential to maintain nutritional status and support patient recovery. This case report aimed to implement the standardized nutrition care process in a patient with malignant neoplasm of the ascending colon and anemia in neoplastic disease undergoing FOLFIRI chemotherapy. The patient was a 62-year-old man with normal nutritional status who was hospitalized with complaints of reduced appetite and gastrointestinal disturbances following chemotherapy. Biochemical examination revealed anemia, with a hemoglobin level of 11.3 g/dL and a hematocrit of 37.5%. The nutrition diagnoses were NI-2.1 Inadequate Oral Intake, NI-5.1 Increased Nutrient Needs (Energy and Protein), NC-3.4 Unintended Weight Gain, and NB-1.3 Not Ready for Diet/Lifestyle Change. Nutritional therapy was individualized according to the patient's clinical condition, nutritional requirements, activity level, and age. The prescribed diet consisted of a High-Energy High-Protein (HEHP) soft diet combined with 57 g/day of a polymeric enteral formula. During the three-day intervention, dietary intake was monitored using food weighing and 24-hour dietary recall. Nutrient adequacy improved, reaching 82.7% for energy, 88.5% for protein, 99.2% for fat, and 70.2% for carbohydrates. The patient's body weight decreased slightly from 64.0 kg to 63.7 kg (0.3 kg; 0.47%). The implementation of the standardized nutrition care process contributed to improved nutrient adequacy, alleviated clinical symptoms, and helped maintain nutritional status in a patient with colon cancer undergoing chemotherapy.