乳癌素食病人的營養照顧

Nutrition care for vegetarian breast cancer patient

化學治療是常見的乳癌療程之一，化學治療期間增加蛋白質的攝取可以幫助減少瘦體組織的流失。而高蛋白質食物中，病友對於大豆及其製品似乎有食用上的疑慮，擔心會增加復發的風險，本篇將討論大豆及其製品對於乳癌的影響與益處。 本個案為一位53歲女性，罹患乳癌第二期（stage IIＢ），經手術治療（conservative surgery）後，給予化學治療。個案自1989年茹素（蛋奶素）至今已17年，喜愛吃糕點。在營養師營養介入之前，個案的飽和脂肪攝取偏多，蛋白質攝取不足，大豆異黃酮攝取量並不高。個案於手術治療後要接受化學治療，所以給予個案高蛋白飲食衛教，詳細的指導蛋白質食物代換，並建議控制飽和脂肪攝取量。經過持續的衛教及追蹤後，個案蛋白質攝取量達到建議量、飽和脂肪小於高脂飲食建議的7%，大豆異黃酮攝取量適量增加，但對於乳癌復發病沒有影響。

Chemotherapy is a common and useful treatment for breast cancer patients. Negative nitrogen balance, a severe complication of chemotherapy, caused lean body mass loss in patients. For vegetarians, soybean and its products are high quality protein source. This study aims to investigate the effect of soybean and its products supplement on cancer recurrence of breast cancer patients. This case was a 53-year-old woman with breast cancer the second phase (stage IIB), conservative surgery after giving chemotherapy. She has been a vegetarian for 17 years. In analyzing her dietary habit, the result showed that she consumed more saturated fat, less protein,and a normal amount of soy isoflavones. She received chemotherapy treatment after surgery. Meanwhile, patient received high-protein diet, health education, food protein substitute for detailed instructions, appropriate amount of saturated fat and increasing soy isoflavone intake. The result showed that soybean and its products intake was no effect on breast cancer recurrence.