Review of the monograph “Nutrition in neoplastic diseases” edited by Prof. Andrzej W. Szawłowski, MD, PhD and Prof. Joanna Gromadzka-Ostrowska, PhD

The new monograph concerning the dietetics in oncological diseases was discussedData presented by the World Health Organization indicate that the worldwide rate of deaths related to malignant tumors could be reduced by 30–50% if dietary guidelines based on the European Code Against Cancer are followed. These recommendations include: eating meals regularly, increasing consumption of vegetables, fruit, fish, milk and dairy products, avoiding red meat and animal fats, limiting intake of sugar and sweets, as well as drinking 1.5 liters of water every day. Other recommendations associated with reduced risk of cancer include: strictly avoiding smoking and exposure to second-hand smoke, adopting healthy activity behaviors, and maintaining normal body weight. It needs to be emphasized that this is already a second excellent monograph discussing the role of nutrition in cancer prevention and treatment published by Wydawnictwo Lekarskie PZWL over the last two years on the initiative of Prof. Andrzej Szawłowski and Prof. Joanna Gromadzka- -Ostrowska. These two outstanding scientists represent the Warsaw University of Life Sciences (SGGW) with its long-established contribution to the development of nutritional sciences and highly- -qualified staff who took on the task of writing half of the chapters in this modern textbook.The arrangement of chapters in this monograph corresponds to the principles universal for all studies which aim to provide current knowledge in a given scientific discipline. The first part presents guidelines for nutrition care in cancer patients adjusted for various stages of disease advancement and treatment methods and discusses the most commonly encountered complications. The second part entitled: “Nutritional support for anticancer treatment” includes a number of practical comments regarding prevention, diagnosis, and treatment of cancer-related malnutrition. Special attention was brought to the prognostic value of decreased immunity caused by the lack of enteral nutrition, i.e. in cases of prolonged fluid therapy for more than 5 days, usually observed in primarily malnourished patients. Perioperative fasting is found to have a highly negative impact on immunity, as cells of the lymphatic system, the majority of which (70%) are located in the small intestine, are nourished from the intestinal lumen. Deprived of nutritional stimulation, lymphatic cells start the process of apoptosis, which only increases the risk of septic complications. Even at their early stages, neoplastic diseases cause progressive loss of appetite and selective food intolerance (e.g. protein intolerance in patients with gastric cancer). This leads to malnutrition, which facilitates the diagnosis of a neoplastic disease and/or requires dietary modifications to be implemented in accordance with guidelines presented in the monograph. In recent years, we have observed a significant change in healthcare priorities in the majority of countries in the world. Instead of decisions to allocate even more than 90% of the budget to the treatment of particular diseases, more and more efforts are being focused on prevention, whose implementation requires adopting different strategies and healthcare priorities than those currently in force. Evidence-based cancer prevention (as well as prevention of other diseases) has been thoroughly discussed in the monograph and both the World Health Organization and the European Code Against Cancer guidelines cited in this publication should be included in graduate education curriculum for doctors, nurses, and public health specialists. Another advantage of the reviewed monograph is the chapter entitled “Nutritional facts and myths” which points out the most common myths regarding food and nutrition in diseases that could have a harmful impact on the course of a particular disease and treatment outcomes. Numerous such myths are still present in various medical fields and fighting them is an important challenge for clinicians. To conclude, I would like to express my sincere congratulations to Professor Szawłowski and Professor Gromadzka-Ostrowska, the initiators and co-authors of the monograph, as well as congratulate all other co-authors of chapters included in this very valuable and needed monograph, which provides reliable scientific support behind increasing the effectiveness of activities in the field of cancer prevention, diagnosis, and treatment.This monograph serves as a useful clinical tool for doctors of all specialties, as each healthcare professional will encounter cancer patients during his or her work and should therefore be familiar with potential causes and threats associated with neoplastic diseases, with nutritional factors being one of the most underestimated yet the most important elements in the process. For obvious reasons, the recommendations presented in this publication should be applied by doctors who treat cancer patients, regardless of the type of oncological treatment administered. The title of this monograph also indicates that it should be introduced into education and everyday practice of dietitians. Unfortunately, Poland remains the only country where dietitians, despite having been able to acquire their education at medical and agricultural universities for the past 20 years, are not considered healthcare professionals and therefore not included in the system of hospitals and clinics. To add more, nutrition counseling is not included on the list of procedures offered by the National Health Fund. Despite the above- -mentioned limitations, this monograph should be implemented in the education of future dietitians and doctors.Warsaw, 5 December 2022 Prof. Bruno Szczygieł, MD, PhD