Nutrition Matters In Cancer Care
Malnutrition in cancer is the result of a combination of metabolic dysregulation and anorexia, caused by the tumour itself or by its treatment. It negatively impact the clinical outcomes and mortality risk of cancer patients. At cancer diagnosis, half of patients present with some form of nutritional deficit. Nutritional status also often declines further during cancer treatment due to various treatment-related side effects such as anorexia, mucositis, and nausea and vomiting. The incidence of malnutrition and weight loss in people with cancer ranges from 31% to 87%
Malnutrition is associated with a lower tolerance to anticancer treatments due to increased toxicity, a lower compliance, and a reduced response to treatments —increased complication rates, poor postoperative outcomes, longer hospitalisation, and a poor quality of life. In particular, cancer patients have to face not only an impaired physical function but also a great deterioration in their health-related quality of life, in terms of psychological, cognitive, social, and emotional functions.
Malnutrition may affect 75% of cancer patients with a wide range of prevalence that varies according to the tumour type and stage, treatment type, patients age, and care setting. Approximately 15%–50% of all cancer patients present with nutritional deficiencies at the time of diagnosis, while 43% and 9% have overt malnutrition or are at risk of malnutrition, respectively, at the first oncologic visit. This prevalence increases during treatment, reaching up to 80% of the patients.
Cancer-related malnutrition may account for up to 20% of cancer deaths and may lead to cachexia, a significant predictor of overall survival, characterised by unintentional weight loss, low body mass index, and reduced muscle mass.
The available evidence suggests that early clinical nutrition interventions are associated with a reduction of therapy-related toxicity, an increase in relative-dose intensity, and fewer delays in cancer treatment. Furthermore, an early assessment of the patient’s nutritional status and monitoring during the whole treatment course is recommended, to improve treatment tolerance, clinical outcomes, and the quality of life.
The continuum of cancer includes diagnosis, treatment, recovery, and survivorship. Each stage in this continuum is associated with specific nutritional challenges to patients. Changes in nutritional status may begin prior to diagnosis, when physical and psychosocial issues commonly have a negative impact on appetite and food intake.
Nutrition intervention in patients with cancer can involve many strategies, including diet education and oral nutritional supplementation. The goals of nutritional support in patients with cancer are numerous and include maintaining an acceptable weight and preventing or treating malnutrition, leading to better tolerance of treatment and its side effects, more rapid healing and recovery, reduced risk of infection during treatment, and enhanced overall survival.
Research has demonstrated that nutritional intervention in patients with cancer can result in positive outcomes.
A recent systematic review and meta-analysis of oral nutritional interventions in malnourished patients with cancer showed that nutritional intervention, including nutritional counselling and oral nutritional supplementation, was associated with statistically significant improvements in weight and energy intake compared with routine care and had a beneficial effect on some aspects of quality of life.
We provide food solutions to prevent malnutrition and promote the pleasure of eating, to help encourage a better quality of life.
Muscaritoli, M., Arends, J., & Aapro, M. (2019). From guidelines to clinical practice: a roadmap for oncologists for nutrition therapy for cancer patients. Therapeutic advances in medical oncology, 11, 1758835919880084. https://doi.org/10.1177/1758835919880084