From Guidelines to Clinical Practice: a Roadmap for Oncologists for Nutrition Therapy for Cancer Patients

Overview

Journal Ther Adv Med Oncol

Specialty Oncology

Date 2019 Nov 26

PMID 31762796

Citations 36

Authors

Maurizio Muscaritoli

Jann Arends

Matti Aapro

Affiliations

Soon will be listed here.

Abstract

Tackling malnutrition in cancer patients remains one of the most challenging tasks in clinical practice. Even though robust evidence exists stressing the role of nutritional status in relation to treatment outcome, its appropriate consideration in clinical practice is often lacking. In this review, we discuss the significance of nutritional status and of malnutrition for the cancer patient. Drawn from experience and from current recommendations of the European Society for Clinical Nutrition and Metabolism (ESPEN), we propose concrete and manageable steps to routinely incorporate nutritional aspects in today's oncological clinical practice.

Citing Articles

The effects of enteral tube feeding on nutrition, survival, and quality of life outcomes in advanced upper gastrointestinal cancers: a systematic literature review.

Mannino A, Lasry C, Kuypers J, Haines T, Croagh D, Hanna L Support Care Cancer. 2025; 33(3):223.

PMID: 40009216 PMC: 11865217. DOI: 10.1007/s00520-025-09263-6.

Effect of Hemoglobin, Albumin, Lymphocyte Count, and Platelet (HALP) Score on Survival of Patients with Metastatic Thyroid Cancer Treated with Tyrosine Kinase Inhibitors.

Oztop H, Hunutlu F, Ekizoglu S, Gul O, Cander S, Sahin A J Clin Med. 2025; 14(4).

PMID: 40004836 PMC: 11856822. DOI: 10.3390/jcm14041306.

The effect of supplementary parenteral nutrition with different energy intakes on clinical outcomes of patients after gastric cancer surgery.

Sun S, Sun W, Xie W, Zhao F, Guo X, Zhou J BMC Surg. 2024; 24(1):424.

PMID: 39731118 PMC: 11674070. DOI: 10.1186/s12893-024-02734-3.

Symptom Burden and Dietary Changes Among Older Adults with Cancer: A Cross-Sectional Study.

Buthe L, Westhofen G, Hille A, Buntzel J Curr Oncol. 2024; 31(12):7663-7685.

PMID: 39727688 PMC: 11675022. DOI: 10.3390/curroncol31120565.

Omega-3 Supplementation and Nutritional Status in Patients with Pancreatic Neoplasms: A Systematic Review.

Pires L, Salaroli L, Podesta O, Kenji Haraguchi F, Lopes-Junior L Nutrients. 2024; 16(23).

PMID: 39683430 PMC: 11643750. DOI: 10.3390/nu16234036.

References

Hebuterne X, Lemarie E, Michallet M, de Montreuil C, Schneider S, Goldwasser F . Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014; 38(2):196-204. DOI: 10.1177/0148607113502674. View

Cheville A, Girardi J, Clark M, Rummans T, Pittelkow T, Brown P . Therapeutic exercise during outpatient radiation therapy for advanced cancer: Feasibility and impact on physical well-being. Am J Phys Med Rehabil. 2010; 89(8):611-9. DOI: 10.1097/PHM.0b013e3181d3e782. View

Cheville A, Kollasch J, Vandenberg J, Shen T, Grothey A, Gamble G . A home-based exercise program to improve function, fatigue, and sleep quality in patients with Stage IV lung and colorectal cancer: a randomized controlled trial. J Pain Symptom Manage. 2012; 45(5):811-21. PMC: 4524515. DOI: 10.1016/j.jpainsymman.2012.05.006. View

Saitoh-Maeda Y, Kawahara T, Miyoshi Y, Tsutsumi S, Takamoto D, Shimokihara K . A low psoas muscle volume correlates with a longer hospitalization after radical cystectomy. BMC Urol. 2017; 17(1):87. PMC: 5604176. DOI: 10.1186/s12894-017-0279-2. View

Pirlich M, Schutz T, Norman K, Gastell S, Lubke H, Bischoff S . The German hospital malnutrition study. Clin Nutr. 2006; 25(4):563-72. DOI: 10.1016/j.clnu.2006.03.005. View

Schiessel D, Baracos V . Barriers to cancer nutrition therapy: excess catabolism of muscle and adipose tissues induced by tumour products and chemotherapy. Proc Nutr Soc. 2018; 77(4):394-402. DOI: 10.1017/S0029665118000186. View

Fearon K, Strasser F, Anker S, Bosaeus I, Bruera E, Fainsinger R . Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011; 12(5):489-95. DOI: 10.1016/S1470-2045(10)70218-7. View

Bourdel-Marchasson I, Blanc-Bisson C, Doussau A, Germain C, Blanc J, Dauba J . Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial. PLoS One. 2014; 9(9):e108687. PMC: 4181649. DOI: 10.1371/journal.pone.0108687. View

Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff S . ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2016; 36(1):49-64. DOI: 10.1016/j.clnu.2016.09.004. View

10.

Gartner S, Kruger J, Aghdassi A, Steveling A, Simon P, Lerch M . Nutrition in Pancreatic Cancer: A Review. Gastrointest Tumors. 2016; 2(4):195-202. PMC: 4924449. DOI: 10.1159/000442873. View

11.

Genton L, Hans D, Kyle U, Pichard C . Dual-energy X-ray absorptiometry and body composition: differences between devices and comparison with reference methods. Nutrition. 2002; 18(1):66-70. DOI: 10.1016/s0899-9007(01)00700-6. View

12.

Mendes N, Barros T, Rosa C, Franceschini S . Nutritional Screening Tools Used and Validated for Cancer Patients: A Systematic Review. Nutr Cancer. 2019; 71(6):898-907. DOI: 10.1080/01635581.2019.1595045. View

13.

Arrieta O, de la Torre-Vallejo M, Lopez-Macias D, Orta D, Turcott J, Macedo-Perez E . Nutritional Status, Body Surface, and Low Lean Body Mass/Body Mass Index Are Related to Dose Reduction and Severe Gastrointestinal Toxicity Induced by Afatinib in Patients With Non-Small Cell Lung Cancer. Oncologist. 2015; 20(8):967-74. PMC: 4524769. DOI: 10.1634/theoncologist.2015-0058. View

14.

Assenat E, Thezenas S, Flori N, Pere-Charlier N, Garrel R, Serre A . Prophylactic percutaneous endoscopic gastrostomy in patients with advanced head and neck tumors treated by combined chemoradiotherapy. J Pain Symptom Manage. 2011; 42(4):548-56. DOI: 10.1016/j.jpainsymman.2011.01.009. View

15.

Caccialanza R, Cereda E, Pinto C, Cotogni P, Farina G, Gavazzi C . Awareness and consideration of malnutrition among oncologists: Insights from an exploratory survey. Nutrition. 2016; 32(9):1028-32. DOI: 10.1016/j.nut.2016.02.005. View

16.

Kouhen F, Afif M, Benhmidou N, Majjaoui S, Elkacemi H, Kebdani T . [What nutritional management in patients with head and neck cancers undergoing radiotherapy? An overview]. Bull Cancer. 2015; 102(10):874-9. DOI: 10.1016/j.bulcan.2015.07.009. View

17.

Adamsen L, Quist M, Andersen C, Moller T, Herrstedt J, Kronborg D . Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ. 2009; 339:b3410. PMC: 2762035. DOI: 10.1136/bmj.b3410. View

18.

Ravasco P, Monteiro-Grillo I, Camilo M . Individualized nutrition intervention is of major benefit to colorectal cancer patients: long-term follow-up of a randomized controlled trial of nutritional therapy. Am J Clin Nutr. 2012; 96(6):1346-53. DOI: 10.3945/ajcn.111.018838. View

19.

Arends J, Baracos V, Bertz H, Bozzetti F, Calder P, Deutz N . ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017; 36(5):1187-1196. DOI: 10.1016/j.clnu.2017.06.017. View

20.

Ryu S, Kim I . Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol. 2010; 16(26):3310-7. PMC: 2900724. DOI: 10.3748/wjg.v16.i26.3310. View