We are not supporting this browser

HCP
Oncology hug
Oncology hug

Oncology

Nutritional Issues in Cancer: Malnutrition exists in at least one-third of cancer patients.1 Over 50% of cancer patients present with weight loss at diagnosis and, for many patients, nutritional status continues to deteriorate during and after treatment.2,3


Causes for malnutrition in Cancer: Reduced food intake, malabsorption, metabolic disturbances and abnormal inflammatory responses may all contribute to the development of under-nutrition in patients with cancer.

Consequences of malnutrition in Cancer: Malnutrition in cancer is associated with decreased performance status, reduced quality of life, increased morbidity and mortality, shortened survival and a poorer response to cancer treatment.3 Patients with cancer who have lost weight have a shorter overall survival than those without weight loss.4
 

Treatment of malnutrition in cancer

The goal of nutritional treatment with cancer is o improve function and outcome by:5

  • Preventing and treating malnutrition
  • Enhancing anti-tumour treatment effects
  • Reducing adverse effects of anti-tumour therapies
  • Improving quality of life

Much research exists to support the role of enteral nutrition in the treatment of malnutrition and weight loss in oncology patients.

  • A systematic review showed that ONS significantly increased total energy intake in patients undergoing radiotherapy and improved protein intake.6
  • The European Society for Parenteral and Enteral Nutrition (ESPEN) have concluded that ONS can be used in combination with dietary advice to prevent therapy-associated weight loss and interruption of therapy in non-surgical oncology patients.5
  • In patients with pancreatic cancer an eicosapentanoeic acid (EPA) enriched ONS has been shown to increase energy and protein intake and to improve body mass.7
  • Research suggests that, when taken appropriately, voluntary food intake is not substantially reduced among patients taking ONS.3
  • A 50% reduction in complications and improved patient outcomes has been observed among cancer patients who used medical nutrition preoperatively.8
  • Cancer patients who are initiated on ONS have, on average, a shorter hospital stay post-operatively than those who are not prescribed ONS, resulting in reduced healthcare costs.9


When should nutrition support be commenced in cancer patients?

ESPEN guidelines on nutrition in cancer state that enteral nutrition in the form of oral nutritional supplements or tube feeding should be started if malnutrition already exists or if food intake is markedly reduced for more than 7-10 days.5

As a guideline, malnutrition exists if a patient has:

  • A Body Mass Index (BMI) less than 18.5
  • Lost more than 10% of body weight in the past 3 to 6 months without trying
  • A BMI less than 20 and has lost more than 5% of body weight over the past 3 to 6 months without trying.


What ONS are most appropriate for use in patients with cancer?

It is difficult to give exact guidance on which ONS is most suitable for cancer patients, as requirements will be determined by a range of factors including:

  • Type of cancer (tumour site/stage/prognosis)
  • Appetite/ability to tolerate large volumes (patients often experience early fullness and may only tolerate a "little and often" approach)
  • Intake of normal food (are they eating quite well and only need an energy boost, or has their intake of normal foods declined significantly?)
  • Taste preference (patients may experience taste changes associated with their treatment)
  • Age of the patient

Importance of good nutrition in cancer patients

 

Resources

Visit our Resource Centre for a wide range of professional resources to support you and your patients.

Products

Find out about Nutricia’s wide range of specialised nutritional products.

News

Stay up to date and find out about our latest news.

British Journal of Nursing - Nutrition and Oncology

BJN Article written by our Webinar speakers, Judith Atkinson and Emma Atkinson on Nutrition and oncology: best practice and the development of a traffic light system.

Do you need support?

Contact our team of experts for guidance and support on the use and composition of the Nutricia product range. We are available Monday to Friday 9am-5pm (except Bank Holidays)

 

  1. Pressoir M et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer. 2010; 102(6): 966-71.
  2. DeWys WD et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med. 1980; 69: 491-497.
  3. Stratton RJ et al. Disease-related malnutrition: an evidence based approach to treatment. Wallingford: CABI Publishing; 2003.
  4. Andreyev HJN et al. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer 1998; 34: 503-509.
  5. Arends J et al. ESPEN Guidelines on enteral nutrition: non-surgical oncology. Clin Nutr 2006; 25: 245-259.
  6. Elia M et al. Enteral (oral or tube administration) nutritional support and eicosapentaenoic acid in patients with cancer: a systematic review. Int J Oncol 2006; 28: 5–23.
  7. Fearon KCH et al. Effect of a protein and energy dense n-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 2003; 52: 1479-86.
  8. Kabata et al. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition – prospective randomised control trial. Support Cancer Care 2015; 23(2): 365-70.
  9. Manasek et al. Perioperative oral nutritional support in colorectal cancer patients may improve clinical and health economics outcomes. Ann Oncol 2015; 26(suppl 4): 1-100.

You may also be interested in

Nutricia uses cookies on this website. With your consent we will use them to measure and analyze usage of the website (analytical cookies), to tailor it to your interests (personalisational cookies), and to present you relevant advertising and information (targeting cookies). For more information please read the cookie policy.

Privacy Settings

You can choose your preferences anytime for cookies and tracking. For more information please read our cookie policy.

  • Strictly necessary

    They are necessary for the website to function and cannot be switched off. They are usually only set in response to actions made by you which amount to a request for services (setting your privacy preferences, logging in, filling in forms, etc.). You can set your browser to block or alert you about these cookies, but some parts of the site will not then work.

  • Analytical cookies

    They allow us to count visits and traffic sources, to measure and improve the performance of our site. They show us which pages are the most and least popular and how visitors move around the site. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.

  • Personalisation cookies

    They enable website’s enhanced functionality and personalisation. They may be set by us or by third parties whose services we have added to our pages. If you do not allow these cookies, some or all of these services may not function properly.

  • Targeting cookies

    They may be set through our site by our advertising partners, to build a profile of your interests and to show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.