Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Apr;30(4):3073-3083.
doi: 10.1007/s00520-021-06661-4. Epub 2021 Nov 23.

Examining guidelines and new evidence in oncology nutrition: a position paper on gaps and opportunities in multimodal approaches to improve patient care

Carla M Prado  1 , Alessandro Laviano  2 , Chelsia Gillis  3 , Anthony D Sung  4 , Maureen Gardner  5 , Suayib Yalcin  6 , Suzanne Dixon  7 , Shila M Newman  8 , Michael D Bastasch  9 , Abby C Sauer  10 , Refaat Hegazi  10 , Martin R Chasen  11   12   13
Affiliations
Review

Examining guidelines and new evidence in oncology nutrition: a position paper on gaps and opportunities in multimodal approaches to improve patient care

Carla M Prado et al. Support Care Cancer. 2022 Apr.

Abstract

Malnutrition, muscle loss, and cachexia are prevalent in cancer and remain key challenges in oncology today. These conditions are frequently underrecognized and undertreated and have devastating consequences for patients. Early nutrition screening/assessment and intervention are associated with improved patient outcomes. As a multifaceted disease, cancer requires multimodal care that integrates supportive interventions, specifically nutrition and exercise, to improve nutrient intake, muscle mass, physical functioning, quality of life, and treatment outcomes. An integrated team of healthcare providers that incorporates societies' recommendations into clinical practice can help achieve the best possible outcomes. A multidisciplinary panel of experts in oncology, nutrition, exercise, and medicine participated in a 2-day virtual roundtable in October 2020 to discuss gaps and opportunities in oncology nutrition, alone and in combination with exercise, relative to current evidence and international societies' recommendations. The panel recommended five principles to optimize clinical oncology practice: (1) position oncology nutrition at the center of multidisciplinary care; (2) partner with colleagues and administrators to integrate a nutrition care process into the multidisciplinary cancer care approach; (3) screen all patients for malnutrition risk at diagnosis and regularly throughout treatment; (4) combine exercise and nutrition interventions before (e.g., prehabilitation), during, and after treatment as oncology standard of care to optimize nutrition status and muscle mass; and (5) incorporate a patient-centered approach into multidisciplinary care.

Keywords: Exercise; Low muscle mass; Malnutrition; Multidisciplinary; Multimodal; Nutrition.

PubMed Disclaimer

Conflict of interest statement

CMP reports receiving honoraria and/or paid consultancy from Abbott Nutrition, Nutricia, Nestlé Health Science, Fresenius Kabi, and Baxter. AL reports receiving honoraria and/or paid consultancy from Abbott Nutrition, Baxter, DSM, Fresenius Kabi, Nestlé Health Science, Nutrition, and Smartfish. CG reports honoraria from Abbott Nutrition and Nestlé. ADS reports receiving funding from the NIH and honoraria from Abbott Nutrition. MG, SD, and SMN report receiving honoraria from Abbott Nutrition. ACS and RH are employees of Abbott Nutrition, Abbott Laboratories. The material presented in this article is based on the best-known clinical evidence and is not affected by this financial relationship.

Figures

Fig. 1
Fig. 1
Proposed nutrition care process for oncology. *MST = Malnutrition Screening Tool; EHR/EMR = Electronic Health Record/Electronic Medical Record; SGA = Subjective Global Assessment
Fig. 2
Fig. 2
Expert energy and protein recommendations for patients with cancer
Fig. 3
Fig. 3
Expert recommendations on type and amount of exercise per week for patients with cancer
Fig. 4
Fig. 4
Clinical practice principles for the nutrition care of patients with cancer
See this image and copyright information in PMC

References

    1. de Melo Silva FR, de Oliveira MGOA, Souza ASR et al (2015) Factors associated with malnutrition in hospitalized cancer patients: a cross-sectional study. Nutr J 14;123. 10.1186/s12937-015-0113-1 - PMC - PubMed
    1. Ní Bhuachalla ÉB, Daly LE, Power DG, et al. Computed tomography diagnosed cachexia and sarcopenia in 725 oncology patients: is nutritional screening capturing hidden malnutrition? J Cachexia Sarcopenia Muscle. 2018;9:295–305. doi: 10.1002/jcsm.12258. - DOI - PMC - PubMed
    1. Martin L, Gioulbasanis I, Senesse P, Baracos VE. Cancer-associated malnutrition and CT-defined sarcopenia and myosteatosis are endemic in overweight and obese patients. JPEN J Parenter Enteral Nutr. 2020;44:227–238. doi: 10.1002/jpen.1597. - DOI - PubMed
    1. Argilés JM, Busquets S, Stemmler B, López-Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer. 2014;14:754–762. doi: 10.1038/nrc3829. - DOI - PubMed
    1. Muscaritoli M, Lucia S, Farcomeni A, et al. Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study. Oncotarget. 2017;8:79884–79896. doi: 10.18632/oncotarget.20168. - DOI - PMC - PubMed