A poor nutritional condition can increase the complications of cancer disease, the risk of infections, and the frequency of hospitalization.
According to different studies and clinical nutrition courses, an early diagnosis of nutritional status can, among other things, improve the patient’s quality of life.
Good nutrition is a fundamental part of any stage and circumstance of life, but for people with oncological diseases, it becomes even more crucial in the struggle to overcome these conditions, which affect them both physically and emotionally.
It is quite common for people going through a disease such as cancer to lose weight significantly at some point during treatment. However, the relevance of the nutritional status of cancer patients and the impact that nutrition can have on their treatment may not be adequately publicized.
According to data from the Pan American Health Organization, the number of cancer cases in the Americas region was estimated at 4 million in 2020 and is projected to increase to 6 million by 2040. About one-third of all cancer cases could be prevented by avoiding key risk factors such as smoking, alcohol abuse, unhealthy diet, and physical inactivity.
Early and timely diagnosis of nutritional status allows intervention, not only to optimize the results of cancer treatment, but also to improve the patient’s quality of life.
It is estimated that the prevalence of malnutrition in cancer patients ranges between 15% and 40% at the time of diagnosis and reaches up to 80% in advanced stages of the disease, according to the research paper “The cancer anorexia-cachexia syndrome” by K.A. Nelson, D. Walsh and A. Sheehan and Cancer cachexia in adult patients by J. Arends, F. Strasser and S. Gonella.
Advice from Specialists
Specialists stress the need to pay special attention to nutrition as part of a comprehensive approach to cancer.
This is a particularly relevant aspect because malnutrition can reduce the response and/or tolerance to oncological treatments, increase possible postoperative complications and increase the risk of infections, but it also generates a greater frequency of hospitalizations, which in turn leads to an increase in healthcare costs.
According to the specialists, when addressing the problem of malnutrition in oncology patients, the first step is to identify them, ideally at the time of diagnosis of the disease, so that an early approach can be initiated.
There are tools to quantify nutritional status, both in hospitalized and ambulatory patients, based on objective indicators such as weight loss, changes in food intake, changes in functional capacity, and digestive symptoms. In addition to the medical team’s physical signs, they make it possible to arrive at a total value that determines whether the patient is well nourished, moderately or severely malnourished, which sets the tone for the degree of nutritional intervention required.
The European Society for Parenteral and Enteral Nutrition (ESPEN), in its latest guidelines for nutritional support in oncology patients, recommends that nutritional risk should be assessed in all oncology patients periodically and from the diagnosis of the disease.
The impact of the disease on the nutritional status of cancer patients can be multifactorial in origin, often linked to the location and extent of the tumour, the evolution of the disease itself, the treatments being received, and the adverse effects associated with them.
It is well established that there is usually a decrease in food intake, often because the disease interferes mechanically with the normal transit of the digestive tract. The clearest example is tumours located in the digestive tract (pharynx, oesophagus, stomach, and pancreas), which cause direct obstruction or a feeling of early satiety due to limited gastric capacity. It is here where specialists must think about nutritional interventions that facilitate the patient’s intake and at the same time nourish, helping to regain the weight.
Nutritional interventions are thus proposed as a complement to oncological treatments since malnutrition is an independent prognostic indicator of poor response to treatment and decreased survival.
In addition, malnutrition reduces the quality of life: patients’ muscle mass and strength are diminished. This progressive fragility can make it difficult for them to stand up or move around by their means, thus relinquishing their autonomy, and this will also have an impact on the psychological level and can induce or intensify depressive symptoms.
Today we have nutritional alternatives available that contribute to providing the nutrients the patient needs, in terms of calories and proteins, helping to reverse the loss of muscle mass and strengthening their overall nutritional status. The evidence indicates that nutritional support for the oncology patient contributes to providing support at the moment of an adequate administration of the treatment.