Nutrition in Cancer Patients

Many factors can modify nutritional status in cancer patients, including cachexia, nausea and vomiting, decreased caloric intake, or oncologic treatments capable of causing malabsorption.

• Cachexia: A complex disease characterized not only by poor intake of nutrients or starvation, but also by metabolic derangement.
• Nausea and vomiting: Often limit nutrient intake, commonly caused by oncologic treatments or chronic opioid therapy.
• Decreased caloric intake: One of the major causes of malnutrition, though the exact causes of anorexia remain unclear.
• Malabsorption: Generally attributed to oncologic treatments reducing gastrointestinal absorption.

Biochemical measurements and immunological tests may not be reliable indicators of nutritional status in cancer patients. Therefore, medical history, physical examination, estimates of daily oral intake, weight changes, and an appropriate consideration of the nutritional requirements according to the stage of disease must still be assessed.

Therapeutic Approaches

• Approaches should be individualized and realistic.
• Whenever possible, oral nutrition is the method of choice, considering specific dietary needs.
• Nausea and anorexia can be reduced by appropriate drugs, chosen with careful clinical judgment.
• A decision to start enteral or parenteral nutrition must balance clinical need against cost, complexity, and patient comfort.
• Factors such as GI tract availability, patient compliance, toxicity from chemotherapy or radiotherapy, costs, and duration of treatment should guide the choice of route.
• Prolonged parenteral nutrition is often required postoperatively after massive intestinal resection or in bowel obstruction.
• Ethical aspects should always be considered, with flexibility in meeting each patient’s nutritional needs.

Points of Interest to Patients

• Ensuring each cancer patient has an individually tailored care plan to meet their needs.
• Undertaking comprehensive assessments of a patient’s nutritional condition.
• Writing reports and discharge summaries for GPs.
• Following up with cancer patients on an outpatient basis to ensure diet compliance.
• Managing the weight of overweight cancer patients.
• Reviewing updated articles in magazines and newsletters.
• Assessing nutritional needs, developing and implementing programs, and reporting results.
• Coordinating with doctors and other healthcare professionals for integrated care.
• Evaluating individual nutritional needs and developing care plans.
• Providing instruction to patients and their families.