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Nutrition in Oncology

Clinical Nutrition for Cancer patients

At B. Braun, we believe in a multi-disciplinary approach involving nutrition therapy alongside cancer treatment, which needs to be a recognised and utilised option for all cancer patients regardless of their health status. Following local guidelines, patients who match the criteria with malignancy should be informed about parenteral nutrition (PN) with the potential benefits, practical implications, and risks when indicated1.

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prehabilitation-in-cancer-cachexia.jpg

Prehabilitation in cancer cachexia

Malnutrition is a major cause of morbidity and mortality in cancer patients2 and causes negative effects on tissue, body structure and organ functions, as well as on the overall clinical course3. Criteria for malignant cachexia is the combination of malnutrition and systemic inflammatory reaction. A nutritional deficiency of this sort has an unfavourable effect on the quality of life and the prognosis of the cancer patient. Prehabilitation in cases of cancer cachexia is essential as we want patients undergoing cancer treatment to be at the optimal nutritional level in order to improve chances of, and progress in recovery.

Nutrition therapy in cancer patients who are malnourished or at risk of malnourishment

  • May help to improve body weight and energy intake4
  • Can reduce the incidence of post-operative infectious and non-infectious complications, together with a positive effect on length of hospitalisation5
  • May improve physical activity and quality of life4
  • Can diminish negative effects of radiotherapy on nutrition status4
  • May improve survival4,6
  • May reduce cancer treatment toxicity4,7
Helping your patient from hospital to home

Beneficial nutrients

Discover six valuable nutrients for cancer patients

A well-balanced diet rich in nutrients won’t cure cancer, but it can help give them the energy they need. Evidence supports that optimising nutritional status during anti-cancer care can help in the following way. Explore the figure below for more information.

CARBOHYDRATES

Altered appetite signals from the CNS can cause anorexia, reducing caloric intake8. Carbohydrates are the primary source of calories and as such, energy9. Thus, replenishing caloric levels are important for cancer patients.

VITAMINS & MINERALS

Micronutrient deficiency induced by cancer and/or treatment, impacts both disease and the treatment whilst increasing risk of complications. It is necessary to ensure a patient has an optimal supply of micronutrients10.

FATS

Increased lipolysis and defective lipogenesis deplete fat depots that normally serve as energy reserves8. Improving the fat intake can increase their chances of providing essential fatty acids and meeting energy demands9.

FLUIDS

Water is essential for life and thus, nutrition support for cancer patients should also include achieving the normal fluid and electrolyte balance9.

PROTEINS

A tumour can cause the liver to stimulate acute-phase protein production, repressing drug clearance and raising risk for cancer treatment toxicity8. Sufficient amino acids are required to support protein synthetic functions9

Nutrition Therapy
Related Information

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Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to B. Braun Medical Ltd (tel: 0800 298 0299)

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References

  1. Naghibi, M., Woodward, J., Neild, P and BIFA Committee, (2020). Palliative parenteral nutrition (HPN) for patients with malignancy. BAPEN. [Online]. Available at: position-statement-on-palliative-hpn-for-patients-with-malignancy-dec-2020.pdf (bapen.org.uk) [Access 02 Februaury 2024]
  2. Pirlich M, Schütz T., Norman K, et al. The German hospital malnutrition study. Clin Nutr. 2006; 25(4) 563-572 Doi: 10.1016/j.clnu.2006.03.005 
  3. BAPEN (2024). Malnutrition: Introduction to Malnutrition. [Online]. BAPEN. Available at: https://www.bapen.org.uk/malnutrition/introduction-to-malnutrition/#:~:text=Malnutrition%20is%20a%20state%20of,and%20function%20and%20clinical%20outcome [Accessed 25 March 2024]
  4. Arends J, Bachmann P, Baracos V, et all. ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition 36 (2017) 11-48.
  5. Xia Yan, Fu-Xian Zhou, Tian Lan, hui Xu, xiao-xi Yang, Cong-hua Xie, Jing Dai, Zhen-ming Fu, Yan Gao, Lu-lu Chen. Optimal postoperative nutrition support for patients with gastrointestinal malignancy: a systematic review and meta-analysis. Clinical Nutrition 36 (2016) 710-721.
  6. 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: 503-9.
  7. Paccagnella A, Morasutti I, Rosti G. Nutritional intervention for improving treatment tolerance in cancer patients. Current opinion in oncology. July 2011, vol 23, issue 4 -p 322-330.e from the hospital. Discharge Management
  8. Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017; 36(5): 1187-1196
  9. Barrera, R., (2002). Nutritional Support in Cancer Patients. Journal of Parenteral and Enteral Nutrition, 26: S63-S71. https://doi.org/10.1177/014860710202600516
  10. Gröber U, Holzhauer P, Kisters K, Holick MF, Adamietz IA., (2016). Micronutrients in Oncological Intervention. Nutrients. 12;8(3):163. doi: 10.3390/nu8030163.
  11. Schweizer, T.F., Würsch, P., (1991). The physiological and nutritional importance of dietary fibre. Experientia 47, 181–186. https://doi.org/10.1007/BF01945423