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January 29, 2024

World Cancer Day 2024: Exploring the role of medical nutrition in holistic cancer care

The time to improve outcomes is now. Find out how medical nutrition can transform lives this World Cancer Day.

Health & Nutrition Medical Nutrition Procurement

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Summary
  • World Cancer Day is acknowledged every February 4th to raise awareness and catalyze action to reimagine a world where millions of preventable cancer deaths are avoided, and life-saving treatment is available to all.
  • There is a high prevalence of malnutrition in cancer patients, which negatively impacts anti-cancer therapy effectiveness and outcomes, including reduced quality of life and increased risk of disease progression and mortality.
  • Explore the latest insights into the effects of disease-related malnutrition and find out how the right tailored nutritional solutions can support the health of patients and promote their recovery and quality of life.
Reflecting on World Cancer Day 2024

Cancer remains the world’s second-leading cause of death with more than 10 million people dying of the disease each year.1 Although there are many non-modifiable risk factors that impact the incidence of this disease group, more than 40% of cancer-related deaths could be preventable.1 World Cancer Day was inaugurated to raise awareness of how suitable strategies for cancer  risk reduction, early detection and treatment could save lives. This year, we’re spotlighting how integrating medical nutrition with cancer therapies can better support patients and improve outcomes.
 

The impact of cancer-related malnutrition

Cancer and its treatment may increase the risk of malnutrition by reducing food intake, nutrient absorption and shifting metabolic demands. This causes substantial weight loss, body composition changes, decreased physical and mental function and tissue degradation.2 Studies demonstrate that between 20-80% of individuals with cancer suffer from malnutrition, with its prevalence varying depending on diverse factors such as age, cancer stage and therapy methods.3,4,5,6,7,8 What’s more, as many as 20% of cancer deaths are associated with malnutrition.3,9,10 Malnutrition potentially increases the toxicity of pharmaceutical drugs and accelerates drug catabolism, resulting in a reduced efficacy of oncology treatments and increasing adverse symptoms.11,12 Despite the negative impact disease-related malnutrition has on patient health and wellbeing, clinical outcomes, cost of care and quality of life,13,14,15 only 30-60% of cancer patients receive the medical nutrition support they need.3,16

The role of medical nutrition in a holistic cancer treatment approach

Medical nutrition supports patients to address disease-related nutritional deficiencies and improve outcomes with a range of specialized nutritional therapy products including oral nutritional supplements (ONS), enteral (tube) and parenteral (intravenous) feeding methods to provide adequate nutrition. There’s mounting evidence to suggest that tailored medical nutrition solutions embedded in multimodal cancer cachexia care could make a significant difference to the lives of patients with cancer.17,18 Multimodal cancer care in this context refers to holistic treatment which addresses different aspects of patient health and wellbeing, including psychological support, physical mobilization and exercise, sleep and lifestyle management.17

Research indicates that some of the advantages of integrating medical nutrition into multimodal therapeutic care plans include a reduction or reversal of malnutrition’s negative effects, advance healthy immune system function, increase the efficacy of drug therapies, improve patient outcomes, quality of life and prognosis – reducing healthcare costs and hospital readmissions as a result. One trial found that early medical nutrition intervention was effective at both significantly improving the quality of life of cancer patients and significantly improving survival rates of patients, when combined with anticancer treatments.19 Another meta-analysis demonstrated that targeted nutrition improved the body weight of patients receiving chemoradiotherapy.20

Insight into attitudes of healthcare professions to malnutrition screening and management

Our latest survey assessed the attitudes and behaviors of healthcare professionals towards screening and management of disease-related malnutrition. The three concepts we assessed were cancer cachexia, stroke rehabilitation and/or cognitive disorder and diabetes. The survey found that only 46% of participating healthcare professionals routinely screen patients for malnutrition. 

Barriers to nutritional screening included a lack of resources like staff time and training on screening tools. There is a clear need for further education on existing screening protocols and nutritional guidelines to improve patient access to medical nutrition.

Of those interviewed, 90% of screening professionals will prescribe medical nutrition. However, only 1 in 3 malnourished patients actually receive it.

Cancer patients require malnutrition screening

The survey results show a consensus among healthcare professionals that cancer patients are among the prime candidates for screening for disease-related malnutrition. This aligns with the finding that 95% of surveyed physicians agreed that screening is important for cancer patients undergoing treatment.

Guideline adherence is lower among oncologists, with 40% reporting they do not follow nutritional recommendations when managing their cancer patients. This aligns with previous market research which suggests that oncologists are hesitant to subscribe cachexia prevention products because they require more evidence in support of the benefits of oral nutritional product descriptions, and also anticipate patients will perhaps not be able to afford treatment or comply.21 However, 59% of oncologists say that they are positive toward the idea of a product that provided targeted nutritional support as an element of multimodal cancer cachexia care.20 The survey further suggests that oncologists require more details on the clinical efficacy to make decisions about prescribing cancer cachexia-related medical nutrition solutions, considering cost and details on calories and other cancer specific nutrients like EPA as must have information prior to purchasing. 

While the importance of paying special attention to the nutritional status of cancer patients through screening is clear, additional work is still needed to promote standards of nutritional care in oncology settings.

Learn more

To gain buy-in, access to robust evidence and data on clinical outcomes, cost-effectiveness, and quality of life, impact is needed, when discussing medical nutrition products and services, download dsm-firmenich's report.

References

1. World Cancer Day. To learn more about "What is Cancer?" click here. [Accessed 19/01/2024]. 

2. Cederholm et al. ESPEN guidelines on definitions and terminology of clinical nutrition, Clin Nutr., vol. 36, no.1, pg. 49-64, 2017.

3. Wie et al. Prevalence and risk factors of malnutrition among cancer patients according to tumor location and stage in the National Cancer Center in Korea. Nutrition, vol. 26, pg. 263-268, 2010.

4. Hebuterne et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enteral. Nutr., vol. 38, pg. 196-204, 2014.

5. Silva et al. Factors associated with malnutrition in hospitalized cancer patients: a cross-sectional study. Nutr J., vol. 14, pg. 123, 2015.

6. Freijer et al. The economic costs of disease related malnutrition. Clin Nutr., vol. 32, pg. 136-141, 2013.

7. Aaldriks et al. Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy. J Geriatr Oncol., vol. 4, pg. 218-226, 2013.

8. Maasberg et al. Malnutrition predicts clinical outcome in patients with neuroendocrine neoplasias. Neuroendocrinology, vol. 104, pg. 11-25, 2017.

9. Pressoir et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer, vol. 102, pg. 966-971, 2010.

10. Esterhenn et al. Significance of autopsy in patients with head and neck cancer. Laryngorhinootologie, vol. 91, pg. 375-380, 2012.

11. Turner et al. Pembrolizumab exposure-response assessments challenged by association of cancer cachexia and catabolic clearance. Clin Cancer Res., vol. 24, pg. 5841–5849, 2018.

12. Aaldriks et al. Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy. J Geriatr Oncol., vol. 4, pg. 218-226, 2013.

13. Hiura et al. Malnutrition diagnosis in critically ill patients using 2012 Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition standardized diagnostic characteristics is associated with longer hospital and intensive care unit length of stay and increased in-hospital mortality. JPEN J Parenter Enteral Nutr., vol. 44, pg. 256–64, 2020.

14. Felder et al. Association of nutritional risk and adverse medical outcomes across different medical inpatient populations. Nutrition, vol. 31, pg. 1385–93, 2015.

15. Felder et al. Unraveling the link between malnutrition and adverse clinical outcomes: association of acute and chronic malnutrition measures with blood biomarkers from different pathophysiological states. Ann Nutr Metab., vol. 68, pg. 164–72, 2016.

16. Planas et al. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES study. Support Care Cancer, vol. 24, pg. 429-435, 2016.

17. Van de Worp, W. R. P. H., et al. Nutritional Interventions in Cancer Cachexia: Evidence and Perspectives From Experimental Models, Frontiers in Nutrition 7(328), 2020.

18. Richards et al. Impact of early incorporation of nutrition interventions as a component of cancer therapy in adults: A review. Nutrients, vol. 12, no. 11, pg. 1, 2020.

19. Bargetzi et al. Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: secondary analysis of a prospective randomized trial. Ann Oncol., vol. 32, pg. 1025–33, 2021.

20. Mae de van der Schueren. Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: current evidence and guidance for design of future trials. Ann Oncol., vol. 29, pg. 1141–53, 2018.

21. Ipsos. DSM Medical Nutritional Product Concepts Research 2022.

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