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Nutritional support for malnourished patients with cancer

Baldwin, Christine

Current Opinion in Supportive and Palliative Care: March 2011 - Volume 5 - Issue 1 - p 29–36
doi: 10.1097/SPC.0b013e328343a05d
Gastrointestinal symptoms: Edited by Dorothy M.K. Keefe and Jervoise Andreyev
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Purpose of review Cancer and its treatments frequently have a negative impact on the weight and nutritional status of patients. Weight loss is associated with reduced survival and poorer outcomes of treatment but is not well characterized and frequently confused with cachexia, which may complicate the interpretation of studies of nutritional support. The aims of this review were to examine the impact of cancer on nutritional status and to review the role of simple oral nutritional interventions and novel agents.

Recent findings The terms weight loss, malnutrition and cachexia refer to different entities and new definitions have recently been proposed that take account of the role of the underlying inflammatory processes. Oral nutritional interventions are widely recommended for malnourished cancer patients, but the evidence for their benefits to clinical, nutritional and patient-centred outcomes is limited. Meta-analysis has highlighted the variability in response to simple nutritional interventions of different cohorts of cancer patients and suggested that improvements in nutritional endpoints and aspects of quality of life may be achieved in some patients. Recent research has largely focused on treatments aiming to modulate the inflammatory processes associated with cachexia, but to date has not identified a single treatment with clear efficacy.

Summary Studies characterizing the potential for nutritional support in combination with anti-inflammatory agents in defined patient groups are defined to advance the evidence base in this area.

Nutritional Sciences Division, King's College London, London, UK

Correspondence to Dr Christine Baldwin, PhD, RD, Nutritional Sciences Division, King's College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, UK Tel: +44 207 848 4318; fax: +44 207 848 4500; e-mail: christine.baldwin@kcl.ac.uk

© 2011 Lippincott Williams & Wilkins, Inc.