Oncology Fresubin

Did you know?

>40 % of cancer patients are affected by
unvoluntary weight loss1

Malnutrition & cachexia –
a challenge for professionals and patients

Cancer cachexia as a multifactorial syndrome needs to be detected early because regaining lost weight, muscle mass and strength is difficult. It is important to start interventions including nutrition management as early as possible.1

Consequences of cancer cachexia

  • Impairing Quality of Life2-4
  • Decreasing treatment tolerance and outcome5,6
  • Increasing health related cost2,7,8

A diagnostic criterion for cachexia

Weight loss ...

  • >5 % over past 6 months, or
  • >2 % and BMI <20 kg/m2 or
  • >2 % and skeletal muscle mass depletion (sarcopenia)

… often associated with reduced food intake and systemic inflammation.9

Nutrition management in cancer cachexia should

1. provide high protein and energy-dense nutrition10

2. provide EPA/DHA from fish oil: 2 g EPA/DHA per day have been proven to support the body’s own anti-inflammatory mechanisms10

Nutrition support alongside the course of cancer disease could be beneficial for your patients.

Here you’ll find detailed information about the dietary management of patients with cancer.

 

Manage the symptoms of your patients with cancer

Side effects of anticancer treatment and cancer itself affect treatment tolerability and overall quality of life. Management of symptoms is of utmost importance to avoid dose reductions, treatment interruptions and increased morbidity of patients.

Malnutrition – more cancer patients than you might have expect are affected

Depending on tumor site, stage and treatment, weight loss and malnutrition are reported in 30 % to >80 % of patients, highest frequencies seen amongst patients with solid tumors.1,2 At the time of diagnosis many cancer patients already suffer from malnutrition3. Guidelines recommend to screen for malnutrition at time of cancer diagnosis.4

Benefits of enteral feeding during anti cancer therapy

Supporting your patients with a specially designed ONS or tube feed helps to manage several symptoms of a cancer treatment like mucositis, fatigue or anorexia. Besides that, a good nutritional status does make a difference, in terms of: 

  • Increased energy intake5-7 
  • Less weight loss8 
  • Support tolerance and outcome of treatment 
  • Nutritional intervention with fish oil may support palliative chemotherapy efficacy without affecting the toxicity profile and may contribute to increased survival9
  • Contribution to quality of life and prolonged survival time

See how nutritional support can help to manage the symptoms of your patients:

Mucositis Nutrition support

Mucositis

Clinically relevant and often dose-limiting side effect of anti cancer therapy.

Cancer Fatique

Fatigue

Affects more patients for longer time than any other symptom.

Cancer Anorexia

Anorexia

Appetite disorders are highly prevalent but frequently underdiagnosed.

References Malnutrition & Cachexia:
1) Bruggeman AR et al. Cancer cachexia: Beyond weight loss. J Oncol Pract. 2016;12(11):1163-1171.
2) Van Cutsem E, Arends J. The causes and consequences of cancerassociated malnutrition. Eur J Oncol Nurs. 2005;9 Suppl 2:S51-S63.
3) Climent M et al. Weight Loss and Quality of Life in Patients Surviving 2 Years after Gastric Cancer Resection. European Journal of Surgical Oncology (EJSO) 2017.pii: S0748-7983(17)30337-2.
4) Takayama et al. Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients—Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study. Support Care Cancer 2016;24(8):3473-3480
5) Odelli C et al. Nutrition support improves patient outcomes, treatment tolerance and admission characteristics in oesophageal cancer. Clin Oncol. 2005;17(8):639-645.
6) Arrieta O et al. Nutritional status, body surface, and low lean body mass/body mass index are related to dose reduction and severe gastrointestinal toxicity induced by afatinib in patients with non-small cell lung cancer. Oncologist 2015;20(8):967-974.
7) Caro MM et al. Nutritional intervention and quality of life in adult oncology patients. Clin Nutr. 2007;26(3):289-301.
8) Pronovost PJ et al. How can clinicians measure safety and quality in acute care? Lancet. 2004;363(9414):1061-7.    
9) Fearon K et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489-95.
10) Arends J et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017; 36(1): 11-48.
 
References Mangage the symptoms:
1)  Hebuterne X et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014;38(2):196-204.
2)  Dewys WD, Begg C, Lavin P, Band PR, Bennett JM, Bertino JR, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69(4):491-7. 
3) MUSCARITOLI, M et al. Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study. Oncotarget 2017; 8(45): 79884.
4) Arends J et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. 
5) Elia M et al. Enteral (oral or tube administration) nutritional support and eicosapentaenoic acid in patients with cancer: a systematic review. Int J Oncol. 2006;28(1):5-23.
6) Isenring EA et al. Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. J Am Diet Assoc. 2007;107(3):404-12.
7) Burden ST et al. An unblinded randomised controlled trial of preoperative oral supplements in colorectal cancer patients. J Hum Nutr Diet. 2011;24(5):441-8. 
8) Lee H et al. Effect of oral nutritional supplementation on weight loss and percutaneous endoscopic gastrostomy tube rates in patients treated with radiotherapy for oropharyngeal carcinoma. Support Care Cancer. 2008;16(3):285-9. 
9) Murphy RA et al. Supplementation with fish oil increases first-line chemotherapy efficacy in patients with advanced nonsmall cell lung cancer. Cancer. 2011;117(16):3774-80.