ESMO recommends nutritional care as integral part of oncology practice

“Nutritional care is important for patients because they really are stressed by anti-cancer treatments and we know that supporting body resources has an impact on clinical outcomes and quality of life of these patients.”
Dr. Jann Arends, Hematologist-Oncologist; Lead author of ESMO guidelines; Head of Nutrition Group German Oncology Society

Cancer-related malnutrition impacts patient outcomes

People with cancer are at high risk of becoming malnourished, with around 1 in 3 patients affected1. Malnutrition has a negative impact on clinical outcomes and mortality in cancer patients. It is associated with shorter survival, poor quality of life and performance status, impaired immune function, increased treatment-related toxicities, as well as increased post-surgical complications2-4. It has also been associated with longer hospital stays and costs of stay5.

Nutricia adult oncology female patient

Malnutrition is highly prevalent in head and neck cancers and those affecting the  GI system10-11, cancer-related weight and muscle loss (cachexia) can be present at diagnosis (due to the tumor itself) and can worsen along the patient’s clinical journey. Anti-cancer treatments particularly can cause nausea and taste changes, with a resulting loss of appetite.

Malnutrition is underdiagnosed and undertreated

Although malnutrition in cancer patient is highly prevalent and can have serious implications for the success of treatment and subsequent recovery, there is work to be done in getting the condition to be recognized and managed as part of day-to-day clinical practice. 

Nutritional management

Watch the video with Dr. Jann Arends, Hematologist-Oncologist; Lead author of ESMO guidelines, to learn more on why the new ESMO cachexia guidelines are important for treating cancer patients.

There is an increasing focus on nutrition from societies and patient associations, and clinical guidelines are available (ESPEN, ASCO & other national societies)[6-9].

Whilst recent positioning papers and clinical guidelines aim to raise awareness of malnutrition and provide guidance to clinicians specializing in cancer care (for example, routine nutritional counselling), implementation of nutritional care in clinical practice remains one of the main challenges.

ESMO launches new clinical guidelines for management of cachexia

European Society for Clinical Oncology (ESMO - one of the leading global oncology societies - has taken the initiative to develop a set of guidelines on the management of cachexia in adult cancer patients, with the aim of improving cancer care and providing a tool for the clinical management of malnutrition in cancer patients.

As part of their new guidelines, ESMO endorses implementation of nutritional management as integral part of cancer care and provides recommendations for identification, prevention and treatment of reversible elements of malnutrition in adult cancer patients. They also recommend nutritional intervention to support clinical outcomes during anti-cancer treatment, stating that they should be an integral part of cancer care, from the time of diagnosis onwards.

“The objective of these guidelines in the end is to really alert the clinical oncology community, to understand the complex pathophysiology of cancer cachexia, what is going on in their patients, what are the standard recommendations to handle these problems, to screen patients, to diagnose patients, to treat patients and to prevent it in an easily understandable fashion.”
Dr. Jann Arends, Hematologist-Oncologist; Lead author of ESMO guidelines; Head of Nutrition Group German Oncology Society

Full ESMO publication

ESMO recommends nutritional care as integral part of oncology practice. Click below button to get access to the full ESMO publication.

To full ESMO publication

The ESMO guidelines

“To support patients not losing body resources, nutrition needs to be standard and central component of supportive care, accompanying every anti-cancer treatment.” Dr. Jann Arends, Hematologist-Oncologist; Lead author of ESMO guidelines; Head of Nutrition Group German Oncology Society

Watch the video with Dr. Jann Arends to learn more on the objective of the new ESMO cachexia guidelines and how the guideline can help you in managing malnourished cancer patients  

The role of Nutricia

Nutricia supports the implementation of the guidelines in clinical practice and provides an easy, guideline-based roadmap (tool) to facilitate this. Nutricia also provides educational materials aiming to help improve oncologists ability to screen, assess and manage malnourished patients. Nutritional care improves patient’s outcomes and quality of life12. Hear experts’ perspectives on the importance and benefits of nutritional care for cancer patients 

News article on ESMO guidelines

The European Society for Clinical Oncology (ESMO) launches new clinical guidelines for management of cancer cachexia. ESMO published guidelines on the management of cachexia in adult cancer patients in order to improve cancer care and provide healthcare professionals with a tool for the clinical management of malnutrition in cancer patients.

Find out more

Cancer and weight loss

Keeping physically strong during cancer can be tough; the side effects of the disease and its treatment can take a toll on the body, negatively affecting appetite, the way we taste food and even the way our body absorbs nutrients. For many cancer patients (30-80%[16]) this leads to weight loss. Importantly, the majority of the weight lost by cancer patients is muscle[17] – or ‘lean body mass’ – the protective tissue needed to keep the body strong and withstand treatment [18-20].

Find out more

  1. Pressoir M, et al. Br J Cancer. 2010;102(6):966-71. Currow et al, 2018 Ann Oncol; 29(5):1090-1091
  2. Chen Y, et al. World J Gastroenterol. 2011;17(13):1779–86, http://dx.doi.org/10.3748/wjg.v17.i13.1779.
  3. van der Meij BS, et al. J Nutr. 2010;140(10):1774 80, http://dx.doi.org/10.3945/jn.110.121202.
  4. Paccagnella A, et al. [missing citation]
  5. Hughes BG, et al. Head Neck 2013;35(3):436–42, http://dx.doi.org/10.1002/hed.22992.
  6. Rauh S, et al. ESMO Open. 2018;3(4):e000345.
  7. Arends J, et al. Clin Nutr. 2016;36(1):11-48.
  8. Arends J et al, Clin Nutr. 2017;36(5):1187-96.
  9. Roeland EJ, et al. Management of Cancer Cachexia: ASCO Guideline [published online ahead of print, 2020 May 20]. J Clin Oncol. 2020;JCO2000611. doi:10.1200/JCO.20.00611.
  10. Pressoir et al, 2010 Br J Cancer. 16;102(6):966-71
  11. Hebuterne et al, 2014 JPEN J Parenter Enteral Nutr.;38(2):196-204
  12. Sánchez-Lara et al. Nutr Cancer. 2012;64(4):526-534

 

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