👤 Authors: J. Arends V. Baracos H. Bertz F. Bozzetti P.C. Calder N.E.P. Deutz N. Erickson A. Laviano M.P. Lisanti D.N. Lobo D.C. McMillan M. Muscaritoli J. Ockenga M. Pirlich F. Strasser M. de van der Schueren A. Van Gossum P. Vaupel A. Weimann
ESPEN Expert Group Recommendations for Action against Cancer-related Malnutrition
The ESPEN guidelines on cancer cachexia offer a comprehensive approach to understanding and managing cancer cachexia. Key recommendations are:
- Definition and Diagnosis: Cachexia in cancer is characterized by a multifactorial syndrome involving weight loss, muscle atrophy, and a decline in physical function, impacting the quality of life and survival rates of patients.
- Prevalence and Impact: Malnutrition and cachexia affect a significant portion of cancer patients, influencing both treatment outcomes and survival. Estimates suggest that malnutrition can contribute to the deaths of 10-20% of cancer patients.
- Underdiagnosis and Management Challenges: Many cases of malnutrition and cachexia in cancer patients remain undiagnosed or underestimated, leading to inadequate management. This is compounded by a lack of robust nutritional support in clinical settings.
- Comprehensive Nutritional Strategy:
- Early Screening: All cancer patients should be screened for nutritional risks early in their treatment regardless of their initial body mass index or weight history.
- Multi-dimensional Assessment: This includes not just weight and BMI but also anorexia, body composition, inflammatory biomarkers, resting energy expenditure, and physical function.
- Multimodal Interventions: Nutritional care plans should be personalized, focusing on enhancing nutritional intake, reducing inflammation, managing metabolic stress, and improving physical activity.
- Implementation of Guidelines: The guidelines emphasize the necessity of integrating these strategies into routine cancer care, advocating for a proactive stance on nutritional support to improve patient outcomes.
- Research and Education: There is a highlighted need for continued research into the mechanisms of cachexia and the development of effective treatments, alongside better education for healthcare providers on the importance of nutritional care in cancer management.
These guidelines aim to shift the clinical approach towards a more proactive, multidisciplinary management of cancer cachexia, recognizing its critical impact on patient outcomes.
