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Oncology nutrition assessment and medical nutrition therapy

Nutrition screening means weighing every patient, asking a few screening questions, and referring those at risk to a dietitian. It is simple, guideline-endorsed, and still not done routinely.

Malnutrition affects 20-70% of cancer patients depending on site and stage and independently predicts treatment toxicity, complications, hospital stay and death. ESPEN (2017, 2021) and ASCO (2020) recommend screening all patients at diagnosis and at intervals with a validated tool (MUST, NRS-2002, MST or PG-SGA), followed by assessment of intake, body composition, inflammation and function, and stepwise medical nutrition therapy: dietary counselling, oral nutritional supplements, then artificial nutrition when oral intake fails. Randomised evidence is strongest for dietitian counselling in head and neck and gastrointestinal cancers, where it improves intake, weight and treatment completion. The EFFORT trial in general medical inpatients (Lancet 2019) showed individualised nutrition support reduced mortality, with a cancer subgroup consistent with the overall effect.

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How it works

Screen early, before weight loss becomes irreversible; treat the reversible causes (nutrition impact symptoms, inflammation, inactivity) and match support to the patient's prognosis and goals.

Strengths
  • Cheap, validated screening tools
  • Guideline consensus across ESPEN, ASCO, ESMO
  • Improves treatment completion in head and neck and GI cancers
Limitations
  • Screening rates in routine care are low
  • Dietitian workforce is thin outside large centres
  • Weight gain does not always mean better survival

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Query for this technology: (TITLE:"Oncology nutrition assessment and medical nutrition therapy" OR ABSTRACT:"Oncology nutrition assessment and medical nutrition therapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Oncology nutrition assessment and medical nutrition therapy, not a curated reading list.

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