Oncology
Advancing nutritional care in oncology to prevent nutritional deficits, improve quality of life and enable completion of anti-cancer treatment.
Malnutrition and weight loss is prevalent in cancer patients, not only because of the disease per se, but also due to the anti-cancer treatment they receive.1-4 Still, malnutrition often remains overlooked and even if diagnosed, is untreated in about 50% of cases.4
Up to ~70%
of cancer patients may be malnourished1
>80%
of cancer patients may not achieve recommended protein and energy intake by the oral route5
~40%
of cancer patients may not achieve recommended protein and energy intake by the enteral route6
1.3-1.7x
higher likelihood of treatment modification in cancer patients with weight loss7
Muscle loss is associated with increased mortality and impairs treatment tolerance
Malnutrition and weight loss in cancer patients is primarily due to loss of skeletal muscle and is associated with increased morbidity and mortality.2-3 Also, weight loss reduces patient tolerance to systemic anti-cancer therapies. Consequently, treatment may need reactive modification which can further deteriorate treatment outcome.7
• A loss of 30% total lean body mass is associated
with a 50% mortality rate8
• Research suggests approximately 20-30% of
cancer patients may die due to consequences of
malnutrition rather than cancer itself4
Why is clinical nutrition important in oncology?
Early intervention to prevent cancer-related weight loss is recommended
Weight loss normally occurs early in the cancer disease process. It is often the first presenting symptom and more than half of patients without metastases experience weight loss by the time of their first oncology visit.1,2 Interventions should therefore be initiated early to prevent excessive deficits.3 ESPEN and ASPEN guidelines recommend early screening via validated nutrition screening tools for nutritional risk and loss of skeletal mass in patients with cancer and nutritional intervention in malnourished patients.3,9
Supplemental parenteral nutrition may improve cancer patient care
Sufficient nutrient intake via oral, oral nutrition supplement (ONS), enteral nutrition and/or parenteral nutrition is key to limiting weight and muscle loss in cancer patients.3 Timely nutritional intervention is associated with improved clinical outcomes in malnourished patients10,11 including a reduced risk of chemotherapy toxicity7,12 and improved survival.13-15 Supplemental PN may provide important clinical and quality of life benefits to cancer patients at risk of malnutrition.16
• 60% of cancer patients had an improved health-related quality of life after receiving PN therapy17
• 66% of cancer patients had an improved physical well-being after receiving PN therapy17
• 52% of cancer patients had an improved functional well-being after receiving PN therapy17
Ready-to-use three-chamber bag (3CB) PN solutions are suitable for homecare and support a safe delivery of PN therapy18,19 as recommended by international guidelines for patients receiving home PN.20 Baxter’s portfolio of ready-to-use 3CB PN solutions provide a broad range of formulations including a high protein option to meet the protein needs of cancer patients while minimizing the levels of glucose and fluid delivered.3,21,22
Home PN should be prescribed to prevent an earlier death from malnutrition in advanced cancer patients with chronic intestinal failure, if their life expectancy related to the cancer is expected to be longer than one to three months, even in those not undergoing active oncological treatment.