DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS Nutrition support, provided by RDs or RDNs, has been seen as essential in improving the prognosis, reducing treatment-related toxicity, and enhancing overall quality of life.
The implications of malnutrition in cancer patients range from a reduced response to treatment to increased mortality. Research indicates that malnutrition may impact 30% to 85% of patients, contributing to 10% to 20% of deaths among them. Strategies for prevention and treatment are presented through a combination of nutritional interventions and ongoing support.
Key Points:
- Malnutrition may affect 30% to 85% of cancer patients, accounting for 10% to 20% of deaths.
- Prevalence of malnutrition is particularly high in certain types of cancers including upper gastrointestinal, head and neck, lung, and colorectal cancers.
- The National Cancer Institute recommends standard nutrition screening and assessments for all cancer patients.
- Nutritional interventions have been proven to enhance the success of cancer treatment, reduce toxicity, decrease hospital stays, and improve survival and quality of life.
- Addressing malnutrition requires collaboration between dietitians and oncology treatment teams, including individualized dietary plans based on a patient’s specific needs.
- Challenges include RD/RDN understaffing, insurance coverage barriers, and the need for increased cultural competency within the dietetics profession.
Additional Points:
- Pediatric cancer patients require specialized dietary planning to maintain growth and address potential long-term nutritional side effects.
- Dietitians must consider social determinants of health and cultural circumstances in nutritional planning.
- Telehealth and removing cost barriers are strategies to increase patient access to essential nutrition therapy services.
- Dietitian-to-patient ratio in outpatient cancer centers is inadequate (1:2,308), whereas 1:120 would be needed.
Conclusion:
- Addressing malnutrition in cancer patients requires comprehensive assessment, tailored interventions, collaboration across the care team, and overcoming existing barriers such as staffing and insurance coverage. The focus must also extend to cultural competency and special considerations, such as pediatric care and social determinants of health.
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“While chemotherapy, radiation therapy, and many medications used in cancer care result in side effects that are catabolic to the body, food and fluids rebuild the body, readying it to receive the next step of treatment.”
Julie Bosworth, RD, LDN
Senior Dietitian on the Nutrition Services Team
Dana-Farber Cancer Institute in Boston