Characteristics of malnutrition in malignant cancer patients
Year: 2024
Type: article
Abstract: Cancer-associated malnutrition, affecting 60% to 80% of cancer patients, is a critical determinant of the high mortality rate, contributing to nearly 8.9 million annual cancer deaths. Unlike traditional malnutrition, cancer-associated malnutrition arises from metabolic alterations induced by the tumor or its treatment, including inflammation, excess catabolism, and anabolic resistance. These changes impair the effectiveness of conventional nutrition therapy by reducing nutrient utilization and are marked by significant skeletal muscle loss and nutrition impact symptoms (NIS), such as anorexia, nausea, and vomiting, which further limit food intake. Managing this condition requires a multi-disciplinary approach, involving oncologists, dietitians, gastroenterologists, and palliative care doctors, alongside the establishment of specialized cachexia clinics to address the complex needs of these patients. The prevalence of malnutrition varies, influenced by tumor type, disease stage, and clinical setting, with hospitalized patients showing higher rates. This underscores the importance of targeted nutritional therapy to improve outcomes. Cancer patients often experience increased resting energy expenditure (REE), further complicating nutritional support. Additionally, the interplay between physiological and psychological stress and cancer highlights the complex relationship between stress, tumor growth, survival, and malnutrition, emphasizing the role of chronic low-grade irreversible inflammation in cancer progression and the ineffectiveness of nutritional interventions in the presence of systemic inflammation. Systemic inflammation and malnutrition are linked to poorer clinical outcomes, with significant weight loss or low body mass index (BMI) associated with an increased risk of infections and decreased survival rates, especially in patients with advanced cancer or those undergoing significant surgeries. Addressing the direct and indirect effects of cancer on nutrition is paramount for enhancing patient outcomes and optimizing cancer treatment responses. This complex scenario places nutritional science at the forefront of therapeutic advancements, highlighting the critical role of dietetics in oncology care and underscoring the necessity for comprehensive nutritional and metabolic support as part of cancer management strategies.
Source: Precision Nutrition
Authors: Qi Zhang, Mengmeng Song, Xi Zhang, Tong Liu, Chenan Liu, Ziwen Wang, Meng Tang, Chunhua Song, Xiaowei Zhang, Minghua Cong, Liuqing Yang, Chinese Society of Nutritional Oncology
Institutions: Yale University, Zhejiang Cancer Hospital, University of California, San Francisco, Capital Medical University, Chinese Academy of Medical Sciences & Peking Union Medical College, Xuan Wu Hospital of the Capital Medical University, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing Shijitan Hospital, Chinese People's Liberation Army, Zhengzhou University
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415477608