Malnutrition and Weight Loss in Cancer

Cancer and its treatment can have a profound effect on a patient’s nutritional status due to biochemical changes, such as an increase in metabolism and inflammation, or as a result of the cancer hindering the digestive system’s ability to properly absorb nutrients.    Treatment side effects can further impact nutritional status by impeding patients’ ability to consume whole food.  All of these factors can result in weight loss and malnutrition.

 

Body Mass is Important Going into Cancer

Weight loss is classified as malnutrition if it is accompanied by inadequate caloric intake, decreased muscle mass, decreased strength, and/or fluid retention.  Malnutrition is present in 50% to 80% of cancer cases and is the most common secondary diagnosis of cancer patients.   Severe malnutrition, known as cachexia or wasting, is the cause of 30% of all cancer deaths [i].

It is important for cancer patients and caregivers to proactively focus on preventing weight loss and malnutrition, beginning at the time of diagnosis, because both result in poor outcomes and, importantly, because both are hard to reverse.   Malnutrition and weight loss result in reduced immune response, increased treatment toxicity, greater and more severe side effects, diminished quality of life, increased length of hospital stay and reduced survival [ii][iii].

Prevention and treatment of malnutrition and weight loss should involve consultation with a Registered Dietitian who specializes in oncology nutrition (CSO).  A CSO can recommend foods, beverages, meal plans and supplements that will provide adequate nutrients and calories for your specific metabolic and caloric needs and help manage nutrition impact symptoms through diet.  It is important to also consult with your oncologist.

 

References
[i] Palesty, J.A., Dudrick, S.J. (2004). Dig Dis, (21)3: 198-213.

[ii] Holder D. (2003). British Journal of Nursing, 12(11): 667-8, 670, 672-4.

[iii] Bosaeus, I. (2008.) Support Care in Cancer, 16(5): 447-51.
[iv] A.S.P.E.N. Malnutrition Task Force and and the A.S.P.E.N. Board of Directors Jane V. White, Peggi Guenter, Gordon Jensen, Ainsley Malone, Marsha Schofield, Academy Malnutrition Work Group (2012). Consensus Statement Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition): Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr.  36: 275.

 

Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

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