Nutrition in Oncology: Overcoming Challenges to Optimize the Patient Journey from Prehabilitation to Rehabilitation
Stanisław Kłęk, Alessandro Laviano, H. Chrostek, Diana Cárdenas
Abstract
Patients with cancer are likely to be more malnourished than patients treated in other specialties, with many remaining at high nutritional risk prior to surgery or medical treatment. Malnutrition in patients with cancer can result in suboptimal clinical outcomes, and is linked to post-operative complications and reduced mortality, along with increased dose-limiting and treatment side effects. In addition, many medical treatments have gastrointestinal side effects which can further compromise the nutritional status of the patient. However, early patient assessment and proactive management of malnutrition using medical nutrition can have a positive impact on a patient’s physiological parameters and functional status, while helping to support their metabolic and dietary needs during their cancer journey. A European Masterclass for Nutrition in Oncology which brought together 50 practitioners, took place on 10–11 October 2024 in Prague, Czech Republic, and aimed to provide an overview of nutrition as the cornerstone of cancer treatment, the use of nutritional prehabilitation in surgery and medical oncology, and optimization of the patient journey with nutrition, including rehabilitation. This paper provides a summary of the content presented, along with insights gained from attendees during four interactive workshop sessions. Many patients with cancer are in a poor functional state, and their diets may not contain sufficient nutrients or their disease may reduce absorption and utilization of food, which can lead to an increased risk of malnutrition. If a cancer patient has malnutrition or is at risk of developing malnutrition, this can make it more difficult for them to withstand the stress of surgery, if required, and lead to a higher chance of post-surgical complications and a shorter than expected survival. In addition, those patients with cancer and malnutrition or at a high risk of malnutrition also find it more difficult to tolerate medical treatments, which often have gut-related side effects, which can lead to the need for the use of less effective reduced treatment doses. Early assessment of patients with cancer and a proactive approach to managing malnutrition, when identified, can help to improve their functional status and nutritional needs during their cancer journey. A meeting of 50 European practitioners, which took place on 10–11 October 2024, in Prague, Czech Republic, explored nutrition as an essential part of cancer treatment. The use of nutritional prehabilitation (dietary support prior to surgery and prior to/during medical treatment) and rehabilitation (dietary support after surgery or medical treatment) were discussed. This paper provides a summary of the content presented during the meeting, along with insights gained from attending practitioners during four interactive workshop sessions.