Why is it important to monitor body weight in cancer patients?
- davorkust
- Aug 1
- 4 min read
Updated: Aug 4
Author: Sandra Krstev Barać, Master of Nutrition
The body weight of oncology patients is a very important parameter in monitoring the development of the disease, which undoubtedly affects the outcome of treatment. Unintentional weight loss is often one of the first signs of the disease, noticeable even before the diagnosis is made, and it is known that even a small weight loss (less than 5% of body weight) before the start of treatment can negatively affect the outcome and tolerance of treatment, as well as the quality of life.
Unfortunately, weight loss, as well as poor nutritional status in general, is a frequent "companion" of the course of malignant diseases and their therapy. The frequency of weight loss depends on the type of malignant disease, but it is known that patients with lung and digestive system cancer (esophagus, stomach, colon, rectum, liver and pancreas) are at the highest risk of unwanted weight loss.
In addition to shortening survival time and reducing quality of life, malnutrition also compromises functional status, which further contributes to the burden of the disease. It is desirable to assess the risk of malnutrition at the time of diagnosis.
An additional problem is the fact that in some patients, as the disease progresses, the loss of body mass and fat tissue is accompanied by the loss of muscle tissue (up to 80% of all body stores) and the presence of severe systemic inflammation. Such physical deterioration is called tumor cachexia syndrome and significantly affects the treatment process itself as well as the survival rate. Although it does not occur in all patients, the incidence of tumor cachexia is high, and the fact that it is the main cause of death in one fifth of oncology patients is devastating.
Given the complexity of the problem itself, and in order to optimize treatment, it is extremely important to start assessing the risk of malnutrition in patients at the time of diagnosis and to regularly reevaluate the nutritional status, even after specific oncology treatment has been completed. The patient himself can already notice some of the negative changes, but it is an educated expert who, based on the examination, anamnestic data, laboratory findings, anthropometric measurements and measurements of basal metabolism and body composition, makes an assessment of the patient's nutritional status.
The importance of cooperation with a nutritionist in oncological treatment
If malnutrition, tumor cachexia and anorexia are recognized early enough, much can be done in terms of nutrition to prevent or at least alleviate further weight loss and the development of malnutrition. The first step is, in fact, dietary counseling with a nutritionist who creates a diet program tailored to the patient and their condition, age and severity of the disease.
A personalized approach is extremely important here because, in the case of oncological diseases where each tumor is specific, the rule "one dietary therapy fits all" does not apply. An individual approach to the patient and cooperation with him in choosing appropriate foods that he tolerates well, helps maintain adequate muscle mass and can improve the outcome of treatment.
When to use oral replacement preparations
In cases where a balanced diet is not sufficient to maintain nutrition, oral replacement preparations are used, which are prescribed to patients by a doctor as needed. These are so-called enteral preparations that are taken orally and provide an additional source of nutrients. The first choice when applying nutritional support in most oncological patients is the selection of high-protein preparations that provide an increased intake of 2.2 g of EPA (eicosapentaenoic fatty acid from the group of omega 3 fatty acids) per day.
It should be emphasized that such preparations do not replace a standard diet, they are only a means to provide additional energy, proteins and other necessary micronutrients, and when applied in a timely manner, they help maintain an appropriate diet, which can improve the therapeutic outcome. In cases where oral intake of food is not possible, but the digestive system is functional, enteral nutrition is applied via a tube or stoma, while partial or complete parenteral nutrition, where specially prepared preparations are applied directly into the circulatory system, is reserved for patients who cannot take food by mouth, cannot tolerate enteral nutrition and have damage to the digestive system.
A proper, balanced diet is important for every individual, but it is especially important for cancer patients. The course of treatment and recovery depends largely on the patient's nutritional status, and with appropriate nutrition it is possible to alleviate unpleasant side effects of therapy, accelerate recovery and improve quality of life. One of the important steps in the treatment of malignant diseases is consulting with an educated nutritionist whose role is not only to assess the nutritional status and risk of malnutrition, but also to help the patient adjust their diet and make informed decisions.
References
1. Arends J et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. 2. Ravasco P. Nutrition in Cancer Patients. J Clin Med. 2019 14;8(8). 3. Marian M, Roberts S. (2010) Clinical Nutrition for Oncology Patients, Sudbury, Massachusetts: Jones and Bartlett Publishers 4. Thompson KL, Elliott L, Fuchs-Tarlovsky V, Levin RM, Voss AC, Piemonte T. Oncology Evidence-Based Nutrition Practice Guideline for Adults. J Acad Nutr Diet. 2017;117(2):297-310. 5. Emenaker N.J., Vargas A.J. Nutrition and Cancer Research: Resources for the Dietetics Professional. J Acad Nutr Diet. 2018; 118(4): 550–554. 6. Krznarić, Ž et al. Hrvatske smjernice za primjenu eikozapentaenske kiseline i megestrol-acetata u sindromu tumorske kaheksije. Liječnički vjesnik, 129 (2007), 12; 381-386.
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