8 The aetiology and management of weight loss and malnutrition in cancer patients

The impact of clinical nutrition on cancer therapy: a frequently underestimated perspective. A complementary approach to cancer patients

“…Inversely related to prognosis, malnutrition causes a worsening in the quality of life, with an increase of morbidity and mortality [3, 4]. In a reasonable percentage of neoplastic patients, the first cause of death seems to be due more to a metabolic-nutritional unbalance than to the disease itself [5].…”

The Sir David Cuthbertson Medal Lecture 1992

“…In surgical practise the consequences of malnutrition (both obesity and undernutrition) are only too familiar to most clinicians. For example, many authors have reported diminished immunity, poor wound healing and reduced voluntary muscle activity in undernourished patients (Von Meyenfeldt et al 1988;Windsor & Hill, 1988;Wan et al 1989). Studley (1936) first showed this to represent a significant risk to the surgical patient, and since then many other authors have confirmed the relationship between undernutrition and increased surgical morbidity, and even mortality (Conti et al 1977;Muller e l al.…”

“…A possible explanation of these findings is that nutritional support may actually enhance tumour growth. Studies have been difficult to perform in man, but using techniques such as ultrasound and conventional radiology to measure tumours it has not been possible to demonstrate any effects of feeding on tumour growth (Nixon et al 1981;Von Meyenfeldt et al 1988). Based on such findings some reviewers have suggested that tumours are autologous and do not respond to the provision of nutrients (Douglas & Shaw, 1990).…”

The use of alternate vertebral levels to L3 in computed tomography scans for skeletal muscle mass evaluation and sarcopenia assessment in patients with cancer: a systematic review

“…Malnutrition and involuntary weight loss are common in cancer patients and can often be attributed to the metabolic burden of the tumour itself with associated cachexia, and/or the toxicities of the treatment modalities used (1)(2)(3) . Recently, skeletal muscle mass (SMM) depletion has gained particular interest, with the use of various body composition methods to determine actual loss of lean tissue rather than total body weight alone (4) .…”