Protein calorie malnutrition, nutritional intervention and personalized cancer care

Abstract

Cancer patients often experience weight loss caused by protein calorie malnutrition (PCM) during the course of the disease or treatment. PCM is expressed as severe if the patient has two or more of the following characteristics: obvious significant muscle wasting, loss of subcutaneous fat; nutritional intake of <50% of recommended intake for 2 weeks or more; bedridden or otherwise significantly reduced functional capacity; weight loss of >2% in 1 week, 5% in 1 month, or 7.5% in 3 months. Cancer anorexiacachexia syndrome (CACS) is a multifactorial condition of advanced PCM associated with underlying illness (in this case cancer) and is characterized by loss of muscle with or without loss of fat mass. Cachexia is defined as weight loss of more than 5% of body weight in 12 months or less in the presence of chronic disease. Hence with a chronic illness on board even a small amount of weight loss can open the door to cachexia. These nutritional challenges can lead to severe morbidity and mortality in cancer patients. In the clinic, the application of personalized medicine and the ability to withstand the toxic effects of anti-cancer therapies can be optimized when the patient is in nutritional homeostasis and is free of anorexia and cachexia. Routine assessment of nutritional status and appropriate intervention are essential components of the effort to alleviate effects of malnutrition on quality of life and survival of patients.

Zoledronic Acid Improves Muscle Function in Healthy Mice Treated with Chemotherapy

“…There have been numerous studies addressing nutritional deficit as a contributing factor of weight loss in patients with cancer. (75) There are no specific, defined, nutritional interventions for patients with advanced cancer undergoing chemotherapy treatment, and nutritional supplementation can increase fat mass but not muscle mass in patients with advanced cancer cachexia. (76) Although there is currently a clinical trial to address nutritional intervention in patients receiving chemotherapy treatment with whole-body protein synthesis as an outcome measure (https:// clinicaltrials.gov/ct2/show/NCT01871350), nutritional supplementation alone may not be adequate to prevent chemotherapy-induced cachexia-like symptoms.…”

Adverse impact of malnutrition markers on major abdominopelvic cancer surgery

“…Thus, the association observed between low albumin and adverse outcomes could be driven by factors other than malnutrition. Furthermore, there is also a co‐existing systemic inflammatory process seen in cancer patients may be playing a role in the observed discordance in nutritional parameters and outcomes . It is reported that up to 50% of patients have an acute‐phase protein response, including increased albumin, at the time of upper‐gastrointestinal cancer diagnosis .…”

Selected aspects of nutrition in palliative care

“…Cancer patients often suffer from protein-calorie malnutrition, which can lead to the loss of skeletal muscle and deterioration in the quality of life [6]. Proteins are important to develop and repair body tissues and are involved in the production of some hormones and enzymes.…”