Malnutrition in oncology – an underestimated risk?

Every year, millions of people fall ill with tumors all over the world. Many tumor patients suffer from malnutrition. A study from DeWys et al. from 1980 was able to prove that 31-87 % of tumor patients had already been subject to weight loss at the moment of diagnosis. Newer studies show that approximately half of the patients in oncological treatment are malnourished. The amount of affected patients is strongly dependent on the type of tumor and how advanced the illness is. Tumor diseases of the higher intestinal tracts and tumors in advanced stages are more likely to cause profound weight loss. Aside from the actual disease and therapy, malnutrition is believed to be the cause of death for a quarter of the patients.

How is malnutrition defined?

In oncology, malnutrition is defined as unwanted weight-loss caused by illness (> 10 % of body weight in less than six months) accompanied by a respective clinical image and laboratory adverse changes.

Why does tumor-associated malnutrition occur?

The cause of malnutrition in cancer patients varies. A large number of tumor illnesses are associated with weight-loss. As the tumor growth consumes a great deal of energy and nutrients, influencing the functions of metabolism. For this reason, an observable consumption and pathological weight-loss (tumor cachexy) can occur even before a diagnosis has been made. Side effects of the illness and the therapy, such as nausea, absence of appetite and indigestion, can lead to additional impairment of ingestion and nutrient uptake.

Another possible reason for malnutrition, which is strongly criticized by experts, is the so called ‘cancer diet’. It promises to prevent or positively affect cancer growth by restricting the intake of calories and certain nutritional components. Scientists have so far not been able to prove this theory, and it is possible that it further promotes the development of nutrient deficiencies.

What are the consequences for tumor patients?

An inadequate nutrition status can reduce the therapy’s effectiveness and at the same time increase the therapy’s side effects. Malnutrition also impairs the quality of life and worsens the overall prognosis.

Which therapy options exist for malnutrition?

A correct diet is an important measure for supporting the cancer therapy. The nutrition status should be regularly evaluated and nutrition therapy should be initiated as quickly as possible. Generally, healthy and well-balanced nutrition is recommended. However, due to the large amount of different tumor types and their varying courses, nutrition therapy should always be individually planned according to the patient’s needs. Goals of the nutrition therapy are to improve the patient’s nutrition status and regeneration or preservation of the patient’s natural nutrient intake. Changes in the nutrition plan or patient’s eating habits can help resolve problems with attendant symptoms, such as loss of appetite and digestive discomfort. In the case of dysphagia or blocked passages, a liquid diet can also be used.

If oral nutrition is no longer possible, feeding tubes or parenteral nutrition can ensure nutrient intake. Feeding tubes transport the nutrition into the gastrointestinal tract while a parenteral nutrition delivers nutrients through an infusion directly into the blood. Even though nutrition can be essential for a successful therapy, it is too often the case that doctors neglect its value. Many clinics don’t offer regular screenings for malnutrition. For this reason, malnutrition will often remain undetected, especially in the early stages of the illness.

How can the seca mBCA contribute to an improved therapy?

Therapy and care for oncology patients is often very acute. With insufficient capacities, it is no surprise that additional tasks such as screenings of nutritional status are disregarded. The bioelectrical impedance analysis (BIA) can be of assistance here. Devices in the seca mBCA series are scientifically validated and suitable for clinical use. With the help of a seca mBCA the patient’s weight, body mass index (BMI) and the exact body composition is determined quickly and easily. Furthermore, the phase angle can offer important information about the patient’s health status.

Due to its user-friendly design, the seca mBCA can be employed for regularly screening of the entire nutrition status. For clinical use, the seca mBCA 515 and the mobile seca mBCA 525 can be used. Many tumor patients can benefit from a regular screening of their nutritional status. Malnutrition can be detected early and detrimental nutrition methods can be stopped. Improving the nutrition situation will prevent excessive depletion of body tissue, protect from infections, and enhance the patient's quality of life as well as positively influencing recovery from the disease.