ESPEN guidelines on nutrition in cancer patients
- Study type
- Clinical guideline
- Study name
- ESPEN Nutrition in Cancer 2017
- Design
- Evidence-based clinical guideline; clinical questions in PICO format, with evidence appraisal and recommendation development by the GRADE method
- Source
- Clinical Nutrition · 2017
In plain words
Weight loss, muscle weakness and malnutrition are common in people with cancer and can make treatment and its results worse. According to this guideline, every patient should be checked regularly for the risk of malnutrition and, if needed, receive step-by-step nutritional support, from advice on eating to feeding through a drip. Exercise should go hand in hand with nutritional care, and cancer survivors should also stay physically active on a regular basis and eat a sensible diet.
Key guideline recommendations
- Grade not stated in the abstract
For screening, prevention, detailed assessment, monitoring and treatment of malnutrition, standard operating procedures, responsibilities and a quality control process should be established in every institution involved in treating patients with cancer.
- Grade not stated in the abstract
All patients with cancer should be screened regularly for the risk or presence of malnutrition.
- Grade not stated in the abstract
In all patients except those in end-of-life care, energy and substrate requirements should be met by offering nutritional interventions in a stepwise manner, from counselling to parenteral nutrition. The benefits and risks of nutritional interventions should be weighed, with special attention in patients with advanced disease.
- Grade not stated in the abstract
Nutritional care should always be combined with exercise training.
- Grade not stated in the abstract
Cancer survivors should engage in regular physical activity and adopt a prudent diet.
Study population
Adults with cancer. This guideline was developed for the multidisciplinary teams responsible for identifying, preventing and treating the reversible aspects of malnutrition in adult cancer patients.
Endpoints
This document is a clinical guideline and has no trial endpoint. It focuses on screening, prevention, detailed assessment, monitoring and treatment of malnutrition and loss of muscle mass in patients with cancer.
Safety and side effects
The abstract gives no adverse event statistics. It only stresses that the benefits and risks of nutritional interventions should be weighed against each other, which is especially important in patients with advanced disease.
Clinical significance and place in guidelines
This guideline provides a framework for multidisciplinary teams: regular malnutrition screening in all cancer patients, standard operating procedures and quality control in treatment centres, stepwise nutritional support and its combination with exercise training. According to the abstract, the available evidence is limited and open questions need to be addressed in future studies. The standing of this guideline relative to other clinical guidelines and more recent ESPEN versions should be checked separately.
Limitations
Because of the scarcity of available evidence, relevant open questions are listed and should be addressed in future studies. The abstract states that only a few pharmacological and pharmaconutrient agents, with limited effect, are available to counter malnutrition in advanced cancer. This guideline dates from 2017, and details of the level of evidence and strength of each recommendation are in the full text.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.