Background

As many as 80% of people with cancer experience malnutrition. Malnutrition, a condition caused by not getting the right balance of nutrients such as protein, vitamins, and minerals, can interfere with cancer treatment and increase the risk of complications, hospitalizations, and death.

Cancer and cancer treatment can have nutrition-related side effects like nausea, appetite and taste changes, and fatigue and make it hard for people with cancer to eat well and absorb nutrients from food. People who have upper gastrointestinal tract, head, neck, lung, blood, gynecological, or colorectal cancers are more likely to experience nutrition problems. People with cancer who have excess weight or obesity are also at greater risk for complications related to poor nutrition.

Cancer-associated malnutrition may be preventable. Studies have shown that interventions like medical nutrition therapy can help people with cancer keep a healthy body weight, maintain strength, respond to cancer treatment, and have a better quality of life.

Challenges

While malnutrition is common among people with cancer, nutritional screening and interventions are not standard parts of outpatient cancer care in the United States. There are no national clinical guidelines to prevent or treat cancer-associated malnutrition before or during cancer treatment, and currently there is a lack of high-quality evidence about how nutritional interventions affect cancer health outcomes. Health care providers and decision-makers need high-quality research on cancer-associated malnutrition screening, nutritional support and therapies, and a comprehensive review of the evidence to inform development of clinical guidelines for preventive care.

Key Questions

Guided by the key questions listed below, speakers in this P2P workshop will assess the scientific evidence on how nutritional interventions affect cancer health outcomes. After the workshop, an independent panel will draft a report on evidence gaps and identify priorities for future research.

• What is the effect of nutritional interventions before cancer treatment in preventing negative treatment outcomes (e.g., effects on dose tolerance, need for hospital care, and survival) in adults diagnosed with cancer who have or are at risk for cancer-associated malnutrition?
• What is the effect of nutritional interventions during cancer treatment in preventing negative treatment outcomes in adults diagnosed with cancer who have or are at risk for cancer-associated malnutrition?
• What is the effect of nutritional interventions on symptoms (e.g., fatigue, nausea and vomiting, appetite, physical and functional status, and quality of life) in adults who will be or are undergoing cancer treatment?
• In adults affected by excess weight or obesity, what is the effect of intentional weight loss before or during cancer treatment in preventing negative treatment outcomes?
• Are nutritional interventions for preventing negative outcomes of cancer treatment cost-effective? What evidence is needed to make the business case for providing nutritional intervention services in outpatient cancer centers?

Sponsoring Organizations

• National Cancer Institute
• National Institute on Aging
• NIH Office of Nutrition Research
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• NIH Office of Dietary Supplements
• NIH Office of Disease Prevention