“One in 3 patients with cancer is malnourished or at risk of malnutrition. The data comes from an observational study conducted in Italy on almost 2,000 patients and which showed that more than 50% had nutritional deficiencies, 9% even in a state of severe advanced malnutrition and 43% were at risk of malnutrition already at the time of first oncological visit. The highest incidence of malnutrition was found in patients with pancreatic (77.1%), gastroesophageal (69%), gastrointestinal (62.2%), colorectal (62.2%), respiratory tract tumors (59.6%) and test-neck (48.4%) “. He reported it Paolo Bossi, oncologist and associate professor of medical oncology at the University of Brescia, speaking at the online presentation of the new “Consensus Document – The management of cancer patients with nutritional problems” promoted by NHSc (Nestlé Health Science).
“The patient with metastases – explained Bossi – has a greater risk of malnutrition than the patient without metastases. This is linked to the burden of the disease because inflammatory processes are activated that lead to a reduction in caloric intake and the absorption of nutrients by the patient’s body. This analysis led us to the approval of the Consensus Document, a fundamental tool for a better management of the cancer patient “.
“Malnutrition – emphasized Bossi – leads to alterations in the patient himself: reduction in the quality of life, greater complications and worse post-operative outcomes, lower survival and an increase in the duration of hospital diagnosis”. Among the critical issues of the current management of cancer patients with nutritional problems, Bossi has listed 6: diagnosis and management, management of the nutritional problem, monitoring of nutritional status, lack of shared protocols, low levels of competence and awareness, lack of resources.
“Often – added the oncologist – we realize that there are problems related to the difficulty of understanding who is dealing with the patient’s nutritional problem, who manages it, who is the patient’s referent. Many times the oncologist does not have time to devote to the nutritional problem as well. Clinical nutritionists should take care of it, but these figures are still few in our hospitals. Furthermore, there is a problem of who has to monitor the patient with nutritional problems over time. For these reasons it is necessary to set up a multidisciplinary team ”.
To overcome the current critical issues and standardize the management of nutritional problems, ensuring timely and effective interventions for all patients “it is necessary the definition of treatment paths and shared protocols that establish the roles and responsibilities of all the actors involved in the management of the malnourished cancer patient. A correct approach – detailed Bossi – should include standardized screening protocols that help in the definition of situations at high risk of malnutrition for which counseling or nutritional intervention is always provided, according to the approach recommended by the guidelines of scientific societies. “.
“It was also hoped for the identification of a reference figure who, according to the phases of the disease and treatment, guarantees the appropriateness of the patient’s nutritional path and the evaluation of nutritional support. Lastly, it is recommended that the organization of computerized files that allow the rapid calculation of scores for the definition of the patient’s nutritional status and facilitate the exchange of information between the experts of the multidisciplinary team ”concluded Bossi.
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