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J Cancer 2022; 13(9):2705-2716. doi:10.7150/jca.73130 This issue Cite

Research Paper

Nutritional Support in Cancer patients: update of the Italian Intersociety Working Group practical recommendations

Riccardo Caccialanza^1✉, Paolo Cotogni², Emanuele Cereda¹, Paolo Bossi³, Giuseppe Aprile⁴, Paolo Delrio⁵, Patrizia Gnagnarella⁶, Annalisa Mascheroni⁷, Taira Monge⁸, Ettore Corradi⁹, Michele Grieco¹⁰, Sergio Riso¹¹, Francesco De Lorenzo¹², Francesca Traclò¹², Elisabetta Iannelli¹², Giordano Domenico Beretta¹³, Michela Zanetti¹⁴, Saverio Cinieri¹⁵, Vittorina Zagonel¹⁶, Paolo Pedrazzoli¹⁷ on behalf of the Intersociety (AIOM-SINPE-FAVO-SICO-ASAND) Italian Working Group for Nutritional Support in Cancer Patients#

1. Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
2. Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, Turin, Italy;
3. Medical Oncology Unit, ASST Spedali Civili di Brescia, and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
4. Department of Oncology, San Bortolo General Hospital, Vicenza, Italy
5. Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Giovanni Pascale IRCCS, Naples, Italy
6. Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
7. Clinical Nutrition and Dietetics Unit, ASST Melegnano-Martesana, 20077 Melegnano (MI), Italy
8. Clinical Nutrition Unit, S. Giovanni Battista Hospital, Torino, Italy
9. Clinical Nutritional Unit, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
10. Department of Surgery, Sant' Eugenio Hospital, Rome, Italy
11. Clinical Nutrition and Dietetics Unit, Maggiore della Carità Hospital, Novara, Italy
12. Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
13. Department of Oncology, Humanitas Gavazzeni, Bergamo, Italy
14. Department of Medical, Surgical and Health Sciences - University of Trieste, and Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy
15. Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy
16. Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology-IRCCS, 35128 Padova, Italy
17. Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine, University of Pavia, Pavia, Italy
^#The Italian Intersociety (AIOM-SINPE-FAVO-SICO-ASAND) Working Group for Nutritional Support in Cancer Patients is listed in the Acknowledgments

✉ Corresponding author: Dr. Riccardo Caccialanza, Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy. Tel.: + 39 0382 501615. E-mail: r.caccialanzapv.it

Abstract

Malnutrition is a frequent problem in cancer patients, which leads to prolonged and repeated hospitalizations, increased treatment-related toxicity, reduced response to cancer treatment, impaired quality of life, a worse overall prognosis and the avoidable waste of health care resources.

Despite being perceived as a limiting factor in oncologic treatments by both oncologists and patients, there is still a considerable gap between need and actual delivery of nutrition care, and attitudes still vary considerably among health care professionals.

In the last 5 years, the Italian Intersociety Working Group for Nutritional Support in Cancer Patients (WG), has repeatedly revisited this issue and has concluded that some improvement in nutritional care in Italy has occurred, at least with regard to awareness and institutional activities. In the same period, new international guidelines for the management of malnutrition and cachexia have been released.

Despite these valuable initiatives, effective structural strategies and concrete actions aimed at facing the challenging issues of nutritional care in oncology are still needed, requiring the active participation of scientific societies and health authorities.

As a continuation of the WG's work, we have reviewed available data present in the literature from January 2016 to September 2021, together with the most recent guidelines issued by scientific societies and health authorities, thus providing an update of the 2016 WG practical recommendations, with suggestions for new areas/issues for possible improvement and implementation.

Keywords: nutritional support, cancer patients, malnutrition, practical recommendations, nutritional care

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