Oncology
Welcome to the Oncology Evidence-Based Nutrition Practice Guideline and Systematic Review
The goals of nutrition care are to identify nutrition impact symptoms, to prevent or reverse nutrient deficiencies, and intervene early if cancer cachexia is identified, preserve lean body mass (LBM), minimize nutrition-related side effects and complications in order to help patients better tolerate treatments. The target audience for this guideline are adults who are receiving oncology treatment or care.
Evidence-Based Nutrition Practice Guideline
The focus of the 2013 Oncology guideline is on oncology nutrition practice during the treatment of adult patients with cancer. Cancer is a complex group of multifactoral diseases that develops from interactions between genetics and environment. Screening for malnutrition risk and performing a comprehensive nutrition assessment are required to identify intervention to maximize adequate intake.
This edition lays the foundation to establish the need for Medical Nutrition Therapy (MNT) in the adult oncology population, since nutrition plays a key role in all cancers and cancer treatments.
The aim of this guideline is to document the areas where more evidence exists in order to strengthen the rationale for MNT. Thus, the workgroup chose to principally target:
- malnutrition screening and nutrition assessment using tools validated in this population,
- the association between nutrition status and morbidity and mortality outcomes,
- the effect of MNT on patients undergoing chemotherapy and radiation treatment, and
- cancer cachexia and the effect of the interventions of dietary supplements and medical food supplements containing fish oil (EPA) on LBM and weight.
Systematic Review
The aim of the systematic review focused on nutrition screening and assessment. The workgroup focused on four subtopic areas:
- The relationship between nutrition status and the following morbidity outcomes in adult oncology patients: hospital admissions or readmissions; hospital length of stay; quality of life; radiation treatment tolerance; and chemotherapy treatment tolerance
- The expert panel reviewed articles on screening and assessment in the oncology population in order to evaluate the available tools and provide evidence-based guidance for the oncology dietitian caring for those patients experiencing nutrition impact symptoms or those at risk for malnutrition.
- Medical Nutrition Therapy (MNT) is defined as an evidence-based application of the Nutrition Care Process and includes in-depth assessment, periodic re-assessment and intervention. The expert panel this definition for MNT and set the following criteria when evaluating the inclusion and exclusion of studies for the evidence analysis questions on this topic: RD (or equivalent food and nutrition practitioner) provided the intervention; more than one nutrition encounter; and individualized approach.
- The effect of dietary supplements and medical food supplements (MFS) containing fish oil (specifically eicosapentaenoic acid [EPA]) on body weight and lean body mass (LBM) in cancer cachexia was reviewed. A dietary supplement is a single nutrient supplement in the form of a pill, capsule, liquid, chew, or other form. An MFS is a commercial or prepared food or beverage that supplements energy, protein, carbohydrate, fiber, or fat intake.
Use the left navigation to view the results of the guideline and systematic review. The complete guideline can be downloaded in PDF format from here.
Expand the section below titled Project Team for a listing of individuals who contributed to the development of the project, conflict of interest disclosures, and project funding information. Expand the section titled Project Resources to view resources developed from this project.