Cancer and malnutrition – study of the nutritional status of patients on oncological wards versus their personal-reflection

Peer reviewed / Manuscript (original) submitted: 27 January 2020 / Revision accepted: 20 May 2020

Introduction

Diet plays an important role in cancer therapy. The severity of the nutritional problems of a tumor disease partly depends on its location. However, cancer or its treatment may lead to cachexia in all types of cancer [1–3]. All in all, there are major problems with malnutrition among patients in German hospitals, and the risk of malnutrition is particularly high at oncology wards (38%) [4, 5]. The high prevalence of malnutrition may also be related to the fact that many physicians do not have the necessary knowledge of nutrition to be able to advise their patients adequately [6–8]. Malnutrition may lead to a weakening of the patient. This results in an increase in side effects and complications (e.g. a poorer tolerance to the therapy) of cancer treatments [9]. Therefore, admission to a hospital may increase and hospital stays may become longer. In addition, the quality of life is lowered when a person is not sufficiently nourished as malaise, fatigue, and depression appear or get stronger [10]. Especially elderly patients are at risk of malnutrition and its sequela [11].

One of the main reasons for the debilitating effects of malnutrition is early sarcopenia or cachexia, which also may arise while the patient's weight and body mass index (BMI) are within the normal or in an increased range [12]. Both malnutrition and sarcopenia are highly associated with increased mortality and worse prognosis [13–17]. Vice versa, individual nutritional therapy may improve quality of life and functional status [18].

Abstract

Background: Every malignant illness goes along with negative effects of the disease and the treatment that may result in malnutrition. The aim of this study is to find out whether the patients recognize this risk by themselves and whether they are alert and search for nutritional advice.
Methods: The SGA-questionnaire was used to interview patients in different oncological wards at a German university hospital. As a special feature, the subjective assessment of the nutritional status was answered by the patients to see how they assess their own situation.
Results: In total, 97 patients completed the questionnaire. 46 patients were categorized as having malnutrition. However, 67 respondents consider themselves as well fed. Overall, 50 respondents reported they had symptoms associated with nutrition intake.
Conclusion: Objective and subjective assessments of malnutrition do not match in several cases. Without regular assessment, risk of malnutrition and even cachexia remain unnoticed from the side of the patients as well as from the doctors.

Keywords: undernourishment, malnutrition, cancer, cachexia, screening, weight loss

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