Dietetic assessment and intervention in lung cancer

Abstract

Purpose of reviewSystemic therapy for lung cancer is increasing in intensity and duration. European nutrition guidelines suggest screening for weight loss and malnutrition, however acknowledges there is a lack of evidence. We discuss current data round this issue and identify opportunities for further research. Recent findingsInternational guidelines now exist to aid the definition of weight loss in cancer, including cachexia, sarcopenia and malnutrition. These allow consistent definition of overlapping, but distinct clinical syndromes. Nutritional status can be assessed in a range of ways including questionnaires, functional assessments, blood markers, physical activity, weight and BMI. Weight loss is commonly associated with a proinflammatory state. Future treatment is likely to be a combination of dietetic support and pharmacological treatment of cachexia. SummaryThere is a paucity of data on dietetic intervention. It is potentially quick, inexpensive and patient specific, using a holistic approach to aid patients who are malnourished or at risk of malnutrition. Lung cancerrelated weight loss is common, further strategies are needed to effectively assess and intervene. Dietetic intervention has the potential to improve patients' quality of life and outcomes.

Change in Body Weight and Serum Albumin Levels in Febrile Neutropenic Lung Cancer Patients

“…Furthermore, pretreatment weight loss is a poor prognostic factor in lung cancer patients (Lau et al, 2018). In recent years, the concepts of cachexia, sarcopenia, and frailty have become widespread, and studies based on these concepts have been conducted in the area of cancer treatment (Jain, Coss, Whooley, & Phelps, 2020;Kidd, Skrzypski, Jamal-Hanjani, & Blyth, 2019;Kurishima, Watanabe, Ishikawa, Satoh, & Hizawa, 2017;Nakamura et al, 2018;Phillips, Hug, Allan, & Ezhil, 2019). We have also been interested in cachexia and sarcopenia in cancer patients, and have reported some findings (Kurishima et al, 2017;Nakamura et al, 2018).…”

Multidisciplinary team care in advanced lung cancer

“…The majority of lung cancer patients suffer from various symptoms, including dyspnoea, chest pain, anorexia, fatigue and cough, therefore a palliative care specialist should be a part of MDT. Palliative care, including for example adequate analgesics, nutrition intervention or anabolics, provides an opportunity to relieve troublesome symptoms, and to improve QoL and PS (33,34). Addition of early palliative care to standard management in advanced NSCLC was also shown to prolong OS (35).…”