Interventions to improve nutritional status for older patients with cancer – a holistic approach is needed

Abstract

Purpose of reviewOlder adults with cancer frequently experience malnutrition and sarcopenia resulting in lower treatment efficacy, increased risk of toxicities and healthcare costs, lower quality of life and shorter survival. Improving nutritional status in this rapidly growing population is an urgent need globally. We reviewed randomized controlled trials from the last 18 months focusing on nutritional status and applying multimodal interventions in older adults with cancer. Recent findingsSeveral randomized controlled trials have been reported recently elucidating the impact of nutritional interventions as a part of multimodal interventions through different stages of cancer care. Although multimodal interventions rarely demonstrate survival benefit, they improve several important aspects of cancer care, including patient-centred endpoints such as physical functioning, adherence, patient satisfaction and quality of life. SummaryMultimodal interventions including nutrition have the potential to improve patient-centred outcomes in older adults with cancer during the continuum of care, from prehabilitation to palliative care. Early, integrated supportive care applying the right intervention in the right setting at the proper time along with personalized antitumor treatment is the cornerstone of optimal holistic cancer care.

Nutritional impairment, psychological health and quality of life among older adults with advanced cancer: A secondary analysis of a randomized clinical trial

“…These guidelines include referring patients to a registered dietitian, providing dietary advice on minimal total caloric and protein intake, identification and treatment of symptoms impairing food intake, and consideration of oral nutritional supplements. A recent review identified four randomized clinical trials that evaluated the feasibility and efficacy of nutritional interventions among older adults with cancer 55 . The authors found that nutritional interventions with a dietitian—either by directly interfacing with the patient or indirectly by providing education to the oncologists—resulted in improved QOL.…”

“…A recent review identified four randomized clinical trials that evaluated the feasibility and efficacy of nutritional interventions among older adults with cancer. 55 The authors found that nutritional interventions with a dietitian—either by directly interfacing with the patient or indirectly by providing education to the oncologists—resulted in improved QOL. However, there is disparate access to nutrition services in outpatient cancer centers and those with impaired psychological health and QOL may have additional challenges in accessing nutrition services and maintaining an adequate diet.…”

Unveiling Psychological Perspectives on Aging Minds and Cancer: A Review

“…Psychological interventions, spanning individual counselling to mindfulness-based techniques and group therapies, stood as integral components within comprehensive care strategies [60]. Integrating these interventions into multidisciplinary care was observed to foster resilience, empower patients, and enrich survivorship experiences among elderly individuals navigating cancer [61,62]. In essence, this review advocates for a paradigm shift towards personalized interventions that honour individual experiences and psychological needs within geriatric oncology.…”

Supportive and palliative care for older adults with cancer

“…Malnutrition and sarcopenia is common among older adults with cancer, which can impact treatment efficacy, risk for toxicities, healthcare costs, quality of life, and survival. Liposits et al [3] reviewed the latest randomized controlled trials focusing on nutritional status and multimodal interventions. Findings of this review support the potential of multimodal interventions incorporating a nutritional component to improve several patient-centered endpoints including physical function, adherence, patient satisfaction, and quality of life.…”

“…Liposits et al . 3 reviewed the latest randomized controlled trials focusing on nutritional status and multimodal interventions. Findings of this review support the potential of multimodal interventions incorporating a nutritional component to improve several patient-centered endpoints including physical function, adherence, patient satisfaction, and quality of life.…”