Risks of weight loss during cancer treatment highlighted

Some 60% of adults are unaware that losing weight or muscle during cancer treatment carries risk even if the patient is overweight or obese, a new survey commissioned by the Irish Society for Clinical Nutrition and Metabolism (IrSPEN) has found.

According to the findings, 56% of people were unclear about the importance of nutritional care during cancer treatment, while 53% were unaware that maintaining muscle mass and strength is key during this time.

Meanwhile, 28% incorrectly believed that if a person is overweight or obese, losing weight is a positive side-effect of cancer, while 32% were unsure about this.

A further 36% believed that overweight cancer patients would be unlikely to require nutritional care, or they were unsure about this. However again, this is incorrect.

“From the time of diagnosis and during active treatment, the goal is to minimise weight change, preserve muscle mass and maintain body strength,” explained IrSPEN spokesperson and obesity specialist at St Vincent’s University Hospital, Prof Carel le Roux.

He pointed out that current medical research shows that maintaining good nutritional health, body weight and muscle mass during cancer care significantly improves medical outcomes, including in people who are overweight or obese.

“Losing weight without trying and losing muscle mass are common problems in cancer, affecting at least one in three patients. Contrary to what people seem to think, weight and muscle loss are unhelpful at the time of treatment – whether people are under or overweight – making treatment less effective and increasing the risk of complications,” Prof le Roux explained.

He said that clinicians need to pay more attention to even relatively modest changes in body weight and muscle mass as this will help to prevent cancer-related malnutrition.

According to IrSPEN president and consultant gastrointestinal surgeon, Prof John Reynolds, there is a need to dispel the myth that weight loss and deterioration in nutritional status is an inevitable consequence of cancer and its treatments.

“High quality cancer care would benefit from a greater focus on the patient’s nutritional status, which is why IrSPEN continues to push for more specialised dietitians in cancer care and mandatory routine nutrition screening for outpatients receiving cancer treatments, not just inpatients.

“It is important to understand that weight loss and malnutrition are not inevitable or something that can be dealt with after treatment. An important pillar of cancer care is to keep the patient in the best possible condition to benefit from the advances we have seen in treatments,” he noted.

Also commenting on this issue, specialist oncology dietitian, Veronica McSharry, pointed out that by the time many cancer patients are referred to her for help, they are already severely malnourished.

“Failure to address nutritional deterioration in cancer, including in those who are overweight, puts the patient at risk of poor tolerance to chemotherapy, increased complications in surgery and increased need for hospital inpatient care.

“We would like all patients to be screened for signs of developing malnutrition at every hospital outpatient visit and treatment setting, so that we can intervene early with patients who are unable to eat enough to maintain their weight and muscle mass,” she explained.

She emphasised that once cancer patients’ nutritional needs have been identified, they can be addressed effectively.

“We can advise on changes to make to dietary patterns, provide treatments for digestive issues, incorporate extra protein or nutrients into foods or recipes, or prescribe protein and energy supplements for those who cannot manage to eat enough. Tube feeding or even intravenous feeding options are available for patients with more complicated issues.

“We need greater awareness not only among people suffering from cancer and their families, but also those involved in providing cancer care that addressing nutrition problems will benefit the patient,” Ms McSharry stated.

She urged all cancer patients, irrespective of their weight, to seek advice from their medical team if they are unable to maintain their weight or are experiencing a noticeable loss of muscle.

The survey was carried out by RED C and involved a representative sample of 1,000 adults.