1578P - Current perspectives of healthcare providers on weight loss and supportive nutritional care in cancer patients

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Supportive Care
Palliative and Supportive Care
Presenter Florian Strasser
Citation Annals of Oncology (2017) 28 (suppl_5): v543-v567. 10.1093/annonc/mdx388
Authors F. Strasser1, J. Arends2, A. Laviano3, N. Georgiou4, R. Audisio5, M. Sawyer6, S. Kaasa7
  • 1Clinic For Oncology/hematology, Cantonal Hospital St. Gallen, 9007 - St. Gallen/CH
  • 2Klinik Für Innere Medizin I, Universitätsklinikum Freiburg, 79106 - Freiburg/DE
  • 3Department Of Clinical Medicine, Sapienza University, 00185 - Rome/IT
  • 4Global Medical Affairs, Nutricia Advanced Medical Nutrition, 1118 BG - Schiphol Airport/NL
  • 5St. Helens Teaching Hospital, Department Of Surgery, University of Liverpool, WA9 2DA - St. Helens/GB
  • 6Medical Oncology, Cross Cancer Institute, University of Alberta, T6G 1Z2 - Edmonton/CA
  • 7European Palliative Care Research Centre (prc), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Norwegian University of Science and Technology and St. Olavs Hospital, Trondheim University Hospital, Oslo University Hospital, 0450 - Oslo/NO

Abstract

Background

Malnutrition and cachexia occur in most cancer patients (pts) impacting quality of life (QoL) and anticancer treatment (Tx) outcomes. Nutritional care can help reverse weight loss and improve pt outcomes; however, previous surveys at ESMO (2014, 2015) suggest nutritional care/assessment is insufficiently implemented in clinical practice, despite educational and academic efforts.

Methods

This survey created by the authors, including questions from prior surveys, was completed by ESMO 2016 delegates visiting the Nutricia booth.

Results

Of 2,011 respondents, 78% were medical oncologists, 56% were Europe based; 61% always discuss nutritional aspects during multidisciplinary tumor boards. To assess malnutrition, 44% measure weight, 30% evaluate systemic inflammation, and 14% assess muscle loss. Eligibility of pts to receive nutritional support is assessed before (48% [44% in 2015; 47% in 2014]) or during (54%) initiation of anticancer Tx, at primary diagnosis (28%), if weight loss is visible during outpatient visits (42%), and when anticancer Tx ends (26%). Main impacts of malnutrition are increased anticancer Tx toxicity (58%; 2015: 53%; 2014: 53%), surgery/radiotherapy complications (40%; 37%; 36%), anticancer Tx discontinuation/decreased effectivity (54%; 40%; 40%), decreased QoL (58%; 56%; 54%), impaired physical function (47%; 44%; 45%), or distress of family members (35%; 32%; 32%). Main goals of nutritional support include QoL (65%; 69%; 64%), completion of anticancer Tx (54%; 52%; 45%), or stabilizing weight (48%; 44%; 47%). Popular approaches to minimize weight loss are antiemetics (48%; 56%), appetite stimulants (41%; 48%), more-effective anticancer Tx (39%; 47%), anticachexia drugs (38%; 43%), and timely and individually tailored dietary advice (36%). During systemic Tx, 85% apply physical exercise programs (either alone or in combination with nutritional care).

Conclusions

Compared with our previous surveys, awareness and assessment of malnutrition in cancer pts seems slightly increased. HCPs recognize impacts of malnutrition but may need better guidance on how to improve nutritional care in the supportive and palliative setting.

Clinical trial identification

Legal entity responsible for the study

Nutricia Advanced Medical Nutrition

Funding

Nutricia Advanced Medical Nutrition

Disclosure

F. Strasser: Funds from: Acacia ACRAF Amgen Baxter Celgene Danone Fresenius GSK Grunenthal Helsinn IsisGlobal Millennium/Takeda Mundipharma Novartis Novelpharm Nycomed Obexia Ono Otsuka Pfizer Pharm-Olam PsiOxus PrIME Santhera Sunstone Teva Vifor A. Laviano: Other substantive relationships: independent talks at industry sponsored educational/scientific events N. Georgiou: Corporate-sponsored research; employee of Nutricia Advanced Medical Nutrition M. Sawyer: Other substantive relationships: honoraria from Nutricia for presentations, honoraria from Fresenius Kabi for presentations S. Kaasa: Stock ownership: Eir solution As All other authors have declared no conflicts of interest.