Chapter 1: Introduction
1. Department of Oncology, Mayo Clinic, Rochester, MN, USA
2. Oncology and Palliative Medicine, University of Oslo, Oslo; Department of Oncology, Oslo University Hospital, Oslo; European Palliative Care Research Centre (PRC), Oslo University Hospital and Oslo University, Oslo, Norway
An old English proverb reads, “Don’t dig your grave with your own knife and fork.” If only it were that simple and if only clinicians were able to resort to one simple imperative when rendering nutritional advice to patients with cancer, to those with a history of cancer, and to individuals at risk for this disease! Had it been that simple, the editors of the European Society for Medical Oncology (ESMO) Handbook of Nutrition and Cancer and the staff at ESMO would have finished their task of finalising this second edition way ahead of schedule!
Instead, for this second edition of the ESMO Handbook of Nutrition and Cancer, dozens of experts well-versed in the interface between nutrition and cancer came together from around the globe to write, critique, edit, deliberate and update a variety of chapter-based topics that span all the way from the basic concepts of nutrition to the health economics of nutrition, all within the context of cancer. The topics covered in this handbook are grounded in basic, translational and clinical science.
One topic focuses on cancer prevention. Others describe how to clinically assess patients with cancer for nutritional decline; how to review the prognostic significance of biomarkers (such as cross-sectional muscle area as measured on computed tomography scans), which serve to flag nutritional compromise; and how to manage patients who might benefit from nutritional counselling, caloric repletion, pharmacological interventions and supportive and palliative care. Recognising that cancer therapy itself can wreak havoc on nutritional parameters, we have included a specific chapter dedicated to nutrition during cancer treatment.
And in keeping with shifting worldwide demographics that point to a growing number of older patients with cancer in some countries and to an increasing number of patients who are surviving after a cancer diagnosis, these two populations are covered in their own respective chapters. Two new chapters – one on implementation science and the other on managing divergent recommendations from different information sources – now serve to address these important areas that are gaining further attention in medicine.
A product of tremendous effort on the part of many, the second edition of the ESMO Handbook of Nutrition and Cancer brings invaluable state-of-the-art management approaches, which go far beyond the accoutrements referenced in the old English proverb above and provide concrete, evidence-based recommendations. We sincerely hope that this handbook will help clinicians as they, in turn, work to help patients with cancer and their families.