[Denutrition in the elderly patient with urologic cancer]

Denutrition in the elderly subject with cancer is a frequent and serious complication. With a complex and multifactorial mechanism, associating causes that are attributable to neoplastic disease with factors related to aging, denutrition is the source of excessive morbidity for these patients. One must systematically search for denutrition in all elderly patients in a standardized gerontological assessment, using the diagnostic criteria set out by the French National Health Authority: weight loss, body mass index, and the Mini Nutritional Assessment. Treatment of denutrition should be integrated into the therapeutic project and should therefore take the ethics dimension into account. Depending on the patient's capacity for spontaneous oral feeding, the choice of nutritional sources will be oriented toward oral nutrition: enriched, fractionated food intake, associated if need be with high-calorie oral complementation; or toward enteral feeding. Whatever nutritional treatment is selected, its tolerance and efficacy must be assessed.