Embedding nutrition into routine oncology care: about time?

Area of Science:

• Oncology
• Nutritional Science
• Clinical Practice Integration

Background:

• Cancer significantly impacts patient nutritional status, affecting treatment tolerance, quality of life, and survival.
• Despite its importance, nutrition is currently underutilized in routine oncology care.

Purpose of the Study:

• To examine current evidence on challenges and propose strategies for integrating nutrition into routine oncology care.
• To address the underutilization of nutritional interventions across the cancer continuum.

Main Methods:

• Review of current evidence regarding nutrition in oncology.
• Analysis of barriers to nutritional care integration.
• Proposal of strategies for embedding nutrition into routine oncology practice.

Main Results:

• Cancer-related malnutrition requires simple, validated, cancer-specific screening tools.
• Barriers include misconceptions about cachexia, poor guideline adherence, limited oncologist training, and lack of dietitian access.
• Positive terminology like "nutritional fitness" is suggested.
• Integration into clinical trials and perioperative care (prehabilitation) is crucial.
• Emerging tools (PRONTO, composite indices) show promise.

Conclusions:

• Early and continuous nutritional monitoring, positive communication, and stakeholder education are vital.
• Reframing nutritional care as a core treatment component, rather than supportive care, can improve outcomes and reshape practice.