Abstract

Nutrition plays a major role in many aspects of cancer development and treatment. Malnutrition is a common problem in cancer patients and has been recognized as an important component of adverse outcomes, including an increase in morbidity or mortality and a decrease in the quality of life. Weight loss has been identified as an important indicator of a poor prognosis for cancer patients. Good nutritional practices can help cancer patients to maintain their weight and store of nutrients, providing them with some relief from nutrition impact symptoms and improving their quality of life. Poor nutritional practices, which can lead to undernutrition, can contribute to the incidence and severity of treatment side effects and increase the risk of infection, thereby reducing chances of survival. Nutrition impact symptoms are those symptoms that impede oral intake. On the other hand, aging is a complex process for all living organisms. During the process of aging, the human body accumulates damage at molecular, cellular, and organ levels, which results in diminished or dysregulated functions and an increased risk of disease and death. These age-related changes are well exemplified in the immune system. The early recognition and detection of various risks associated with malnutrition through nutritional risk screening, followed by comprehensive assessments, has been increasingly recognized as imperative in the development of quality standards for care in oncology practices. A patent’s nutritional status is often jeopardized by the natural progression of some neoplastic disease. Protein-calorie malnutrition (PCM) is the most common secondary diagnosis for cancer patients. PCM in cancer can result from multiple factors most often associated with anorexia, cachexia, and early satiety frequently experienced by cancer patients. In addition, cancer-induced abnormalities in the metabolism of major nutrients can increase the incidence of PCM. Such abnormalities may include glucose intolerance, insulin resistance, increased lipolysis, and increased whole-body protein turnover. If left untreated, PCM can lead to progressive wasting, weakness, and debilitation because the protein synthesis is reduced and the lean body mass is lost, possibly resulting in death. Anorexia can be exacerbated by side effects of chemotherapy and radiation therapy, including changes in taste and smell, nausea, and vomiting. Anorexia can hasten the course of cachexia, a progressive wasting syndrome evidenced by weakness and a marked and progressive loss of body weight, fat, and muscle tissue. Cachexia is estimated to be the immediate cause of death in 20% to 40% of cancer patients. Several theories of the etiology suggest that cachexia is caused by a complex mix of variables, including tumor-produced factors and metabolic abnormalities. Some individuals do respond to nutrition therapy, but most do not see a complete reversal of the syndrome, even with aggressive therapy. Therefore, the most prudent and advantageous approach to cachexia is the prevention of its initiation through nutrition monitoring and intervention. Nutrition plays a critical role in maintaining the immune response of the aged, but there is a need for a more in-depth and holistic approach to determining optimal nutritional strategies that can help maintain a healthy immune system for the aged and promote their resistance to infection and other immune-related diseases. (SMN 2012;3:9-15)

• Keywords: Nutrition, Geriatric oncology