Edited by: Shanjun Tan, Zhongshan Hospital, Fudan University, China
Reviewed by: Samir Giuseppe Sukkar, San Martino Hospital (IRCCS), Italy; Alessandro Laviano, Sapienza University of Rome, Italy
†These authors have contributed equally to this work
‡ORCID: Ludovico Carbone,
This article was submitted to Clinical Nutrition, a section of the journal Frontiers in Nutrition
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Malnutrition is a common condition in cancer patients which is usually associated with functional limitations, as well as increased morbidity and mortality. Based on the support of the young sections of Italian Association of Medical Oncology (AIOM), Italian Association of Radiotherapy and Clinical Oncology (AIRO) and Italian Society of Surgical Oncology (SICO) merged into the NutriOnc Research Group, we performed a multidisciplinary national survey with the aim to define the awareness of nutritional issues among healthcare professionals delivering anticancer care. The questionnaire was organized in four sections, as follows: Knowledge and practices regarding Nutritional Management of cancer patients; Timing of screening and assessment of Nutritional Status; Nutritional Treatment and prescription criteria; Immunonutrition and educational topics. The modules focused on esophagogastric, hepato-bilio-pancreatic and colorectal malignancies. Overall, 215 physicians completed the survey. As regards the management of Nutritional Status of cancer patients, many responders adopted the ERAS program (49.3%), while a consistent number of professionals did not follow a specific validated nutritional care protocol (41.8%), mainly due to lack of educational courses (14.5%) and financial support (15.3%). Nearly all the included institutions had a multidisciplinary team (92%) to finalize the treatment decision-making. Cancer patients routinely underwent nutritional screening according to 57.2% of interviewed physicians. The timing of nutritional assessment was at diagnosis (37.8%), before surgery (25.9%), after surgery (16.7%), before radiochemotherapy (13.5%) and after radiochemotherapy (7%). Most of the responders reported that nutritional status was assessed throughout the duration of cancer treatments (55.6%). An important gap between current delivery and need of nutritional assessment persists. The development of specific and defined care protocols and the adherence to these tools may be the key to improving nutritional support management in clinical practice.
The authors thank Barbara Borlotti Amico (Nestlè Health Science) and Iside Morabito (Isi Events) for support, Mariateresa Cirillo for graphic design. The authors affiliated to the IRCCS Istituto Tumori “Giovanni Paolo II” in Bari are responsible for the views expressed in this article, which do not necessarily represent the Institute.