| [ Summary ] |
Malnutrition in cancer patients is characterized by weight loss and muscle protein depletion due to inadequate food intake and systemic inflammation. The prevalence of sarcopenia and frailty is much higher in dialysis patients, leading to a higher risk of malnutrition when complicated by cancer. The aims of nutritional intervention are to maintain or improve food intake and mitigate metabolic derangement, maintain skeletal muscle mass and physical performance, reduce the risk of interruption of scheduled anticancer treatments, and improve the quality of life (QOL). In cancer patients, nutritional therapy assumes that total energy expenditure is 25 to 30 kcal/kg/day, similar to that in healthy controls. Protein intake should be at least 1.0 g/kg/day, and if possible, up to 1.5 g/kg/day. Preoperative fasting and fluid restriction should be limited according to guidelines. If oral food intake is inadequate during chemo-radiotherapy, supplemental nasogastric tube feeding should be started. Furthermore, to prevent progression to sarcopenia and frailty, individualized resistance exercise, as well as aerobic exercise, are required in cancer patients. We should also routinely screen and assess nutritional status in patients with advanced cancer to maintain their QOL. |