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Nutrition intervention during all phases of disease and treatment

Prof Maurizio Muscaritoli

Prof Maurizio Muscaritoli

Presentation Roadmap/ Summary

  • The aim of this presentation is to illustrate the „parallel pathway“ concept and its rationale in the nutritional and metabolic support of cancer patients.
  • Nutritional and metabolic needs of cancer patients may substantially vary across the different phases of the cancer journey. For this reason, patients should be offered differentiated options to meet their nutritional needs according to tumor type, stage and type of antineoplastic treatments.
  • Barriers exist which have prevented the implementation of structured clinical nutrition pathways in oncology, such as insufficient awareness and the lack of high-quality RCT-based evidence of effectiveness of nutritional therapy. This has considerably weakened the interest of oncologists toward clinical nutrition.
  • Evidence-based ESPEN Guidelines for nutrition in cancer patients will hopefully contribute to improve nutritional care in cancer patients

Learning Objectives

At the conclusion of the presentation, the participant will be able to:

  1. Know and apply the “parallel pathway” for metabolic and nutritional support in cancer
  2. Know and apply current evidence-based ESPEN Guidelines for nutrition in cancer patients
  3. Choose the best nutritional approach to be implemented in cancer patients

Key Takeaways/ Fast Facts

  • Evidence exists that nutrition support should be implemented early during cancer treatment
  • Aims of nutritional therapy may vary across the natural history of patients
  • Barriers exist which prevent the implementation of structured clinical nutrition pathways in oncology           

Key references

  1. Muscaritoli M, Molfino A, Gioia G, Laviano A, Rossi Fanelli F. The “parallel pathway”: a novel nutritional and metabolic approach to cancer patients. Intern Emerg Med. 2011; 6:105-112.
  2. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017 ;36(1):11-48.
  3. Muscaritoli M, Molfino A, Lucia S, Rossi Fanelli F. Cachexia: a preventable comorbidity of cancer. A T.A.R.G.E.T. approach. Crit Rev Oncol Hematol. 2015; 94:251-259


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