TABLE 1.

Summary of the AIOM-SINPE practical recommendations for nutritional support in cancer patients

- Nutritional screening should be performed using validated tools (NRS 2002, MUST, MST, MNA) upon diagnosis and systematically repeated at regular time points in patients with cancer type, stage or treatment potentially affecting nutritional status.

- Patients at nutritional risk should be promptly referred for comprehensive nutritional assessment and support to clinical nutrition services or medical personnel with documented skills in clinical nutrition, specifically for cancer patients.

- Nutritional support should be actively managed and targeted for each patient according to nutritional conditions, clinical status, planned treatment and expected outcome. It should comprise nutritional counseling with the possible use of oral nutritional supplements and/or artificial nutrition (enteral nutrition, total or supplemental parenteral nutrition) according to spontaneous food intake, tolerance and effectiveness.

- Nutritional support and dietary modifications should aim to assist the maintenance or recovery of nutritional status by increasing or preserving protein and calorie intake. “Alternative hypocaloric anti-cancer diets” (e.g. macrobiotic or vegan diets) are not recommended.

- Nutritional support may be integrated into palliative care programs, according to individual-based evaluations, quality of life implications, life expectancy and patients' awareness.

- Home artificial nutrition should be prescribed and regularly monitored using defined protocols shared between oncologists and clinical nutrition specialists.

- Nutritional parameters should be considered as relevant outcomes or potential confounders in outcome assessment in clinical oncology research.

- Well-designed clinical trials are needed to improve the evidence in favour of nutritional support in different care settings for cancer patients.