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Just Say No to Malnutrition

By Margaret Martin, RD, MS, LDN, CDCES September 28, 2017Pearls of Wisdom Blog

What’s all this talk about malnutrition and cancer? Isn’t a cancer diagnosis enough without adding malnutrition? Yes, cancer is enough without adding malnutrition to the mix. That’s why you need to maintain good nutrition throughout cancer treatment.

A cancer diagnosis can be quite overwhelming. But do you know the second most frequent diagnosis for a person with cancer? It’s malnutrition. Up to 85% of people with cancer will experience some type of malnutrition or weight loss during their treatment (1, 2). That’s about 8 out of 10 people diagnosed with cancer.

Malnutrition is risky business. Cancer patients who have it often have poor quality of life, loss of muscle strength, frequent infections, complications from surgery, more hospital admissions, and other health complications from malnutrition when compared with those without a malnutrition diagnosis. Also, they often are not able to complete their treatment plans which leads to higher mortality or death from cancer. If that’s not shocking enough, 20% to 40% of people with cancer don’t die of the cancer but from malnutrition (3).

Eating well along your cancer journey is tough. With the damage that cancer may cause to your body and the side effects from surgery and other treatments, you face an up-hill battle keeping up with your nutritional needs. Nutrition problems may be overlooked by people with cancer, their caregivers, and their healthcare team. How can that happen? Why are malnutrition and nutrient deficits overlooked? The focus for the person with cancer may be making it through the appointments, testing, medication management, treatment, and keeping track of expenses. Life with cancer is very complicated. Your nutrition status may be lost in the ebb and flow of your medical care. It takes you and all your healthcare team members to keep an eye malnutrition symptoms and signs.

If you had help along the way, someone to screen you for nutrition issues, would you ask for this help?

Let’s stop malnutrition in its tracks. Right now. Today.

Ask this important question: “What is My Nutrition Score?”

Each outpatient cancer center and hospital have a process for nutrition screening that assigns a nutrition score to each person. Based on your nutrition score, you may be referred for nutrition care. The higher your score, often the higher the risk of malnutrition. The sooner your nutrition issues can be identified and treated, the better the outcome may be. If malnutrition is identified later in your cancer care, the less likely the nutrition issues can be reversed or treated at all in some cases. So, be proactive and learn all you can about nutrition and the signs of malnutrition. The signs and symptoms can be found in lab tests, body weight changes, physical exams that include muscle evaluations, and food history just to name a few.

For example, ask about your iron, protein, hemoglobin, and Vitamin B12 lab results and your weight patterns over time. Even a 5% weight loss in a month can be harmful (4). Some studies suggest that 5% weight loss can predict decreased response to therapy and decreased survival. Ask your healthcare team to monitor your nutrition status at every visit or milestone on your cancer journey. If you have nutrition issues, ask immediately for a referral to a registered dietitian nutritionist with experience in helping people with cancer.

What if there were zero incidence of malnutrition in persons with cancer? In the words of the great musician Louis Armstrong, “I think to myself, what a wonderful world!” Do your part today. Ask your healthcare team often, “What is my nutrition score?”


1. 1Bozzetti F, Mariani L, Lo Vullo S, et al.: The nutritional risk in oncology: a study of 1,453 cancer outpatients. Support Care Cancer 20 (8): 1919-28, 2012.[PUBMED Abstract]

2. H buterne X, Lemari E, Michallet M, et al.: Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr 38 (2): 196-204, 2014.[PUBMED Abstract]

3. 12. Ottery FD. Cancer cachexia: prevention, early diagnosis, and management.Cancer Pract. 1994;2:123-131.

4. White JV, Guenter P, Jensen G, et al.: Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr 36 (3): 275-83, 2012.[PUBMED Abstract]

Margaret Martin, RD, MS, LDN, CDCES

Author Margaret Martin, RD, MS, LDN, CDCES

Nutrition Educator Margaret Martin is a Licensed Dietitian and Nutritionist in the State of Tennessee as well as a Certified Diabetes Educator. Margaret graduated from the University of Alabama with a Bachelor of Science in Dietetics and received her Master’s Degree in Nutrition Science & Public Health from the University of Tennessee. With more than 10 years of experience in Clinical Nutrition, Margaret has also worked in the insurance industry with WellPoint Inc. and Blue Cross Blue Shield providing telephonic nutrition consultations, service assistance, and web-based nutrition education. In her free time Margaret volunteers with the American Lung Association’s annual “Lung Force Walk" in Middle Tennessee. She belongs to the Oncology Nutrition & Diabetes Care and Education Dietetic Practice Groups of the Academy of Nutrition and Dietetics.

More posts by Margaret Martin, RD, MS, LDN, CDCES

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