People with cancer who are well nourished and who are capable of maintaining a healthy body weight may have better outcomes than patients who are undernourished or underweight. Survival is generally shorter for those patients who lose weight prior to starting cancer treatment. Maintaining a healthy diet through cancer treatment may help maintain the immune system and the general well-being of patients. Weight and nutrition can be managed by eating more protein, eating more calories, drinking more water, and reducing alcohol consumption. Calories and protein may come from foods that would regularly be consumed in the diet or through high-calorie and high-protein shakes or beverages. When ingesting adequate nutrition by mouth is not a possibility due to nausea, swallowing difficulty, or a very sore mouth or throat, alternative feeding methods could be necessary. These methods may include providing fluids and nutrition through a feeding tube (enteral nutrition) or intravenous line (parenteral nutrition).

The purpose of this review is to evaluate the evidence and guidelines regarding the effect of nutritional supplementation on the clinical outcomes of patients with cancer.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• APPENDIX 1 Selection of Included Studies
• APPENDIX 2 Characteristics of Included Publications
• APPENDIX 3 Summary of Critical Appraisal of Included Studies and Guidelines
• APPENDIX 4 Main Study Findings and Authors’ Conclusions
• APPENDIX 5 Grading of guidelines and levels of evidence in the ASPEN Guideline² (, page 474)

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.