Amsterdam, The Netherlands - Nov 09, 2023

• Europe-wide research shows that over 60% of patients experience eating problems as a direct result of their cancer and cancer treatment 
• Due to this, many patients experience weight loss, a visible consequence of malnutrition that is a major concern both for them and their support system
• Although medical nutrition is proven to support patient outcomes, fewer than 1 out of 3 patients report receiving it

A new survey by Ipsos finds nearly two thirds (64%) of patients with cancer experience eating challenges or have nutrition concerns during their cancer journey, with significant impact on their treatment plans for many. The findings, shared during Malnutrition Awareness Week, highlight the need to increase awareness of the risks of disease-related malnutrition, which affects up to 70% of patients with cancer¹. 

The survey was conducted among 700 adult patients who currently have or had cancer in the last 5 years, across France, Germany, Italy, the Netherlands, Poland, Spain and the United Kingdom. The survey aims to increase understanding of patient experiences around nutrition during cancer care and was commissioned by Nutricia.

Cancer & daily life

The majority of patients surveyed experienced issues with mental health (73%), such as sleeping troubles and feelings of depression, social life (57%), including opting out of social engagements and giving up on hobbies, and physical activity (50%). Challenges related with eating and drinking were also prevalent (64%). Many patients reported experiencing at least 3 problems related to food either often or very often; these included appetite loss, dry mouth, taste changes and nausea. The prevalence and number of eating problems was higher in people with certain types of cancer, such as in gastrointestinal and gynaecological cancer. Daily food habits were also reported as an issue, with over 1 in 3 responding not knowing what to eat to best support recovery and no longer enjoying their favorite meals.

Weight loss & malnutrition in cancer

Up to 70% of patients with cancer are malnourished, depending on the type of tumor and stage of cancer¹. Weight loss is often a visible consequence of malnutrition, which presented as a major concern for both patients as well as caregivers, as 3 out of 5 patients report having lost weight at some point during their cancer journey. For the vast majority (82%), this weight loss was clinically significant (i.e., more than 5% of their initial weight). 

The impact of disease-related malnutrition in cancer becomes clear when looking at the staggering one third of survey participants whose weight loss resulted in delays, interruption or change to their treatment plan. Clinical evidence also points to how weight loss is accompanied by muscle loss in cancer², which was also present in the survey sample, as more than half of patients who lost weight also self-reported reduced muscle strength or muscle loss (57%). Literature suggests that muscle loss is associated with increased toxicities from anti-cancer treatment².

Professor Alessandro Laviano from Sapienza University of Rome shares his view on these findings: “This survey confirms what I see every day in clinical practice: patients with cancer struggle with eating, with a domino effect on their weight and muscle mass, and subsequently on their treatment plan. Clinical evidence shows us that losing weight and muscle during cancer can also increase complications and affect treatment tolerance – it’s clear that cancer-related malnutrition is a real problem in cancer care. Healthcare professionals play a pivotal role in detecting and addressing malnutrition early and effectively, through appropriate screening and tailored nutritional care.”

Nutrition as an integral part of cancer care

83% of patients consider nutrition to have an important role during treatment and recovery, and many of them find that nutrition should be addressed at the early stages of the cancer journey. Access to nutrition advice during cancer seems to be highly varied and spread out between healthcare provider specializations, according to the survey. While all providers play a role in detecting and addressing malnutrition in cancer, for many who could benefit from consultations with nutrition specialists including dietitians or nutritionists, such as patients who lost a lot of weight or experience many eating challenges, there remain significant gaps.

Clinical studies have proven that addressing unwanted weight loss through nutritional support that includes medical nutrition contributes to positive outcomes across cancer treatment and recovery, for example in reducing treatment-related complications³. Patients take notice of these benefits too, as more than 8 out of 10 patients who used medical nutrition in the survey sample indicated that it supported them through their treatment (83%); similar numbers reported it allowed them to regain energy, as well as regain and maintain a stable weight. 

However, despite the high prevalence of eating challenges and weight loss, fewer than 1 out of 3 of survey respondents reported having used medical nutrition, such as oral nutritional supplements. Although guidelines from leading medical societies (including ESPEN, the European Society for Clinical Nutrition & Metabolism, and ESMO, the European Society for Medical Oncology⁴) highlight the importance of meeting the specific nutritional needs of patients with cancer, nutrition is not integrated as a core element of national cancer care plans in most European countries. 

As European-wide policy efforts to improve cancer care are in development, such as the European Commission’s Beating Cancer Plan, high-quality cancer care should also take into account concerns of patients around eating, like the ones highlighted in this survey. Such patient-centric approaches can only be delivered by addressing policy gaps in workforce training, early screening and monitoring of malnutrition for patients, and the inclusion of multidisciplinary teams in cancer plans. 

Overall, the survey findings reiterate the importance of ensuring adequate nutrition support to all people who need it through integrated and systematic approaches. Commenting on the survey, Katrien van Laere, Senior Vice-President Research and Innovation, Medical and Nutritional Science at Danone noted: “With 19 million new cases of cancer every year, it is imperative to understand patient experiences. It’s the only way to improve their quality of life and contribute to their recovery and survival. We know the right nutrition at the right time can make a positive difference to our health, which is especially true if we fall sick. Nutricia is committed to contributing to this by working with healthcare professionals, patient associations and research institutes to ensure all patients receive the right nutritional care that truly addresses their needs.”