Clinical Perspectives

Up to 85 Percent of Patients with Cancer Experience Malnutrition or Weight Loss

March 29, 2019


“Malnutrition occurs at a very high rate in patients facing a GI cancer diagnosis,” explains Erin Gurd, RD, LDN, CNCS, a Clinical Dietitian in the Department of Gastrointestinal Oncology at Moffitt.

As part of her role, Erin leads an initiative to combat this comorbidity by focusing on the importance of early and appropriate diagnosis of malnutrition. Malnutrition can lead to increased risk of infection, loss of muscle, physical disability, a delay in treatment and other problems.

Conducting Early Nutrition Screening

Physicians most often initiate a consult with a dietician due to weight loss, poor appetite, diarrhea, and other digestive issues, in order for the patient to be treated. As part of an integrated care team, the GI nutritional support program at Moffitt offers a registered dietitian onsite available for consults every day, Monday through Friday.

Often times, same day consults can be accommodated for convenience. Outpatient nutrition consults last approximately 30 minutes to 1 hour, depending on the specific needs of the patient.

Even for cancer patients who are not malnourished prior to surgery, pre-surgical nutrition therapy significantly improves nutritional status and reduces post-operative surgical complications compared to cancer patients who did not receive pre-surgical nutrition support. At Moffitt, an inpatient dietitian can also request a post-operative consult for the patient’s follow up visit to the clinic.

Combatting Malnutrition with Nutritional Therapy

Nutritional status affects acceptability and tolerability of anticancer therapies, in turn potentially limiting therapeutic choices. Individualized nutrition support provided by a clinical dietitian can help patients obtain the nutrients needed to tolerate and recover from treatment and prevent or reverse malnutrition. Dietitians assess patients’ nutritional status and address deficiencies through diet modification, education, dietary supplements and, in some cases, tube feeding or intravenous feeding.

Providers most commonly request a nutrition consult and find them beneficial for:

  • Gastroesophageal cancers
  • Pancreatic cancer
  • Head and neck cancers
  • Colorectal cancer
  • Lung cancer
  • Pre-surgical nutritional therapy
  • Post-operative therapy following a Whipple Procedure or other surgery on an inpatient stay

“Many esophageal patients have trouble with getting food to pass or are tube fed. Likewise, pancreatic cancer is a hypermetabolic cancer,” resulting in patients with these specific cancer types to be more prone to malnutrition, confirmed Erin. After an esophagogastrectomy, patients will also have new dietary needs requiring support from a licensed dietician.

“Many facilities do not have onsite licensed dietitians or any nutrition resources available,” says Erin. “In those situations, patients and caregivers often look for support and our nutrition team at Moffitt can be a resource for information about fuel for healing and recovery.”

To learn more about Moffitt’s Nutrition services click here.