the 10 rights for appropriate nutritional support – breaking latest news

The numbers clearly frame the problem: overall about 30% of cancer patients suffer from a state of malnutrition, or at risk of it, already at the time of diagnosis. And with the passage of time and the succession of therapies, insufficient nutrition becomes a very common problem, so much so that it affects up to 60-80% of patients. Especially when you arrive in the advanced stages of cancer or if you suffer from certain types of cancers such as those of the pancreas, esophagus, stomach, head and neck. This leads to more probabilities of surgical complications, a lower efficacy of the therapies, a higher toxicity and a worsening of the patients’ quality of life, so much so that according to the statistics one cancer patient in 4 dies because he is malnourished and not directly from cancer.

The card in 10 points

Inflammation of the oral cavity, digestive and intestinal disorders, loss of appetite are just some of the most frequent side effects caused by anti-cancer treatments, which can significantly worsen the lives of patients and even those who recover – underlines Francesco De Lorenzo, president of the Italian Federation of voluntary associations in oncology (Favo) -. Several researches have shown that in the case of chemo and radiotherapy treatments, it is not important to know how to choose only the most correct foods, but also to know how to modulate them in the different phases of treatment, ie before, during and after the treatment. For this reason Favo together with the Italian Association of Medical Oncology (Aiom) and the Italian Society of Nutrition and Metabolism (Sinpe) has developed a handbook to explain the correct principles in terms of nutrition to cancer patients. The goal is to respond to the requests of patients and their families about nutrition and the right to receive correct nutritional prescriptions. The ten rights formulated in the decalogue are listed below.

Right to advice

Every cancer patient has the right to receive from health personnel with documented and recognized clinical nutrition skills: exhaustive, correct and clinical evidence-based information regarding their nutritional status, the possible consequences associated with it and the various nutritional therapeutic options; a nutritional counseling that provides indications on how to adapt one’s diet to the principles universally recognized as useful in the primary and secondary prevention of cancer, also in relation to any comorbidities, medical, surgical or radiotherapy therapies.

Right to Screening

Every cancer patient has the right to nutritional screening aimed at identifying the possible presence of the risk of malnutrition. Screening must be performed with instruments validated at diagnosis and repeated systematically by the treating team at regular intervals, in the case of neoplasms which, by type, stage or treatment, can negatively influence the state of nutrition. Every patient at risk of malnutrition has the right to a complete and timely assessment of their nutritional status by health personnel belonging to the Clinical Nutrition Services or, in any case, with documented and recognized clinical nutrition skills. The nutritional evaluation must be an integral part of the diagnostic-therapeutic and care pathways developed by the oncological structures.

Right to nutritional prescriptions

Every malnourished cancer patient with weight loss has the right to be prescribed appropriate nutritional support by medical personnel belonging to the Clinical Nutrition Services or with documented and recognized clinical nutrition skills.

Right to additions

Every cancer patient at risk of malnutrition has the right, in relation to the clinical conditions and deficiencies present, on the prescription of medical personnel belonging to the Clinical Nutrition Services or with documented and recognized clinical nutrition skills, to free access to oral nutritional supplements, including vitamin and mineral supports.

Right to timely artificial nutrition

Artificial nutrition is a complex therapeutic method which requires specific medical skills and which can present, if not conducted according to quality and safety criteria, even serious complications. Every cancer patient at risk of malnutrition, unable to maintain a satisfactory state of nutrition through nutritional counseling and any supplements, has the right to receive both in hospital and in residential facilities, as part of a continuity care project, a appropriate and timely support of artificial nutrition, on the prescription of medical personnel belonging to the Clinical Nutrition Services or with documented and recognized clinical nutrition skills.

Right to home nutrition

Any cancer patient who needs to continue artificial nutrition support beyond the terms of hospitalization has the right to receive appropriate and safe home artificial nutrition treatment, on the prescription of medical personnel belonging to the Clinical Nutrition Services or with documented and recognized skills of clinical nutrition.

Right to monitoring

Every cancer patient who needs nutritional support has the right to receive periodic re-evaluation of the appropriateness and efficacy of the treatment by the oncologist and health personnel belonging to the Clinical Nutrition Services or with documented and recognized clinical nutrition skills, in the context of integrated health care paths shared by multidisciplinary teams.

Right to be treated for overweight

Every cancer patient has the right to free access to Clinical Nutrition Services in the context of cancer rehabilitation programs during and after active treatments, in order to recover their ideal weight, also in consideration of the impact of being overweight on the prognosis and on the clinical course of many neoplastic pathologies.

Right to psychological support

Defect malnutrition and overweight significantly affect the patient’s body image and often trigger important intra-family dynamics. Any patient at risk of significant changes in their nutritional status is entitled to appropriate and timely free psychological support.

Right to participate in clinical trials

Every cancer patient has the right, if he so wishes, to be included in controlled clinical trials aimed at combating malnutrition in the different phases of the disease.