NUTRI-ONCOCARE: New integral nutrition care model to prevent and treat malnutrition in cancer patients.

Objective: The maximum expression of malnutrition in cancer patients is  cancerous cachexia, always linked to an unfavorable prognosis. Given its  evolutionary nature it is recommended to detect and act early in those patients with nutritional risk. The objective is to propose an action  algorithm for the nutritional approach of patients with solid tumors.

Method: Through the nominal group technique, specialists in hospital pharmacy, nutrition and oncology who established a prioritization  of issues related to nutritional status and its approach in patients with  solid tumors were brought together. Their discussion and analysis allowed  us to design a performance algorithm.

Results: The algorithm differentiates two groups of patients according to  the location of the tumor and its impact on nutritional status: high-risk tumors (group 1) include cancers of the head and neck, upper  digestive tract and colorectal and low-risk tumors (group 2) include the  rest of the neoplasms. Group 1 patients (with the exception of those with  colorectal cancer) are directly assessed nutritionally in the first 3-5 days  after their presentation in the Tumor Committee, starting the nutritional  support required at that time. Patients in group 2 and those diagnosed  with colorectal cancer are screened (through NUTRISCORE) after their  presentation in the Committee, those with positive risk being referred to  nutritional consultation to perform a complete evaluation and propose  treatment options. Patients without nutritional risk are periodically re- evaluated. Follow-up is planned according to cancer therapy, with  continuous monitoring in each treatment cycle or during the perioperative  period.

Conclusions: From the nominal group technique, agreements were reached to propose an algorithm of nutritional approach of the cancer patient. The adoption of the proposed algorithm could reduce  variability in institutional clinical practice, promoting a timely and adequate nutritional approach in cancer patients.