Skip to main content
Log in

Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy—a pilot study

  • Short Communication
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript


Goals of the work

The aim of this study was to examine the effect of nutrition intervention on outcomes of dietary intake, body composition, nutritional status, functional capacity and quality of life in patients with cancer cachexia receiving chemotherapy.

Patients and methods

Patients received weekly counselling by a dietitian and were advised to consume a protein- and energy-dense oral nutritional supplement with eicosapentaenoic acid for 8 weeks. The medical oncologist determined the chemotherapy protocol. Eight patients enrolled and seven completed the study.

Main results

There were significant improvements in total protein intake (median change 0.3 g/kg per day, range −0.1 to 0.8 g/kg per day), total energy intake (median change 36 kJ/kg per day, range −2 to 82 kJ/kg per day), total fibre intake (median change 6.3 g/day, range −3.4 to 20.1 g/day), nutritional status (patient-generated subjective global assessment score, median change 9, range −5 to 17), Karnofsky performance status (median change 10, range 0–30) and quality of life (median change 16.7, range 0–33.3). There were clinically significant improvements in weight (median change 2.3 kg; range −2.7 to 4.5 kg) and lean body mass (median change 4.4 kg, range −4.4 to 4.7 kg), although these were not statistically significant. Change in nutritional status was significantly associated with change in quality of life, change in Karnofsky performance status and change in lean body mass.


Nutrition intervention together with chemotherapy improved outcomes in patients with pancreatic and non-small-cell lung cancer over 8 weeks. Supplement intake does not inhibit meal intake.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  2. Barber MD, Ross JA, Voss AC, Tisdale MJ, Fearon KCH (1999) The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer. Br J Cancer 81:80–86

    Article  CAS  PubMed  Google Scholar 

  3. Bruera E, Strasser F, Palmer JL, Willey J, Calder K, Amyotte G, Baracos V (2003) Effect of fish oil on appetite and other symptoms in patients with advanced cancer and anorexia/cachexia: a double-blind, placebo-controlled study. J Clin Oncol 21:129–134

    Article  Google Scholar 

  4. Capra S, Bauer J, Davidson W, Ash S (2002) Nutritional therapy for cancer-induced weight loss. Nutr Clin Pract 17:210–213

    Google Scholar 

  5. Davidson W, Ash S, Capra S, Bauer J, Cancer Cachexia Study Group (2004) weight stabilisation is associated with improved survival duration and quality of life in unresectable pancreatic cancer. Clin Nutr 23:239–247

    Article  PubMed  Google Scholar 

  6. Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, Jeejeebhoy KN (1987) What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 11:8–13

    CAS  PubMed  Google Scholar 

  7. DeWys WD, Begg C, Lavin PT, et al (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69:491–497

    CAS  PubMed  Google Scholar 

  8. Fearon KCH, von Meyenfeldt MF, Moses AGW, van Geenen R, Roy A, Gouma DJ, Giacose A, Van Gossum A, Bauer J, Barber M, Aaronson NK, Voss AC, Tisdale M (2003) The effect of a protein and energy dense, n-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 52:1479–1486

    Article  CAS  PubMed  Google Scholar 

  9. Forbes GB (1962) Methods for determining composition of the human body. Paediatrics 29:477–494

    CAS  Google Scholar 

  10. Isenring E, Bauer J, Capra S (2003) The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57:305–309

    Article  CAS  PubMed  Google Scholar 

  11. Jatoi A, Rowland K, Loprinzi CL, Sloan JA, Dakhil SR, MacDonald N, Gagnon B, Novotny PJ, Mailliard JA, Bushey TI, Nair S, Christensen B; North Central Cancer Treatment Group (2004) An eicosapentaenoic acid supplement versus megestrol acetate versus both for patients with cancer-associated wasting: a North Central Cancer Treatment Group and National Cancer Institute of Canada collaborative effort. J Clin Oncol 15:2469–2476

    Article  Google Scholar 

  12. Martin C (2000) Calorie, protein, fluid, and micronutrient requirements. In: McCallum PD, Polisena CG (eds) The clinical guide to oncology nutrition. The American Dietetic Association, Chicago, pp 45–52

  13. McCarthy D, Weihofen D (1999) The effect of nutritional supplements on food intake in patients undergoing radiotherapy. Oncol Nurs Forum 26:897–900

    CAS  PubMed  Google Scholar 

  14. Moses AWG, Slater C, Preston T, Barber MD, Fearon KCH (2004) Reduced total energy expenditure and physical activity in cachectic patients with pancreatic cancer can be modulated by an energy and protein dense oral supplement enriched with n-3 fatty acids. Br J Cancer 90:996–1002

    Article  CAS  PubMed  Google Scholar 

  15. Nitenberg G, Raynard B (2000) Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol 34:137–168

    CAS  PubMed  Google Scholar 

  16. Oettle H, Arnold D, Hempel C, Riess H (2000) The role of gemcitabine alone and in combination in the treatment of pancreatic cancer. Anticancer Drugs 11:771–786

    Article  CAS  PubMed  Google Scholar 

  17. Ottery FD (1996) Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 12 [1 Suppl]:S15–19

  18. Splett PL (1996) Cost outcomes of nutrition intervention: part 2. Mead Johnson, New York

    Google Scholar 

  19. Stratton RJ, Elia M (1999) A critical, systematic analysis of the use of oral nutritional supplements in the community. Clin Nutr 18:S29–84

    Google Scholar 

  20. Vansteenkiste JF, Vandebroek JE, Nackaerts KL, Weynants P, Valcke YJ, Verresen DA, Devogelaere RC, Marien SA, Humblet YP, Dams NL; Leuven Lung Cancer Group (2001) Clinical-benefit response in advanced non-small-cell lung cancer: a multicentre prospective randomised phase III study of single agent gemcitabine versus cisplatin-vindesine. Ann Oncol 12:1221–1230

    Article  CAS  PubMed  Google Scholar 

Download references


We gratefully acknowledge the support of The Wesley Research Institute (grant no. WRI-NR1-2000) and Ross Abbott Laboratories (study product). We are also grateful to Ms. Beverley Gallagher for assistance with data collection.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Judith D. Bauer.

Additional information

This work was presented as a poster at the 16th MASCC International Symposium, Miami, 2004.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bauer, J.D., Capra, S. Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy—a pilot study. Support Care Cancer 13, 270–274 (2005).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

Key words