Nutrition in Cancer.

In cancer patients, oral nutrition is the preferred route of feeding since it is a significant part of the patient's daily routine and contributes to the patient's autonomy. It represents a privileged time to spend with family and friends, avoiding the tendency for isolation in these patients. The acknowledgement that the prescribed diet is individualized, adapted and adequate to individual needs empowers the patient with a feeling of control, and thus it is also a highly effective approach of psychological modulation. All these factors may potentially contribute to improve the patient's quality of life and may modulate treatment morbidity. The referral to a nutrition professional responsible for the individualized dietary counseling should always be based on evidence-based decision-making plans. The implementation of individualized nutritional counseling should consider the common causes for a poor nutritional intake in elderly cancer patients. A proper approach through counseling requires professionals with specific experience in both nutrition and oncology. Oral nutritional supplements are a simple and practical way to meet nutritional requirements when normal food intake is compromised. Ideally, oral nutritional supplements should be in addition to and not instead of meals. Supplements should be administered at a time which does not interfere with the appetite of the patient. The administration after the meal theoretically potentiates the anabolic effect on protein metabolism. Supplements with high energy density (>1 kcal/ml) or enriched with ω-3 fatty acid are probably the most effective.