Protein calorie malnutrition, nutritional intervention and personalized cancer care

Anju Gangadharan, Sung Eun Choi, Ahmed Hassan, Nehad M. Ayoub, Gina Durante, Sakshi Balwani, Young Hee Kim, Andrew Pecora, Andre Goy and K. Stephen Suh _

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Oncotarget. 2017; 8:24009-24030. https://doi.org/10.18632/oncotarget.15103

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Anju Gangadharan1, Sung Eun Choi2, Ahmed Hassan1, Nehad M. Ayoub3, Gina Durante4, Sakshi Balwani1, Young Hee Kim4, Andrew Pecora5, Andre Goy5 and K. Stephen Suh1

1 The Genomics and Biomarkers Program, JT Cancer Center, Hackensack University Medical Center, Hackensack Meridian Health, Hackensack, NJ, USA

2 Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, USA

3 Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan

4 Department of Clinical Nutrition, Baystate Medical Center, Springfield, MA, USA

5 Clinical Divisions, JT Cancer Center, Hackensack University Medical Center, Hackensack Meridian Health, Hackensack, NJ, USA

Correspondence to:

K. Stephen Suh, email:

Keywords: malnutrition, cancer therapy, chemo treatment, biomarkers, nutritional intervention

Received: July 25, 2016 Accepted: January 23, 2017 Published: February 04, 2017


Cancer patients often experience weight loss caused by protein calorie malnutrition (PCM) during the course of the disease or treatment. PCM is expressed as severe if the patient has two or more of the following characteristics: obvious significant muscle wasting, loss of subcutaneous fat; nutritional intake of <50% of recommended intake for 2 weeks or more; bedridden or otherwise significantly reduced functional capacity; weight loss of >2% in 1 week, 5% in 1 month, or 7.5% in 3 months. Cancer anorexia-cachexia syndrome (CACS) is a multifactorial condition of advanced PCM associated with underlying illness (in this case cancer) and is characterized by loss of muscle with or without loss of fat mass. Cachexia is defined as weight loss of more than 5% of body weight in 12 months or less in the presence of chronic disease. Hence with a chronic illness on board even a small amount of weight loss can open the door to cachexia. These nutritional challenges can lead to severe morbidity and mortality in cancer patients. In the clinic, the application of personalized medicine and the ability to withstand the toxic effects of anti-cancer therapies can be optimized when the patient is in nutritional homeostasis and is free of anorexia and cachexia. Routine assessment of nutritional status and appropriate intervention are essential components of the effort to alleviate effects of malnutrition on quality of life and survival of patients.

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