Nutrition and Supplement Guidance for Cancer Patients

Guideline-Based Recommendations

The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines state that physicians do not agree on the use of dietary supplements during cancer treatment, and many cancer experts advise against taking supplements during treatment unless necessary to treat a specific deficiency 1
The American Cancer Society recommends that cancer patients should not take supplements containing higher amounts than 100% of the daily value unless recommended by their healthcare team for a specific reason 1

Cancer patients should maintain skeletal muscle mass through adequate protein intake (1.2-2 g/kg/day) and physical activity 2, 3, 4
Ambulatory cancer patients should ensure a total energy intake of 25-30 kcal/kg/day, while bedridden patients should aim for 20-25 kcal/kg/day 5
Cancer patients experiencing weight loss or reduced intake should seek professional nutrition counseling as first-line therapy 3

Systemic inflammation in cancer patients should be managed through medical management of pain and symptoms, pharmacological agents to control inflammation when indicated, and combined nutrition and physical therapy 2, 3, 4

If oral intake is inadequate (<60% of estimated energy expenditure for >10 days), cancer patients should use established nutritional interventions, starting with oral nutritional supplements, followed by enteral nutrition if necessary, and parenteral nutrition only if the enteral route is not feasible 3, 5, 6, 7

Cancer patients should not substitute unproven supplements for evidence-based nutritional therapy, as the safety profile of glucosamine/chondroitin does not justify their use when the evidence for benefit is weak and likely confounded 1
Early initiation of professional nutrition counseling, adequate protein/calorie intake, and physical activity have established benefits for maintaining muscle mass, reducing treatment toxicity, and improving quality of life 2, 3, 4