Chapter 3: Nutrition Risk Screening and Assessment of the Oncology Patient

Question 1

Percentage of oncology patients that experience wt loss prior to diagnosis

Answer 1

40%

Question 2

Percentage of oncology patients that experience malnutrition during treatment

Answer 2

40-80%

Question 3

Wt loss during treatment

Answer 3

Correlates with decreased performance, reduced survival, and reduced quality of life

Question 4

Cancers with the highest risk of wt loss and malnutrition

Answer 4

GI and head and neck cancers

Question 5

Safe wt loss during treatment

Answer 5

No more than 2 lb per week. Must be closely monitored and cannot interfere with treatment

Question 6

When should malnutrition screening take place

Answer 6

Upon admission to oncology services and routinely throughout treatment

Question 7

Outpatient Malnutrition screening tools

Answer 7

Patient Generated-Subjective Global Assessment (PG-SGA)

Malnutrition Screening Tool (MST)

Question 8

Inpatient Malnutrition Screening Tools

Answer 8

Malnutrition Screening Tool for Cancer Patients (MSTC)

Malnutrition Universal Screening Tool (MUST)

Question 9

The Academy’s definition of nutrition assessment

Answer 9

A systematic method for obtaining, verifying, and interpreting data needed to identify nutrition-related problems, their causes, and significance. The ongoing, non-linear, dynamic process that involved initial data collection, but also continual reassessment and analysis od the patient’s status compared to specific criteria

Question 10

Definition of malnutrition in oncology patients

Answer 10

malnutrition usually refers to undernutrition and changes in body composition, which occur due to cancer itself or from the impact of the oncology treatment

Question 11

Cancer cachexia definition

Answer 11

a multifactorial syndrome characterized by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and least to progressive functional impairment

Question 12

Stages of cancer cachexia

Answer 12

Pre-cachexia, cachexia, and refractory cachexia (occurs last 3 months of patient’s life)

Question 13

Benefits of good nutrition during cancer treatment

Answer 13

fewer complications
improved quality of life
ability to tolerate full treatment

Question 14

The purpose of nutrition screening and assessment

Answer 14

To identify patients who are at risk for malnutrition

Question 15

A weight loss as little as ___ predicts a reduced response to oncology treatment, reduced survival, and reduced quality of life

Answer 15

6%

Question 16

What percentage of upper GI cancer patients experience weight loss?

Answer 16

80%

Question 17

What does diet history cover

Answer 17

allergies, portion sizes, food patterns, use of functional foods, alcohol, diet, food intolerances or aversions

Question 18

What do biochemical data, medical tests, and procedures cover

Answer 18

hydration status, electrolytes, WCB, RBC, ANC, CRP, GI function tests, liver function, glucose, CT scans

Question 19

What is NIS, provide examples

Answer 19

Nutrition Impact Symptoms that impede intake, digestions or absorption
Dysphasia, mucositis, stomatitis, nausea, vomiting, gastroparesis

Question 20

Clinical Characteristics of Malnutrition

Answer 20

Energy intake
Wt loss
Body Fat
Muscle Mass
Fluid Accumulation

Question 21

How many characteristics must be present to diagnose malnutrition

Answer 21

2 out of 6

*documentation of all 6 characteristics represents a complete nutrition assessment

Question 22

Pathophysology of cancer cachexia

Answer 22

Charachterized by a negative protein and energy balance driven by reduced oral intake or abnormal metabolism