Nutritional Factors during and after Cancer: Impacts on Survival and Quality of Life.

The French National Cancer Institute conducted a collective expertise study with researchers and clinical experts from the French Network for Nutrition And Cancer Research (NACRe Network). The objective was to update the state of knowledge on the impacts of nutritional factors on clinical endpoints during or after cancer. Data from 150 meta-analyses, pooled analyses or intervention trials and 93 cohort studies were examined; they concerned 8 nutritional factors, 6 clinical events and 20 cancer locations. This report shows that some nutritional factors have impacts on mortality and on the risks of recurrence or second primary cancer in cancer patients. Therefore, high-risk nutritional conditions can be encountered for certain cancer sites: from the diagnosis and throughout the health care pathways, weight loss (lung and esophageal cancers), malnutrition (lung, esophageal, colorectal, pancreatic, gastric and liver cancers), weight gain (colorectal, breast and kidney cancers) and alcohol consumption (upper aerodigestive cancers) should be monitored; and after cancer treatments, excess weight should be detected (colorectal, breast and kidney cancers). These situations require nutritional assessments, and even support or management by health care professionals, in the context of tertiary prevention. This report also highlights some limitations regarding the existing literature and some needs for future research.

[During and after cancer: identification of high-risk nutritional situations]. / Pendant et après un cancer : repérer les situations nutritionnelles à risque.

"During and after cancer: identification of high-risk nutritional situations At the end of 2020, the French National Cancer Institute published a report presenting the state of knowledge on the impact of nutritional factors on clinical endpoints during or after cancer. This report is the result of a collective expertise by an expert group from the French Network for Nutrition And Cancer Research (NACRe Network, www.inrae.fr/nacre). This report shows that some nutritional factors have an impact on the mortality, and the risk of recurrence or second primary cancer in cancer patients. Therefore, high-risk nutritional situations can be encountered for certain cancer sites: from the diagnosis and throughout the healthcare circuit, weight loss (for lung and esophageal cancers), malnutrition (for lung, esophageal, colorectal, pancreatic, gastric and liver cancers), weight gain (for colorectal, breast and kidney cancers), or alcohol consumption (upper aerodigestive cancers) should be monitored; and after cancer treatments, excess weight should be detected (colorectal, breast and kidney cancers). These situations require nutritional assessments, or even support or management by healthcare professionals, in the context of tertiary prevention."

Pendant et après un cancer : repérer les situations nutritionnelles à risque Fin 2020, l'Institut national du cancer a publié un rapport présentant l'état actuel des connaissances sur l'impact des facteurs nutritionnels sur des événements cliniques pendant et après un cancer. Ce rapport est issu d'une d'expertise collective ayant fait appel à des experts du Réseau national alimentation cancer recherche (Réseau NACRe, www.inrae.fr/nacre). Le rapport montre que certains facteurs nutritionnels ont un impact sur la mortalité, le risque de récidive et de second cancer primitif chez les patients atteints de cancer. Ainsi, des situations nutritionnelles à risque pourraient être rencontrées pour certaines localisations du cancer  : dès le diagnostic et tout au long du parcours de soins, il convient d'être vigilant face à une éventuelle perte de poids (cancers du poumon et de l'oesophage), la dénutrition (cancers du poumon, de l'oesophage, du côlon et du rectum, du pancréas, de l'estomac et du foie), une prise de poids (cancers colorectal, du sein et du rein) ou la consommation d'alcool (cancers des voies aérodigestives supérieures)   ; et, après les traitements, à un excès de poids (cancers colorectal, du sein et du rein). Ces situations nécessitent des évaluations nutritionnelles, voire un accompagnement ou une prise en charge par des professionnels de santé, dans le cadre de la prévention tertiaire.

[Impact of nutritional factors during and after cancer]. / Impact des facteurs nutritionnels pendant et après cancer.

Nutritional factors (diet, weight, alcohol, physical activity) are identified as factors having an impact on the onset of several cancer sites. Less abundant scientific data also underline their impact on the tumor progression. A review of the scientific literature was carried out by a group of experts established by the French National Cancer Institute (INCa) to better document the influence of nutritional factors during and after cancer on outcomes such as overall mortality, cancer specific mortality, recurrence, second primary cancers and quality of life. This analysis of the literature completes messages of reduction of alcohol consumption, prevention of undernutrition or excess weight and adherence to dietary recommendations, avoiding the use of dietary supplements, fasting or restrictive diets and strengthens messages promoting the practice of physical activity and the fight against sedentary lifestyle.