# Nutrition screening and support during cancer treatment

Source: https://onco.cc/protocols/nutrition-screening-and-support-during-cancer-treatment/  
OnCo record `nutrition-screening-and-support-during-cancer-treatment` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Weight loss and poor eating are common in cancer and make treatment harder. Your weight and eating should be checked from diagnosis onwards. If you are losing weight or eating less, you should get dietary advice, help with symptoms that stop you eating, and drinks or other supplements if needed. Staying active helps keep your muscles.

## Summary

ESPEN (2021) recommends regular evaluation of nutritional intake, weight change and body mass index from cancer diagnosis onwards, repeated according to how stable the situation is (strong, very low evidence, strong consensus); NICE CG32 screens all hospital inpatients on admission and all outpatients at the first clinic appointment, weekly for inpatients and on clinical concern for outpatients, with a tool such as MUST. An abnormal screen leads to assessment of intake, nutrition impact symptoms, muscle mass, physical performance and systemic inflammation (ESPEN).

Targets are energy of about 25 to 30 kcal/kg/day and protein above 1 g/kg/day, up to 1.5 g/kg/day if possible; vitamins and minerals at about the recommended daily allowance, without high-dose micronutrients; and no energy-restricting diets in people with or at risk of malnutrition. Support is stepped: dietary advice, treatment of symptoms that impair eating and oral nutritional supplements first (strong, moderate); enteral nutrition if oral intake remains inadequate, parenteral if enteral is not sufficient or feasible (strong, moderate); slow increase with precautions against refeeding syndrome after prolonged poor intake. Physical activity is maintained or increased (strong, high evidence). During radiotherapy to the head and neck, thorax and gut, intake is protected by individual counselling and supplements to avoid treatment interruptions. In advanced cancer, nutrition is offered after weighing prognosis, benefit and burden with the patient; in the dying, care is for comfort.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: malnutrition screening in cancer; MUST screening; dietitian referral in cancer; oral nutritional supplements in cancer; ESPEN cancer nutrition
- Tags: protocol; nutrition; supportive-care

## Connected records

- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Cachexia-directed therapy (GDF-15 blockade)](https://onco.cc/technologies/cachexia-therapy/), [Exercise & lifestyle oncology](https://onco.cc/technologies/exercise-oncology/)
- institutions: [European Society for Clinical Nutrition and Metabolism](https://onco.cc/institutions/espen/), [National Institute for Health and Care Excellence](https://onco.cc/institutions/nice/)
- terms: [Cancer cachexia](https://onco.cc/terms/cachexia/)
- ideas: [Nutrition risk screening when cancer treatment starts, with a dietitian plan for everyone who screens positive](https://onco.cc/ideas/idea-upgrade-nutrition-risk-screening-at-treatment-start/)

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