The Impact of Early Referrals to Dietitians for Patients With Esophagogastric Cancer

Abstract

Weight loss is a physical representation of the impact of cancer on the body and loss of control. For patients with esophagogastric cancer (EGC), loss of appetite and weight loss lead to reduced quality of life and poor clinical outcomes. In this issue of JNCCN, Dijksterhuis et al1 present data evaluating the prevalence of pretreatment cachexia, association of pretreatment cachexia with survival, and early integration of dietitians in the care of patients with EGC. This 3-year Dutch study included >400 patients with EGC across all stages. Half of the patients had cachexia at presentation, which was associated with decreased survival. In our opinion, the key finding of this study is that 3-month median weight loss was lower for the patients referred to a dietitian at diagnosis (0% vs 2%; P=.047).1 These findings suggest that early involvement of dietitians may slow or stabilize weight loss in the care of patients with EGC and highlight 3 key take-away points for practicing oncologists: (1) clarify the difference between weight loss and cachexia, (2) identify precachexia and (3) refer early to dietitians.