EXAMINING GUIDELINES AND NEW EVIDENCE IN ONCOLOGY NUTRITION: A POSITION PAPER ON GAPS AND OPPORTUNITIES IN MULTIMODAL APPROACHES TO IMPROVE PATIENT CARE

Publish Date: 27 October 2021
Author(s): Carla Prado, Chelsia Gillis, Anthony Sung, Şuayib Yalçın, Suzanne Dixon, Shila Newman, Abby Sauer, Refaat Hegazi, and Martin R. Chasen

Abstract:

Malnutrition, muscle loss, and cachexia are prevalent in cancer and remain key challenges in oncology today. These conditions are frequently underrecognized and undertreated and have devastating consequences for patients. Early nutrition screening/assessment and intervention are associated with improved patient outcomes. 
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Author Bios

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Dr. Carla Prado is a professor at the University of Alberta in Canada and a Campus Alberta Innovate Program (CAIP) chair in Nutrition, Food and Health. She is also the director of the Human Nutrition Research Unit at the university. Dr. Prado received her PhD in human nutrition and metabolism from the University of Alberta, Canada, and is a registered dietitian in both Canada and Brazil. Dr. Prado is an expert in assessing nutritional status through the precise measurement of body composition and energy metabolism. The focus of her current research program is to develop targeted nutrition interventions for the prevention and treatment of low muscle mass in patients with cancer. She is currently the principal investigator for 2 randomized controlled trials investigating the impact of nutrition intervention on body composition and health. She is also conducting the first study looking at protein requirements in cancer using indicator amino acid oxidation rate technique. She is currently a member of the GLIM Body Composition Working Group, and the Sarcopenic Obesity Consensus Group (ESPEN/EASO). She is an Associate Editor of Clinical Nutrition and the Journal of Cachexia, Sarcopenia and Muscle. Alessandro Laviano
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Dr. Chelsia Gillis is a registered dietitian. She has expertise in surgical metabolism, surgical nutrition, prehabilitation, Enhanced Recovery After Surgery, epidemiology, and patient engagement. She received her PhD in epidemiology from the University of Calgary and is currently completing a postdoctoral fellowship at McGill University in Montreal, Quebec. Dr. Gillis has been a collaborator and principal investigator for several Canadian dietetic and nutrition research trials. Her current research includes collaboration to understand which factors influence functional capacity in personalized prehabilitation for older patients scheduled for colorectal cancer surgery with malnutrition and/or low physical performance. Additionally, Dr. Gillis has authored/coauthored many articles in peer-reviewed journals.
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Dr. Anthony Sung is an assistant professor of medicine in the Division of Hematologic Malignancies and Cellular Therapy and associate director of the Duke Microbiome Center at the Duke University School of Medicine in Durham, North Carolina, US. He received his medical degree from Harvard Medical School in Boston, Massachusetts, US. Dr. Sung completed his residency in internal medicine at Johns Hopkins Hospital in Baltimore, Maryland, US, and fellowship at Duke University School of Medicine. His current research interests include hematopoietic stem cell transplantation (HCT), with a focus on preventing complications such as infections, gastrointestinal toxicity, and graft-versus host disease through modulation of the microbiome; delivery of care, such as home-based HCT and mHealth, medication adherence, and behavioral economic incentives; costs associated with HCT; and novel cellular therapies. Dr. Sung’s research encompasses murine, phase 1, phase 2, and correlative studies. He has authored/coauthored numerous articles published in peer-reviewed journals and presented his research at several conferences.
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Ms. Maureen Gardner is a clinical oncology dietitian for Florida Cancer Specialists and Research Institute in Tampa, Florida, US. She received an MA in gerontology from the University of South Florida in Tampa. Ms. Gardner has extensive experience in the care of oncology patients, including survivorship and prevention, and has worked in the field of oncology nutrition for almost 25 years. She is a board-certified specialist in oncology nutrition. Currently, Ms. Gardner is the coordinator of all aspects of nutrition care for outpatients in four bay area clinics, caring for patients before, during and after cancer treatment. In her spare time Ms. Gardner volunteers for a national group of oncology dietitians: The Oncology Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics.
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Dr. Şuayib Yalçın is a professor in the Department of Medical Oncology at the Hacettepe University Cancer Institute in Sihhiye, Ankara, Turkey. He received his medical degree from the Hacettepe University School of Medicine and completed his residency in internal medicine there as well. Dr. Yalçın’s primary research interests are gastrointestinal oncology, including neuroendocrine tumors and gastrointestinal stromal tumors; supportive care, including pain, nutrition, and emesis. He has participated in many international multicenter clinical trials resulting in practice changes in oncology. Diagnosis and management. He has authored/coauthored more than 200 articles in peer-reviewed journals. He is the editor of Textbook of Gastrointestinal Oncology and also the editor of Neuroendocrine Tumors: Diagnosis and Management which is being prepared for the second edition.
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Ms. Suzanne Dixon, a registered dietitian and epidemiologist, is best known as the creator of an award-winning cancer nutrition website, which was acclaimed by the New York Times and Time magazine. She has delivered more than 200 invited and submission-accepted lectures to patient and professional groups and has received numerous awards from the Academy of Nutrition and Dietetics for her work. She is a Past Chair of the Oncology Nutrition Dietetic Practice Group and formerly managed the Outpatient Oncology Nutrition and HIV Nutrition Care Programs at the University of Michigan Health System. Suzanne has served as an appointed member to the National Comprehensive Cancer Network, the ASCO Obesity and Energy Balance Work Group, the ASCO Cachexia and Nutrition Guidelines Development Group and the Institute of Medicine workshop on Assessing Nutrition Care in Outpatient Oncology. She is currently a Research Consulting Lead with Humana in Portland, Oregon.
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Ms. Shila Newman has 22 years of experience in oncology nursing. She is currently part of a team of nurse navigators at Thompson Cancer Survival Center in Knoxville, Tennessee, US. Ms. Newman currently focuses on site-specific nurse navigation for patients with head and neck cancers and hematological malignancies. Her previous experience includes 10 years as a stem cell transplant coordinator/navigator at Thompson Cancer Survival Center and 9 years as an oncology staff nurse as part of the inpatient oncology/stem cell transplant unit at Fort Sanders Regional Medical Center in Knoxville. As a nurse navigator, Ms. Newman helps patients understand their diagnosis and treatment options; coordinates care with the medical team; aids in communication among patients, physicians, and other care providers; and advocates for the patient.
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Dr. Michael D. Bastasch is the medical director and a radiation oncologist at the University of Texas Health/East Texas Cancer Institute in Athens, Texas, US. He received his medical degree from the University of Kansas School of Medicine in Kansas City, Kansas, US. He completed his residency in radiation oncology at Baylor College of Medicine in Houston, Texas. Dr. Bastasch provides oversight and management for radiation oncology services in the treatment of approximately 170 adult patients each year. He practices community-based patient care for a large diverse population of patients, including pediatric, adult, geriatric, and mentally ill patients, and is results and outcome oriented. Dr. Bastasch initiated the high dose rate program for gynecologic, breast, and prone breast technique. He has authored/coauthored many articles in peer-reviewed journals and presented at national and international conferences.
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Ms. Abby Sauer joined Abbott Nutrition in 1999 and is currently a Senior Manager within the Scientific and Medical Affairs department, External Engagement. Her areas of experience include malnutrition, nutrition screening, assessment, and intervention, geriatric nutrition, oncology nutrition, and renal nutrition. Abby earned her BS in dietetics from Miami University in Oxford, Ohio and completed her dietetic internship at Barnes Jewish Christian Hospital in St. Louis, Missouri. She earned a Master’s in Public Health from The Ohio State University.
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Dr. Refaat Hegazi is the head of Global Medical Affairs for Nutrition at Abbott. As a physician scientist, Dr. Hegazi oversees a team of nutrition experts and medical directors that advance education, clinical research, science and product development of nutrition products. He is passionate about leading his team to uncover the role of nutrition in health and disease. He has interest in studying the correlation between nutrition and immune and glycemic responses to develop therapies to manage chronic and acute diseases.

Dr. Hegazi joined Abbott in 2009 and helped develop a global diabetes nutrition care model that encompassed transcultural differences in diets and lifestyle. Also an expert in malnutrition, he has contributed to advances in the treatment of malnutrition through healthcare coalitions and educational programs.

Dr. Hegazi is a graduate of Mansoura University Faculty of Medicine, Mansoura, Egypt. He earned a Master of Occupational Health and Industrial Medicine from Mansoura University Faculty of Medicine in Mansoura, Egypt. He also has a Master of Public Health from the Graduate School of Public Health at the University of Pittsburgh. Additionally, he has a PhD in Nutritional Epidemiology from the Graduate School of Public Health, University of Pittsburgh and Master of Business Administration from the Franklin University. He completed his post-Doctoral fellowship in Gastrointestinal Immunology at the University of Pittsburgh School of Medicine.

Dr. Hegazi is certified by the American Board of Physician Nutrition Specialist and has authored 50 peer reviewed articles and five book chapters.
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Dr. Martin R. Chasen is an associate clinical professor in the Departments of Medicine and Community and Family Medicine at University of Toronto in Ontario, Canada, and the medical director of palliative care at William Osler Health System in Brampton and Etobicoke, Ontario. He obtained a specialist degree in internal medicine, medical oncology and Palliative care from the University of Cape Town, South Africa. He currently holds professorships at the Universities of Toronto, McMaster, Ottawa, and McGill in Canada. Dr. Chasen was the medical lead for both Ottawa and Brampton, Ontario, when these sites received European Society for Medical Oncology (ESMO) accreditation as a designated site for integrated oncology and palliative care. He is the national principal investigator on a CIHR grant, The MENAC trail Multimodal Intervention for Cachexia in Advanced Cancer Patients Undergoing Chemotherapy. Dr. Chasen has authored/coauthored more than 110 peer-reviewed publications, abstracts, and book chapters.
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