Cancer Nutrition Support at VICI Healthcare

Nutrition in cancer is not a diet. It is getting enough food, protein, and fluid into a body that the disease and treatment are pulling in the opposite direction. We screen, support, and treat the symptoms blocking eating so patients finish treatment stronger. Care, kept close.

• Roughly one in two patients with a solid tumour loses clinically meaningful weight at some point, rising to higher rates in upper GI, pancreatic, lung, and head and neck cancers.
• Cancer cachexia is not starvation. It is a metabolic state driven by inflammation from the tumour, and feeding alone will not fully reverse it, but feeding still matters because patients who keep weight through treatment tolerate chemotherapy better and live longer.
• Every modern oncology guideline asks teams to screen every patient for nutrition risk at diagnosis and at every clinic visit during treatment, because early support stops patients from falling too far.
• The most effective nutrition support in India is often a homemade high-protein milkshake built from milk, paneer, banana, peanut butter, and whey protein, costing a fraction of commercial supplements and keeping patients eating when taste and appetite are broken.

Nutrition in cancer is not a diet plan. It is the everyday work of getting enough food, protein, and fluid into a body that the disease and its treatment are pulling in the opposite direction. A patient on chemotherapy may wake up nauseous, lose her sense of taste by lunch, and find that the smell of her usual dal makes her gag by dinner. A patient finishing head and neck radiation may have a mouth so sore that water hurts. A patient with pancreatic cancer may eat the same meal she ate last year and still lose weight every week. None of this is about willpower.

Weight loss in cancer is common and it is dangerous. Losing more than five percent of body weight in six months, or more than two percent if already underweight, meets the definition of cancer cachexia. But cachexia is not the same as starvation. The body is in a different metabolic state, driven by inflammation from the tumour. Feeding still matters, because patients who keep their weight and muscle through treatment tolerate chemotherapy better, finish radiation on schedule more often, recover from surgery faster, and live longer on average.

Nutrition care in oncology has three jobs. Find the patients who are losing ground, before they fall too far. Match the food, the texture, and the route of feeding to what the patient can actually manage today. Treat the symptoms that are blocking eating, because no diet plan survives untreated nausea, untreated mouth pain, or untreated constipation.

Every modern guideline asks oncology teams to screen every patient for nutrition risk at diagnosis, and then again at every clinic visit during treatment. The point of screening is to be quick. The point of assessment is to be thorough.

The Malnutrition Screening Tool (MST) and the Nutritional Risk Screening 2002 (NRS-2002) are the two most widely used. MST asks two questions: Have you lost weight without trying? Are you eating less than usual because of poor appetite? Both take under two minutes. When screening flags a patient, the team moves to a fuller assessment. The Patient-Generated Subjective Global Assessment (PG-SGA) is the most validated tool in oncology. It captures weight history, food intake history, symptoms that affect eating, functional capacity, and a brief physical exam for muscle and fat loss. A trained dietitian can complete it in fifteen to twenty minutes and the score guides whether the patient needs counselling, oral supplements, or escalation to tube or vein feeding.

Body composition matters. A patient who loses five kilograms of muscle and gains three kilograms of fluid looks stable on the scale and is in deep trouble. Where available, body composition measurement by bioelectrical impedance or by a single CT slice at the L3 vertebra from a staging scan gives a truer picture than weight alone. Most Indian centres do not have routine bioimpedance in the clinic, but the L3 CT slice is sitting in the radiology archive of nearly every patient who has had staging imaging.

The European Society for Clinical Nutrition and Metabolism (ESPEN) clinical guideline on nutrition in cancer patients gives a target of about twenty-five to thirty kilocalories per kilogram of actual body weight per day for most ambulatory patients with cancer. The guideline recommends a protein intake of at least one gram per kilogram per day, with a target closer to one and a half grams per kilogram per day in patients with active inflammation, sarcopenia, or cachexia, and as much as the patient can tolerate up to two grams per kilogram per day in selected cases. These numbers are higher than the protein intake of a typical Indian vegetarian diet, which often sits closer to half a gram per kilogram per day.

Closing that gap is one of the central tasks of cancer nutrition counselling in India. It usually means adding pulses, paneer, eggs where acceptable, milk, curd, soy, and a measured amount of an oral nutritional supplement, rather than asking the patient to eat unfamiliar food. Micronutrients matter too, but a patient who eats a varied diet does not need a multivitamin. A patient with documented deficiency, a patient on long-term proton pump inhibitors, a patient after gastric or pancreatic surgery, or a patient with chronic diarrhoea often needs targeted replacement, and the team should test rather than guess.