The first version of the guideline general and tumour specific nutritional and dietary treatment (1.0) was written in 2006 based on the dietary protocols in the Guide for dietetic counselling in cancer patients (Leidraad voor voedingsdeskundigen bij kanker, 2006), and the Dietetic Guideline Cancer (Dieetbehandelingsrichtlijn Kanker, 2003). This version was approved by the Dutch Dieticians Oncology Group (Landelijke Werkgroep Diëtisten Oncologie, LWDO).
The current revised guideline general and tumour specific nutritional and dietary treatment (2.0) is based on the Manual Nutrition in cancer, 2012 (Handboek Voeding bij kanker 2012). An expert group (see appendix 1) of registered dieticians specialized in oncology from hospitals and medical centres in the Netherlands composed this manual. These guidelines have also been approved by the Dutch Dieticians Oncology Group (Landelijke Werkgroep Diëtisten Oncologie, LWDO) in cooperation with the Surgical Association Dieticians Academic Hospitals (Chirurgisch Overleg Diëtisten Academische Ziekenhuizen, CHIODAZ) and the Dutch Dieticians Haematology and Stem Cell Transplants Group (Landelijk Overleg Diëtisten Hematologie en Stamceltransplantatie, LODHS).
Scope Cancer patients, like everybody else, need a well-composed, sufficient and attractive diet, to keep their nutritional status in balance. Disease and treatment have an negative influence on nutritional status and body composition and cause a negative effect on treatment response and quality of life. In illness and treatment the capacity of a cancer patient to eat well is limited which can lead to moderate of severe malnourishment. Nutritional and dietary treatment is therefore an important supportive therapy to achieve cure or good palliative care.
Goal The guideline aims to give insight into the current knowledge of nutrition, nutritional symptoms and the nutritional care process in cancer.
Target group The guideline is intended mainly for dieticians as support in their treatment of cancer patients. But it is also intended for other professionals who take care of the nutritional status of a cancer patient such as medical specialists, general practitioners and (specialised) nurses.
Abstract The guideline consist of two parts. The first part General nutritional and dietary treatment (2.0) include aspects of the nutritional care process that concern most cancer patients and treatments that focus on nutritional status, nutritional requirements and dietary advice for symptoms in general. The second part, Tumour specific (2.0), includes specific information on treatment policy and nutritional advice in different stages and treatments of the specific tumour.
Working method If possible nutritional interventions in cancer are based on the most current nutritional research in oncology, but scientific evidence is not always available. Dietary advice is often best practice-based: a mix of scientific research and practical experience.
Clinical questions. A nationwide survey was initiated to obtain insight into the most relevant clinical nutritional questions in the daily practice of dieticians.
Scientific evidence. The general part is mostly based on the scientific conclusions, considerations and recommendations of the evidence based Dutch guideline Malnutrition in cancer patients (Ondervoeding bij patienten met kanker) by the Comprehensive Cancer Centres of the Netherlands (IKNL). For other chapters of the general part and the tumour specific part systematic searches were performed by research bureau ‘Wetenschap en Voeding' in Haarlem. For each chapter a selection has been made from the most relevant references.
Practical expertise. The guideline incorporates the practical experiences and competences of dieticians in the Netherlands specialised in oncology. Also nutritional guidelines from the cancer centres in the USA, United Kingdom, Germany and Australia were used.
Cancer patients. An online survey was designed to give insight into the wishes and needs of cancer patients.
The guideline connects to the recently developed nutritional guidelines in the Netherlands: Malnutrition in cancer patients (Ondervoeding bij patiënten met kanker, 2012), National Primary Care Collaboration Agreement (Landelijke Eerstelijns Samenwerkings Afspraak Ondervoeding (LESA), Ondervoeding, 2010) and Screening and Treatment of Malnutrition (Screening en behandeling van Ondervoeding, 2011).