Joint Call to Action

To influence EU programmes and to support national initiatives, the European Nutrition for Health Alliance and its partners have developed a joint call to action with 7 actionable recommendations designed to ensure the protection of nutritional status in cancer in national health policies.

The call to action is a template that can be tailored to your country’s or region’s specific situation and needs. The European Nutrition for Health Alliance can also support the organisation of your policy seminar.

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The right of patients to nutritional care in cancer treatment

Recognising the need for every member state to take coordinated actions for Europe’s Beating Cancer Plan implementation, this joint call to action includes 7 key recommendations designed to ensure the protection of the nutritional status of patients with cancer.

It is our position that high-quality care cannot be delivered without fully integrating nutritional care into the cancer care pathway, from diagnosis through the entire disease trajectory. We urge all EU member states and their respective institutes to incorporate these essential recommendations in national cancer strategies and all relevant national and local health and healthcare policies.

Background

Failure to protect nutritional status in cancer is undermining the quality of cancer care in Europe.
There is now overwhelming scientific evidence that a failure to prevent weight and muscle loss in patients with cancer may undermine the effectiveness of treatments and significantly increase the risk of serious side effects^1,2,3,4.  For those in whom cure is no longer possible, poor nutritional status impairs quality of life and reduces survival time ^4,5,6,7,8. Yet malnutrition, despite being the single most frequent, serious complication in cancer continues to receive unacceptably low priority in national cancer care policies and patient services ⁹.  This urgently needs to change.

Patients pay the price of nutritional care not taken seriously.
The low priority placed on nutritional care in cancer across Europe has undoubtedly had distressing consequences for some patients and their families, with inequities and gaps in care highlighted in a recent European survey of patients¹⁰. Not only do gaps in nutritional care expose cancer patients to increased risks of potentially avoidable complications and treatment side effects, but for some, the inability to access early nutritional care means that they have less time, or poorer quality time, to spend with loved ones ^{11,12,13, 14}.  It is important not to allow any further time to elapse.

Based on available research (1,14), it is estimated that 10 and 20% of the 1.3 m cancer deaths in the EU (2020) can be attributed to malnutrition, rather than cancer itself.

Call to Action: make optimal nutritional care a mandatory component of high-quality cancer care.
The European Nutrition for Health Alliance, on behalf of its member organisations, is calling for national governments across Europe to make nutritional care a mandatory and fully integrated component of high-quality care.  Taking action to ensure early access of patients to proactive nutritional care has the potential to prevent treatment-limiting side effects, allowing more patients to benefit from advances in cancer treatments, whilst improving the quality of life and survival time for many others.

Europe’s Beating Cancer Plan commits to giving everyone with cancer the same access to high-quality care – which must include nutritional care.
The European Nutrition for Health Alliance and its partners, recognise Europe’s Beating Cancer Plan as a true game-changer to address inequities in the quality of cancer care across member states.  With a €4.1billion budget aimed at supporting the implementation of this ambitious programme, national policymakers now have an unrivalled opportunity to align their cancer programmes with best international practice for high-quality care that carries the same hope of survival and quality of life. However, high-quality cancer care cannot be delivered without addressing the gaps in workforce training, clinical pathways and dietetic services that leave many patients without timely access to information, dietary counselling or nutrition support needed to achieve their best possible outcome.

7 Effective and actionable recommendations

① The right to high-quality cancer care and medicines must explicitly apply to optimal nutritional care.

② Measuring and monitoring nutritional and metabolic status should be systemised and reviewed as a standardised part of the multidisciplinary team (MDT) processes.

③ All multidisciplinary teams should include a specialist oncology dietitian.

④ Development of a standardised framework for nutrition education and training, extended to all those involved in cancer care currently and in the future.

⑤ All member state authorities should establish a nutrition steering group linked to comprehensive cancer centres.

⑥ Research funding should be allocated to identify effective implementation strategies for integrating optimal nutritional care into cancer care.

⑦ Cancer patients should have timely access to information and resources regarding nutrition, diet, and nutritional therapies relevant to their disease type and stage.

Rewatch EU4Nutrition LIVE

This policy seminar, held April 2021 under the Portuguese EU presidency, has identified concrete implementation recommendations at EU member state level and explores how patients and countries can benefit from Europe’s Beating Cancer plan.