The Importance of Good Nutrition in Oncological Surgery

Nutrition and Oncological Surgery: The Evidence

Malnutrition affects 30–50% of cancer patients at diagnosis. In surgical oncology, poor nutritional status is associated with significantly higher rates of surgical complications, longer hospital stays, impaired wound healing, increased infection risk and worse overall survival. Optimising nutrition is not optional — it is an integral part of oncological care.

Assessment and Screening

Nutritional screening should be performed at first oncological contact using validated tools (NRS-2002, MUST or GLIM criteria). Patients identified at risk require detailed dietitian assessment and intervention before, during and after treatment. Key parameters include: weight loss history, body mass index, serum albumin, pre-albumin and inflammatory markers.

Pre-Operative Nutrition

Oral nutritional supplements (ONS): Protein-rich supplementation for 7–14 days pre-operatively. Immunonutrition: Formulas containing arginine, omega-3 fatty acids and glutamine show benefit in major abdominal surgery. Carbohydrate loading: Pre-operative carbohydrate drinks reduce insulin resistance and protein catabolism. Avoid prolonged fasting: Modern enhanced recovery protocols permit clear fluids up to 2 hours before surgery.

Post-Operative Nutrition

Early enteral nutrition (within 24 hours of surgery) reduces complications and length of stay. Parenteral nutrition is reserved for patients who cannot tolerate enteral feeding for >5 days. Protein requirements in major oncological surgery are elevated (1.5–2g/kg/day). Nutritional support should continue for weeks to months post-operatively during recovery.

During Chemotherapy and Radiotherapy

Regular dietitian review throughout treatment. Management of specific side effects: nausea, mucositis, dysphagia, diarrhoea. Small, frequent, nutrient-dense meals. Avoidance of extreme diets and unproven supplements that may interfere with treatment.