TY - JOUR
T1 - Practical cancer nutrition, from guidelines to clinical practice
T2 - a digital solution to patient-centred care
AU - Hustad, K. S.
AU - Koteng, L. H.
AU - Urrizola, A.
AU - Arends, J.
AU - Bye, A.
AU - Dajani, O.
AU - Deliens, L.
AU - Fallon, M.
AU - Hjermstad, M. J.
AU - Kohlen, M.
AU - Kurita, G. P.
AU - Lundeby, T.
AU - Mitrea, N.
AU - Payne, C.
AU - Roselló-Keränen, S.
AU - Warmbrodt, N.
AU - de Wilde, A.
AU - Kaasa, S.
AU - de Vos-Geelen, J.
AU - Laird, B. J.A.
AU - MyPath consortium
N1 - Funding Information:
The MyPath solution introduces several benefits, such as digital support that retrieves PROMs and makes them available to the HCP. In contrast with standalone applications, MyPath as a complete and comprehensive solution also guides clinicians in efficiently gathering necessary information and automatically provides the assessment and corresponding management algorithms. Thus, MyPath aims to support the clinical processes needed for the implementation of PCC. The emphasis on ease of use is pivotal in ensuring that clinicians, regardless of their geographic location or clinical setting, can readily incorporate the assessment and management pathways provided by MyPath into their routine practice. This will not only streamline the process of nutritional assessment but also facilitate the implementation of tailored interventions, thereby improving the overall quality of cancer care on a global scale. Furthermore, MyPath ensures that individuals undergoing cancer care become active participants in their nutritional assessment and management. This empowers patients and fosters a collaborative approach between HCPs and those receiving care.We would like to express our gratitude to Merlijn Graus for illustrating and producing the figure designs, and to the members of the MyPath consortium who have provided timely feedback when presented with the present work. MyPath is funded by the European Union [grant number 101057514] and supported by Innovate UK and the Swiss State Secretariat for Education, Research and Innovation (SERI). The authors have declared no conflicts of interest. MyPath consortium, K. Absolom1,2, M. Andresen3, M. Atter4, D. Ausen3, S. Bea4, K. Beernaert5, A. Caraceni6,7, A. Cervantes8,9, K. Cresswell10, O. Dajani11, J. de Vos-Geelen12, L. Deliens5, F. Evans13, M. Fallon4, V. Freitas8, V. Fusetti6, I. Gonzalez-Barrallo8, P. Hall4, M. J. Hjermstad11, M. Huerta8, K. S. Hustad11, A. Jacobs14, S. Kaasa11, L. H. Koteng11, G. P. Kurita15,16,17, H. Larsen18, U. Lassen17,19, N. J. Latino13, T. Lundeby11, E. D. Lundereng11, C. C. Lykke18,20, G. Massa6,7, U. Mathiesen18, N. Mitrea21,22, D. Mosoiu22,23, S. O. Damink24,25,26, H. Pappot17,18,19, K. Pardon5, C. Payne27, O. Predoiu22, A.-L. Scherrens5, M. Shkodra6, P. Sj\u00F8gren18, E. Storaas11, A. Urrizola11, P. H. Utne11, F. Van Landschoot5, G. Velikova1,2, L. Warrington2, N. White4 & R. Williams28, 1Leeds Cancer Centre, St James's University Hospital, Leeds; 2Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; 3DNV Imatis AS, Porsgrunn, Norway; 4Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK; 5Department of General Practice and Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium; 6Fondazione IRCCS Istituto Nazionale dei Tumori, Milan; 7Dipartimento di Scienze Cliniche e di Comunit\u00E0\u2014Dipartimento di eccellenza 2023\u20132027 Universit\u00E0 degli studi di Milano, Milan, Italy; 8Department of Medical Oncology, INCLIVA Biomedical Research Institute, Valencia; 9CIBERONC, Instituto Salud Carlos III, Madrid, Spain; 10Usher Institute, University of Edinburgh, Edinburgh, UK; 11European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 12Department of Internal Medicine, Division of Medical Oncology, GROW\u2014Research Institute for Oncology & Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands; 13Department of Scientific & Medical Affairs, European Society for Medical Oncology (ESMO), Lugano, Switzerland; 14Department of Media and Communication Studies, Vrije Universiteit Brussel (VUB), Imec-SMIT Research Group, Brussels, Belgium; Departments of 15Oncology; 16Anaesthesiology, Pain and Respiratory Support, Rigshospitalet Copenhagen University Hospital, Copenhagen; 17Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Departments of 18Oncology, Section of Palliative Medicine; 19Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen; 20Department of Oncology and Palliative Care, North Zealand Hospital, Denmark; 21Department of Fundamental Disciplines and Clinical Prevention, Faculty of Medicine, University of Transilvania from Brasov, Brasov; 22Department of Education and National Development, HOSPICE Casa Sperantei, Brasov; 23Department of Medical and Surgical Specialties, Faculty of Medicine, University of Transilvania from Brasov, Romania; 24Department of Surgery, Maastricht University Medical Centre, Maastricht; 25NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; 26Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Essen, Essen, Germany; 27European Association for Palliative Care, Vilvoorde, Belgium; 28Institute for the Study of Science, Technology and Innovation, University of Edinburgh, Edinburgh, UK
Funding Information:
MyPath is funded by the European Union (grant no. 101057514) and supported by Innovate UK and the Swiss State Secretariat for Education, Research and Innovation (SERI).
Publisher Copyright:
© 2025 The Author(s)
PY - 2025/4/1
Y1 - 2025/4/1
N2 - Background: Malnutrition affects 20%-70% of cancer patients, depending on tumour type, disease stage, and clinical setting. While nutritional care is essential for improving patients’ quality of life and clinical outcomes, it is not systematically integrated into routine cancer care. MyPath is a European Union project aiming to implement patient-centred care (PCC) at nine European cancer centres using implementation science. Multidisciplinary teams have developed standardised digitally supported PCC pathways based on patient-reported outcomes (PROs) with linked evidence-based management options. Through systematic assessment and management of common symptoms and psychosocial problems in cancer patients, MyPath aims to facilitate changes in clinical practice to improve PCC for all. As part of this, the MyPath Nutrition Care Pathway (NCP) aims to facilitate necessary clinical changes to routinely assess and address nutrition in all patients. Materials and methods: Between September 2022 and August 2024, an international multidisciplinary team reviewed evidence-based nutrition guidelines to select relevant PROs and other variables necessary to systematically assess patients, allowing for tailored nutritional care. Results: The MyPath NCP assessment relies on nutritional status (Malnutrition Screening Tool for malnutrition risk, modified Global Leadership Initiative on Malnutrition criteria for malnutrition, and body mass index/weight change for obesity/unintentional weight gain), health status (functional status, cancer diagnosis and prognosis, and prehabilitation needs), and inflammatory status (C-reactive protein levels). Based on this assessment, the digital solution suggests tailored, evidence-based nutritional interventions. Continuous monitoring through PROs and clinical consultations will customise care to patients’ dynamic nutritional needs. The first version of this digital solution will be piloted in 2025. Conclusions: Inconsistent implementation of nutrition guidelines is a key challenge in cancer care. The MyPath NCP offers an accessible, patient-centred assessment and management system that integrates nutritional care into routine cancer care, providing a versatile solution that can be implemented across diverse health care settings.
AB - Background: Malnutrition affects 20%-70% of cancer patients, depending on tumour type, disease stage, and clinical setting. While nutritional care is essential for improving patients’ quality of life and clinical outcomes, it is not systematically integrated into routine cancer care. MyPath is a European Union project aiming to implement patient-centred care (PCC) at nine European cancer centres using implementation science. Multidisciplinary teams have developed standardised digitally supported PCC pathways based on patient-reported outcomes (PROs) with linked evidence-based management options. Through systematic assessment and management of common symptoms and psychosocial problems in cancer patients, MyPath aims to facilitate changes in clinical practice to improve PCC for all. As part of this, the MyPath Nutrition Care Pathway (NCP) aims to facilitate necessary clinical changes to routinely assess and address nutrition in all patients. Materials and methods: Between September 2022 and August 2024, an international multidisciplinary team reviewed evidence-based nutrition guidelines to select relevant PROs and other variables necessary to systematically assess patients, allowing for tailored nutritional care. Results: The MyPath NCP assessment relies on nutritional status (Malnutrition Screening Tool for malnutrition risk, modified Global Leadership Initiative on Malnutrition criteria for malnutrition, and body mass index/weight change for obesity/unintentional weight gain), health status (functional status, cancer diagnosis and prognosis, and prehabilitation needs), and inflammatory status (C-reactive protein levels). Based on this assessment, the digital solution suggests tailored, evidence-based nutritional interventions. Continuous monitoring through PROs and clinical consultations will customise care to patients’ dynamic nutritional needs. The first version of this digital solution will be piloted in 2025. Conclusions: Inconsistent implementation of nutrition guidelines is a key challenge in cancer care. The MyPath NCP offers an accessible, patient-centred assessment and management system that integrates nutritional care into routine cancer care, providing a versatile solution that can be implemented across diverse health care settings.
KW - implementation
KW - MyPath
KW - nutritional assessment
KW - nutritional care
KW - patient-centred care
U2 - 10.1016/j.esmoop.2025.104529
DO - 10.1016/j.esmoop.2025.104529
M3 - Article
SN - 2059-7029
VL - 10
JO - ESMO Open
JF - ESMO Open
IS - 4
M1 - 104529
ER -