Cancer and nutrition among children and adolescents in low- and middle-income countries

Figures & data

Table 1. Five year average net survival rates for children with cancer in 2015–2019 by world region.^a

Region	Rate (%)^b
Africa	11.6
(Eastern Africa)	8.1
(Western Africa)	8.5
Asia	39.6
Latin America^c	55.0
Oceania	64.4
Europe	74.3
North America	83.0

^a From Ward et al. (ref. [6]).

^b All cancers combined.

^c Including the Caribbean.

Figure 1. Dual energy X ray absorptiometry of Total Body Less Head.

Table 2. Measures of body composition.

Total body water (^2H or ^18O dilution) Whole body ^40K (Fat-free mass) Air displacement plethysmography (BOD POD) Bio-electrical impedance assessment (BIA) Dual energy X ray absorptiometry (DEXA) Computed tomography (CT) Magnetic resonance imaging (MRI)

Table 3. Body composition in a 3 compartment model.

Fat mass + Lean body mass + Whole body bone mineral content = Total body weight. Lean body mass = Skeletal muscle + solid organs + blood cells Appendicular lean mass (ALM)    Lean body mass in all 4 limbs Skeletal muscle mass = 1.19 X ALM – 1.65 kg. (Formula for adults)

Table 4. Important messages for families and health care professionals

Families * Ensuring adequate nutrition is essential for health and health-related quality of life * Providing nutritional support does not ‘feed the cancer’ * Use of complementary and alternative medicines (CAMS) should be discussed with the health care team Health care professionals * Malnutrition has an adverse effect on clinical outcomes, including side effects of therapy and survival * Effective treatment of cancer adds to nutritional morbidity * Frequent monitoring of nutritional status is essential to overall care * Nutritional support is necessary for patients with defined deficiencies * Assessing safety, efficacy and costs of CAMS should be done with every family

Atun R, Bhakta N, Denburg A, et al. Sustainable care for children with cancer: a Lancet Oncology Commission. Lancet Oncol. 2020;21:e185–e224.

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