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Objective: The maximum expression of malnutrition in cancer patients is  cancerous cachexia, always linked to an unfavorable prognosis. Given its  evolutionary nature it is recommended to detect and act early in those patients with nutritional risk. The objective is to propose an action  algorithm for the nutritional approach of patients with solid tumors., Method: Through the nominal group technique, specialists in hospital pharmacy, nutrition and oncology who established a prioritization  of issues related to nutritional status and its approach in patients with  solid tumors were brought together. Their discussion and analysis allowed  us to design a performance algorithm., Results: The algorithm differentiates two groups of patients according to  the location of the tumor and its impact on nutritional status: high-risk tumors (group 1) include cancers of the head and neck, upper  digestive tract and colorectal and low-risk tumors (group 2) include the  rest of the neoplasms. Group 1 patients (with the exception of those with  colorectal cancer) are directly assessed nutritionally in the first 3-5 days  after their presentation in the Tumor Committee, starting the nutritional  support required at that time. Patients in group 2 and those diagnosed  with colorectal cancer are screened (through NUTRISCORE) after their  presentation in the Committee, those with positive risk being referred to  nutritional consultation to perform a complete evaluation and propose  treatment options. Patients without nutritional risk are periodically re- evaluated. Follow-up is planned according to cancer therapy, with  continuous monitoring in each treatment cycle or during the perioperative  period., Conclusions: From the nominal group technique, agreements were reached to propose an algorithm of nutritional approach of the cancer patient. The adoption of the proposed algorithm could reduce  variability in institutional clinical practice, promoting a timely and adequate nutritional approach in cancer patients., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: Malnutrition is a common complication in cancer patients and can negatively affect the outcome of treatments. This study aimed to reach a consensus on nutritional needs and optimize nutritional care in the management of cancer patients at a national level., Methods: A qualitative, multicenter, two-round Delphi study involving 52 specialists with experience in nutritional support in cancer patients was conducted., Results: Regarding the presence of malnutrition, 57.7% of the participants stated that < 30% of the patients had malnutrition at the time of diagnosis, 40.4% considered that 31-50% had malnutrition during cancer treatment, and 26.9% that > 50% at the end of the treatment. Forty percent of participants believed that the main objective of nutritional treatment was to improve quality of life and 34.6% to improve tolerability and adherence to chemotherapy. The quality nutritional care provided at their centers was rated as medium-low by 67.3%. Enteral and parenteral nutrition was administered to less than 10% and less than 5% of patients in 40.4 and 76.9% of cases, respectively. In relation to nutritional screening at the time of diagnosis, 62.9% of participants considered than screening to assess the risk of malnutrition was performed in < 30% of patients., Conclusions: There is an important variability in the management of cancer patient nutrition, which is associated with the absence of a national consensus on nutritional support in this field. Given the incidence of nutritional disorders in cancer patients, a specialist in clinical nutrition (regardless of his/her specialty) should be integrated into the strategic cancer plan.