Chemotherapy’s profound impact on nutritional health: New insights from European Gaza Hospital
Cancer therapy, particularly chemotherapy, remains a cornerstone of oncological treatment worldwide. While highly effective against malignancies, chemotherapy exerts significant collateral damage on patients’ physiological systems. Recent research emerging from the Oncology Department of European Gaza Hospital unveils the alarming extent to which chemotherapy compromises patients’ nutritional status, emphasizing the urgent need for comprehensive nutritional monitoring throughout treatment.
The study, involving 64 adults newly diagnosed with various cancers, meticulously assessed patients’ nutritional parameters before initiating chemotherapy and after its completion. Utilizing Subjective Global Assessment (SGA) coupled with anthropometric measurements, biochemical markers, and dietary intake analysis, the investigation delivered a multidimensional picture of nutritional dynamics during cancer treatment. The findings raise critical concerns regarding the insidious nutritional deterioration accompanying chemotherapy.
Cancer patients undergoing chemotherapy frequently experience a constellation of adverse effects like nausea, vomiting, diarrhea, and fever—all interfering with nutritional intake and metabolic stability. These manifestations synergistically reduce appetite, disrupt physical activity, and result in significant weight loss. However, the study’s revelations extend beyond these clinical symptoms to underscore underlying biochemical disturbances that exacerbate nutritional deficiencies.
One pivotal revelation involved a stark rise in malnutrition rates post-chemotherapy, soaring from 35.9% at baseline to an alarming 80.3% upon treatment completion. This deterioration reflects both moderate and severe malnutrition, painting a dire picture of patients’ declining physiological reserves. Such malnutrition is not merely a clinical observation but a complex biochemical and metabolic phenomenon with serious implications for treatment outcomes.
Delving deeper into biochemical alterations unveiled a functional vitamin B12 deficiency induced by chemotherapy. Serum B12 levels plummeted significantly from median values of 355.0 pg/mL pre-chemotherapy to 219.0 pg/mL post-treatment, a stark decrease with profound metabolic consequences. Simultaneously, the study documented significant elevations in methylmalonic acid (MMA) and homocysteine (Hcy), metabolites whose accumulation signals disrupted B12-dependent enzymatic processes.
Vitamin B12 plays a vital role in DNA synthesis, red blood cell formation, and neurological function. Deficiency can thus provoke hematological anomalies, neuropathy, and impaired cellular regeneration, compounding cancer patients’ vulnerability. The rise in MMA and homocysteine post-chemotherapy confirms the biochemical derailment of one-carbon metabolism pathways, shedding light on previously underappreciated side effects of anti-cancer drugs.
Besides biochemical markers, the research spotlights dramatic shifts in dietary intake patterns. Macronutrient and micronutrient consumption significantly declined after chemotherapy, reflecting an interplay of reduced appetite, gastrointestinal disturbances, and altered taste perception common among patients. This nutritional depletion threatens not only immediate energy needs but also long-term recovery and immune function.
These findings underscore a critical need to embed rigorous, periodic nutritional assessments into cancer treatment protocols. Subjective Global Assessment emerges as a valuable tool in this context, enabling clinicians to detect malnutrition early and tailor interventions accordingly. Nutritional support strategies, including supplementation and dietary counseling, may mitigate treatment-related nutritional decline, potentially improving prognosis.
Furthermore, the study’s context—conducted at a hospital in Gaza, a region with unique healthcare challenges—reinforces the global relevance of nutritional management in oncology. Resource-limited settings may exacerbate patients’ vulnerability to malnutrition, underscoring the ethical imperative to prioritize integrated nutritional care alongside medical therapy.
The multi-pronged approach of this research—combining clinical evaluation, anthropometry, biochemical assays, and dietary analysis—sets a benchmark for future oncology nutrition studies. By capturing dynamic changes throughout chemotherapy cycles, it provides actionable insights for clinicians and nutritionists striving to optimize supportive care.
Understanding the biochemical pathways affected by chemotherapy also opens avenues for targeted therapeutic strategies. For example, monitoring and supplementing specific vitamins and micronutrients such as vitamin B12 could represent a cost-effective approach to reduce metabolic complications and improve quality of life.
Moreover, malnutrition in cancer patients is not an isolated issue but a potent negative prognostic marker. It can impair tolerance to chemotherapy, elevate infection risk, prolong hospital stays, and even increase mortality. Therefore, integrating nutritional assessment is not ancillary but central to comprehensive cancer care.
Clinicians should advocate for interdisciplinary collaboration involving oncologists, dietitians, and biochemists to develop individualized nutritional plans. Early identification of at-risk patients through robust screening tools can prevent deterioration and associated complications, ultimately supporting better survival outcomes.
The study also prompts reflection on the potential for personalized medicine strategies that incorporate metabolic profiling. Tailoring chemotherapy regimens and supportive nutrition based on biochemical assessments like vitamin B12 status may revolutionize patient management.
Public health policies must recognize nutritional monitoring as a core component of cancer treatment guidelines. Training healthcare workers to perform assessments such as the Subjective Global Assessment and to interpret biochemical markers could dramatically improve patient care not only in Gaza but globally.
Finally, this research resonates well beyond its geographic origin, alerting the medical community worldwide to the silent epidemic of chemotherapy-induced malnutrition and metabolic disruption. The evidence compels actionable change—intensifying nutritional intervention research, updating clinical protocols, and fostering patient education about maintaining nutritional health amidst cancer therapy.
In summary, the incisive work from European Gaza Hospital elucidates how chemotherapy exacts a heavy toll on patients’ nutritional status, biochemical equilibrium, and dietary intake. It underscores an urgent mandate for robust, continuous nutritional surveillance and intervention to mitigate these effects and improve cancer treatment outcomes.
Subject of Research: Nutritional status assessment in cancer patients undergoing chemotherapy.
Article Title: Assessment of nutritional status of patients receiving chemotherapy: sample from European Gaza hospital.
Article References: EL-Najjar, S.E., Naser, I.A., AL-Wahidi, K.M. et al. Assessment of nutritional status of patients receiving chemotherapy: sample from European Gaza hospital. BMC Cancer 25, 1224 (2025). https://doi.org/10.1186/s12885-025-14571-5
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