Dietary Counseling and Nutritional Monitoring for Cancer Cachexia in Breast Cancer: A Randomized Controlled Trial

Objective: To assess the effectiveness of personalized dietary counseling and regular nutritional monitoring in improving cancer-related cachexia among women with breast cancer, using the validated Mini-Cancer Cachexia Score (Mini-CASCO). Methodology: A parallel, single phase, two-arm interventional study was conducted at Fauji Foundation Hospital, Rawalpindi from June to December 2024. A total of 134 participants were randomized in a 1:1 ratio using block stratified allocation to either an intervention group (n=67), which received standard oncologic care supplemented with individualized dietary counseling and nutritional monitoring every 15–21 days, or a control group (n=67), which received standard care alone. The magnitude and severity of cachexia was assessed at baseline and 6 months using Mini-CASCO across five domains including body composition, inflammatory-metabolic profile, physical performance, appetite, and quality of life. Results: Of 134 participants enrolled, 130 (97%) completed follow-up. After 6 months, the intervention group demonstrated a significant reduction in overall Mini-CASCO score (Δ=−14.4 ± 5.1; p