Background/Objectives: Malnutrition, sarcopenia, cachexia, and frailty often coexist in older cancer patients and are associated with worse treatment tolerance, reduced quality of life, and increased mortality. These syndromes can be underrecognized, and the therapeutic approach is often fragmented. In light of this, the aim of this review was to synthesize current evidence on the screening and clinical management of nutritional aspects and the related tools, favoring multidimensional and personalized nutritional care. Methods: This narrative review was conducted according to the SANRA guidelines. A comprehensive literature search was performed on PubMed for studies published between January 2000 and June 2025, with no language restrictions. Eligible studies included adults aged ≥65 with cancer, addressing malnutrition, sarcopenia, cachexia, frailty, or nutrition-related interventions. Results: Malnutrition affects 30–80% of older cancer patients and is strongly associated with reduced survival, impaired treatment tolerance, and poorer quality of life. Tools such as PG-SGA, G8, GNRI, and CONUT offer practical options for early risk identification. Nutritional interventions, including oral supplements, dietary counseling, symptom management, and multimodal strategies (nutrition plus exercise), are associated with improved clinical outcomes. Evidence also supports the prognostic value of early screening and individualized nutrition care pathways. Conclusions: Malnutrition represents a modifiable risk factor in geriatric oncology and should be assessed considering other related conditions such as sarcopenia, cachexia, and frailty. Systematic screening and targeted interventions should be integrated into standard cancer care to improve outcomes in older adults. Future research should prioritize personalized nutrition strategies and multicenter trials focused on survival, function, and quality of life.

Background: Bromelain, a proteolytic enzyme extracted from Ananas comosus, exhibits anti-edematous and anti-inflammatory properties that may facilitate postoperative recovery. Troxerutin and escin, respectively, a vasoactive flavonoid and a saponin derivative, also provide anti-edematous and microcirculatory benefits that could enhance tissue repair and functional outcomes. Evidence on their combined use in older adults undergoing rehabilitation after major orthopedic surgery remains limited. Methods: We conducted retrospective observational study in adults aged 65 years or older admitted to a post-acute rehabilitation unit after total hip or total knee arthroplasty. Half of the participants received an oral supplement containing bromelain (400 mg/day), troxerutin (300 mg/day), and escin (40 mg/day) for up to 21 days alongside usual care and standard medications. The primary outcome was pain reduction assessed through the Visual Analog Scale (VAS). Secondary outcomes included changes in postoperative edema and functional recovery, evaluated through range of motion, the Barthel Index, and gait performance. Result: Forty participants were enrolled (mean age 69.4 ± 7.2 years; 58 percent women). Individuals receiving the combined supplement achieved significantly greater pain improvement than controls. At day 10 (T1), VAS scores declined from 6.8 ± 1.0 to 3.2 ± 0.9 in the supplemented group versus 6.7 ± 1.1 to 4.5 ± 1.0 in controls (p < 0.01). At day 21 (T2), VAS further decreased to 1.8 ± 0.7 in the supplemented group and to 3.1 ± 0.8 with standard treatment (p < 0.001). Functional performance also improved more markedly with supplementation, with earlier mobilization and faster recovery of autonomy. No significant side effects were reported. Conclusions: In this pilot study, combined bromelain, troxerutin, and escin supplementation was associated with meaningful reductions in postoperative pain and edema and with faster functional recovery. Larger controlled trials are warranted to confirm these effects and elucidate underlying mechanisms.