ABSTRACT

The primary objective of nutritional support of the cancer patient is to rehabilitate or maintain nutritional status so that appropriate antineoplastic therapy can be attempted or completed with maximal safety. Whereas the rationale for total parenteral nutrition in major injury is defined, its use and ultimate value in the undernourished cancer patient is less well defined. Some metabolic changes that occur during the neoplastic process also are natural consequences of aging, namely loss of lean body mass, decreased rate of protein synthesis, and depressed immune response. Many nutritionally important untoward effects can be prevented or treated nonspecifically with antiemetics, analgesics, antidiarrheal agents, antibiotics and transfusion during the initial critical phase of therapy to maintain appropriate nutritional status. In addition to systemic effects, various neoplasms may have a number of more localized effects leading to nutritional problems. The potential for complications arising as a result of aggressive intravenous feeding programs could limit the feasibility of this form of nutritional support.