Newsletter

[ Vol. 10 No. 3 ] (September - December 2009 )
Nutrition support in patients with cancer

Vanessa Fuchs
Mexico City, Mexico

Cancer and its oncological treatment cause symptoms which increase patients’ risk of suffering from malnutrition. This situation affects the patient’s health status negatively by increasing the number of complications, reducing the tolerance to the oncology treatment and a decrease of the patient’s quality of life. Nutrition assessment and intervention will depend on the type of the oncology treatment and nutritional risk as these again are determined by the type of cancer and patient’s previous nutritional status.

There are studies demonstrating that with nutritional counseling, supplemental feeding and pharmacological support weight loss decreases and appetite improves; however, this has no effect on Karnofsky performance status and course of the disease. Other studies demonstrate that in spite of the severity of the disease in some types of cancer, nutritional intervention may reduce weight loss, and improve body composition as well as biochemical indicators of nutritional status.

The route in which nutrition support is given leads to the suggestion that PEG tubes should be used selectively, not routine in patients with cancer, and that the use of either a gastrostomy or NG tubes have advantages and disadvantages. So the decision regarding options of feeding should be determined after full consideration of each patient’s condition and economics.

Parenteral nutrition is used many times in a palliative role. The regimen on parenteral nutrition should be tailored to the needs of the patient; further research is needed in order to determine who may benefit from parenteral nutrition in advanced cancer patients.

Lately, there are studies suggesting that combination treatment with nutritional support and modulation of metabolic and inflammation changes are promising. In this regard, n-3 fatty acids are associated with an improvement of clinical, biological and functional parameters and with amelioration of quality of life.

Overall, nutrition support is required to help improve prognosis, and reduce the consequences of cancer-associated nutritional decline. Early intervention with nutritional supplementation has been shown to halt malnutrition and may improve outcome in some patients.

REFERENCES

• Marin Caro MM, Gómez Candela C. Castillo Rabaneda R. Nutritional risk evaluation and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group.   Nutr Hosp 23(5), 2008:458-68.
• Giacosa A, Rondanelli M. Fish oil and treatment of cancer cachexia. Genes Nutr 3(1) 2008:25-3.
• Dobrila Dintinjana R, Guina T, Krznaric Z. Nutritional and pharmacologic support in patients with pancreatic cancer. Coll Antropol 32(2) 2008:505-8.
• Fuchs V, Barbosa V, Mendoza J, et al. Effect of an intensive nutritional treatment in nutritional status of head and neck cancer patients in stages III and IV. Nutr Hosp 23(2) 2008:134-40.
• Bozzetti F. Total Parenteral nutrition in cancer patients. Curr Opinio Support Palliative Care 1(4) 2007:279-80.

From   
PENSA 2009
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 39