NUTRITIONAL ISSUES IN CANCER MANAGEMENT

The objective of this article was to investigate the relationship betw een nutrition and cancer, as it relates to the initiation, promotion, and treatment of tumor growth. English-language studies published in t he last 25 years were retrieved using MEDLINE, bibliographies, and con sultation with experts. MEDLINE search terms included ''cancer,'' ''ma lnutrition,'' and ''nutritional support.'' In vitro and in vivo contro lled studies addressing the impact of nutritional factors on cancer pr evention and treatment were selected. Approximately 30% of cancers in the Western countries are diet-related The presence of malignancy affe cts patients' nutritional status negatively, leading to increased morb idity and mortality. Standard nutritional support (both enteral and pa renteral) is not always effective in significantly improving outcome i n malnourished cancer patients, due to characteristic changes in host metabolism. Preliminary studies suggest that newer nutritional-pharmac ologic agents may be beneficial in counteracting the derangement of ho st metabolism, and consequently in ameliorating cancer patients' nutri tional status and outcome of malnourishment. This review suggests that dietary manipulations and nutritional-pharmacologic therapy might be highly effective adjuncts in controlling the symptoms of patients with neoplastic disease.