TOTAL NUTRITIONAL MANIPULATION IN HUMANS - REPORT OF A CANCER-PATIENT

We report here on a patient requiring home total parenteral nutrition (TPN) for a huge intraabdominal desmoid associated with chronic small bowel pseudo-obstruction who was kept on a special lipid-based calorie regimen for 5 months. The rationale was to attempt to feed the host w ith a minimal stimulation of tumour growth by using lipid as caloric s ubstrate instead of glucose which is utilized by the tumour. Gluconeog enesis was tentatively inhibited at the level of phosphoenolpyruvate-c arboxy-kinase through the oral intake of hydrazine sulphate. The regim en consisted of 28 non-protein lipid Kcal/kg/day plus 1.5 g amino acid per kg/day. Only a small amount of glucose (approx. 40 g/day) was all owed. Tolerance to the regimen was good and body weight maintained. Li ver enzymes remained within the normal range and liver sonography was normal throughout the 5 months' therapy and there were no episodes of symptomatic hypoglycaemia. The tumour volume did not substantially cha nge.