OPTIONS FOR ARTIFICIAL NUTRITION OF CANCER-PATIENTS

Background: Until today, 25 to 50% of ill or severely disabled patient s show qualitative or quantitative nutritional deficits which can lead to a disease aggravation and thus may be a limiting factor in oncolog ic treatment strategies. Therefore the various options for artificial nutrition should be used according to strict indications, These are wh enever the patient is not able to eat (e. g. acute mucositis), does no t want to eat (e. g. nausea Grade 3 to 4) or is not allowed to eat (e. g. pancreatitis). Methods: The principle is to apply as much as possi ble enteral feeding because of its advantages. Enteral nutrition is mo re physiological, safer and more reasonable. A prerequisite for an ade quate feeding is the optimal nutrient composition and detection of pat ient's individual nutritional status. Numerous options for the adequat e application technique of nutritional support are available: 1. oral diets with commercially available supplement drinks: 2. the pump-assis ted application by using nasal or percutaneous probes bears many advan tages when same important basic rules are not neglected to guarantee a complication free course, e. g. the choice of right nutrients for the right indications, the control of the tube-position and a smooth buil d-up of the application; 3. peripheral or central venous application i s necessary if contraindications prevent the use of enteral nutrition (e. g. ileus, pancreatitis). The following parameters have to be taken into account when generating a parenteral nutrition programme: diagno sis, the present status of the patient's disease, the actual body weig ht and ideal weight, the laboratory test results, the need of total en ergy of nutrients in detail and of fluid and electrolytes. Conclusions : The prevention of malnutrition by adequate therapies for patients wi th anorexia or cachexia may contribute to a reduction of morbidity and mortality in cancer therapy. There is also a substantial impact of ma lnutrition on the outcome of anti cancer therapies. Finally a large de crease in health care costs may result from a prevention of cachexia.