19 - Mechanisms and Management of Malnutrition States in Patients with Cancer

Abstract

In this discussion of malnutrition in patients with malignant disease, we have attempted to point out the multifactorial nature of this problem. There are several areas that require further investigation. For example, it is apparent that the biochemical background and mechanisms of the commonly seen anorexia and cachexia syndrome of advanced malignancy are incompletely understood. Also, it is clear that surgery and radiation therapy used in the treatment of patients with malignancy are capable of producing malnutrition states by physically removing or disrupting absorptive surfaces, and this potential must be carefully considered in designing treatment plans. Another phenomenon requiring further investigation is the role of chemotherapy in causing malabsorption and alterations in patient nutrition. The effects of chemotherapy may be important parameters relating to both antitumour response and patient tolerance of chemotherapy. It is hoped that continued investigative efforts into these problems and other aspects of the mechanisms and management of malnutrition states in the cancer patient will lead to an improved understanding of the pathophysiology and management of these conditions.