Aspects of practical oncology. Oncologic dietetics--treatment of anorexia and cachexia

Abstract

Tumor- and/or therapy-related malnutrition can be a crucial factor in the success of treatment of neoplastic diseases. The aetiology of anorexia in many patients is still unknown. Impaired survival rates and the outcome of therapy are related to the nutritional status, although this has not been investigated in well controlled clinical studies. However, it is generally accepted that it is possible to improve therapy by balancing the diet. It is not known whether additional parenteral nutrition improves survival rates. Therefore, the individually adjusted diet which considers the patient's tastes and disease-related abnormalities (i.e. stomatitis or therapy-related mucosal dryness) should be preferred. Balanced formulas allow an additional caloric intake. In advanced disease status, a difficulty in swallowing or tumors which obstruct the oesophagus or the cardia may make tube feeding necessary. Total parenteral nutrition is possible via venous catheters for weeks or even months if antiseptic principles are followed very carefully. If a dietary concept is included early in cancer therapy, the quality of life is improved and surgical, radio- and/or chemotherapy, when performed, is made easier and more successful.