Cancer Nutrition: Total Parenteral Nutrition for Cancer Patients

Cancer Nutrition: Total Parenteral Nutrition for Cancer Patients
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Challenges

To maintain strength and recover from cancer, patients need to maintain good nutrition. When disease and treatment side effects make it impossible for cancer patients to eat enough, they may receive extra nutrients through a feeding tube.

Not all cancer patients are able to digest or absorb nutrients through their gastrointestinal systems. Some patients have tumors blocking their intestines. In advanced cancer, the toll of chemotherapy, radiation therapy, and multiple surgeries, especially when there is an abdominal tumor, can result in malnutrition even with a feeding tube. Certain cancers of the blood, such as myeloma and leukemia, may be treated by bone marrow transplant, an procedure that has as a side effect severe irritation of the digestive tract, making digestion impossible. Patients who cannot obtain adequate nutrition through digestion require total parenteral nutrition (TPN). (ACS 2008; Patil 2005)

Parenteral Nutrition

Total parenteral nutrition is nutrition given via the bloodstream with an intravenous line. The parenteral nutrition solution contains all the nutrients that would normally be absorbed through the intestines: carbohydrates , proteins in the form of amino acids, and fats in the form of lipids. The solution also contains electrolytes to maintain the blood’s chemical makeup, as well as all the necessary vitamins and minerals.

For some cancer patients, TPN may be an adjunctive therapy given in addition to other nutritional interventions such as nasogastric tube feedings (enteral nutrition). In others, it may be the sole source of nutrition. TPN may be given on a short-term basis, especially for patients undergoing major surgery, which can “freeze” or paralyze the gut. For some patients with compromised digestive systems, it may be a long-term therapy. (Patil 2005)

TPN does not need to be given in a clinical setting; patients can take their intravenous feedings at home. In one study, researchers interviewed patients receiving TPN at home (Orrevall et al. 2005). They found that while home TPN had some negative impacts on the patients’ social lives, the overall impact was positive. Home TPN reduced the anxiety of frequent clinical visits for feedings and improved patients’ physical well-being because they were not suffering from malnutrition.

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