Onkológia 4/2013

Malnutrition in cancer patients – practical and ethical issues

Malnutrition in cancer patients is associated with causes directly related to the cancer disease, its treatment as well as with the consequences of the treatment following recovery. It may involve a simple energy depletion or protein-caloric malnutrition (PCM). Malnutrition is associated with higher morbidity and reduced survival (2), but according to meta-analysis from 2012, the improvement of nutrition status does not improve the overall survival of cancer patients (3). The problem of artificial nutrition in patients with advanced cancer diseases lies mainly in the reasonability of the indication, definition of the treatment objectives and ability to discontinue the treatment when these objectives are not met. Functionality of the GI tract in progressive cancer disease and the capability to utilize substrates in cancer cachexia are the main points that help us in deciding to (not) indicate the artificial nutrition to patients with incurable cancer disease.

Keywords: malnutrition, artificial nutrition, oral nutritional supplements (ONS), enteral nutrition through feeding tube, parenteral nutrition.