Nutritional therapy is crucial to our ability to manage diseases in general and infections, surgeries and trauma, in particular. The goal of nutrition therapy is to maintain or improve nutritional status and prevent and treat malnutrition by maintaining body tissue, activating plasma protein stores and preventing macro- and micronutrient deficiencies.
Nutritional support can be provided either orally (oral nutritional supplements), through a digestive tube (enteral nutrition) or, when the digestive tract cannot be used, through an intravenous catheter inserted directly into the veins (parenteral nutrition).
The type of nutrition therapy depends largely on the patient’s’ condition, disease, and needs. For example, the nutritional requirements of patients after surgery are not the same as those of ICU patients and are different from those of patients undergoing anti-cancer treatment or chronic dialysis.
Nutritional therapy for cancer patients
Malnutrition can very often be observed among cancer patients: First, many cancers induce tumor cachexia, a consumptive syndrome with metabolic disorders. Second, side effects of treatment, such as subacute or chronic radiation enteropathy, chemotherapy-induced nausea and vomiting, or mouth mucosal ulcers, often limit food intake.
Malnutrition in cancer patients has been associated with increased morbidity and mortality and decreased response to treatment. Given the negative impact of cachexia on the progression of the cancer patient, it is important to identify the risk of malnutrition. Actions aimed at reversing cachexia or, at least, at slowing the progression of malnutrition are important and parenteral nutritional intake is usually indicated.
Medical societies recommend routine screening of cancer patients in order to initiate adequate nutritional therapy in time. Depending on the patient’s physical condition, the preferred feeding route is enteral, both through oral and tube supplementation, whenever possible. Parenteral nutrition offers the possibility of ensuring nutrient intake in patients in whom enteral nutrition is not feasible, is contraindicated, or is not accepted by the patient.