Parenteral nutrition in the cancer patient

The nutritional state of patients with malignant disease must be assessed at the beginning of treatment. Nutritional supplements, given either orally or intravenously, enable patients to tolerate larger doses of chemotherapy and radiotherapy and the clinical response may be enhanced by nutritional support. Crystalline L aminoacids and glucose are the main nutrients used intravenously and fat emulsions are required in prolonged parenteral nutrition. Hypophosphataemia related to glucose administration and infection related to access to the circulation are the main complications, both of which are preventable. Total parenteral nutrition alone will not improve the results of cancer treatment significantly but its careful use in association with surgery, radiation therapy and chemotherapy can be most valuable.