Total parenteral nutrition in cancer patients: why and when?

Total parenteral nutrition (TPN) is sometimes utilized in cancer patients. Previous studies suggest that TPN provides clinical benefit in the perioperative setting among severely malnourished cancer patients and among those who are receiving blood or marrow transplants. However, the negative impact of TPN on quality of life, its adverse event profile, and its cost all suggest that this intervention must be used judiciously in cancer patients. Although a few case reports and other studies imply that TPN may benefit select patients with metastatic cancer, this approach represents a departure from the standard of care and therefore must be clearly thought through and justified prior to implementation.