Hyperalimentation in cancer

A growing body of work has been addressed to the hypothesis that because patients with cancer who have poor nutritional status have a worse prognosis, increased nutritional support in these patients will result in better tolerance of surgical interventions, chemotherapy and radiation therapy, and a better outcome from the cancer. Although the hypothesis is an attractive one, there is only a single well-conducted, randomized, prospective trial to date that shows that active nutritional support is of benefit in the therapy of patients with cancer. Based on this review of the literature, it is felt that though cachexia is clearly of negative import in patients with cancer, there is little evidence to support the hypotheses that any nutritional support changes the outcome or the course of therapy of patients with cancer. It seems reasonable to continue the nutritional support to cachectic patients with cancer concomitant with specific anticancer therapy, but supportive nutritional therapy alone with postponement of specific anticancer treatment, as in awaiting weight gain or anabolism, cannot be justified with the current state of the art.