Nutritional supportive care

Author:  Dipl.-Biol. Maria Yiallouros, Editor:  PD Dr. med. Gesche Tallen, Reviewer:  Prof. Dr. med. Dr. h.c. Günter Henze, English Translation:  Hannah McRae, Last modification: 2014/05/21

Due to both the disease and the side effects of the intensive treatment, children and adolescents with cancer often suffer nausea and vomiting, changes of taste sensation, thus loss of appetite, painful inflammation of the mucosa of the upper gastrointestinal tract (mucositis) as well as sore throats with difficulty swallowing and abdominal pain.

As a consequence, a lot of childhood cancer patients suffer what is called "malnutrition" or "cancer cachexia". These conditions are defined by the lack of gaining weight or weight loss (anorexia), muscle wasting and other deficiencies, such as anemia (reduced number of red blood cells).

Even when not being sick, children and adolescents require a balanced diet since they are still growing. In some cancer patients, lack of gaining weight and – to some extent – even weight loss can be tolerated because children recover relatively quickly after treatment and catch up with their growth curve during breaks in chemotherapy.

In some patients, however, the extent of the side effects and subsequent malnutrition is severe. These patients might need parenteral nutrition (PN) for a while, if nutritional support with oral or enteral supplements remains unsuccessful. PN is administered intravenously, usually through the already existing central venous catheter. It consists of a solution that is prepared according to the individual needs of the patient, thereby containing all the necessary nutrients (carbohydrates, proteins, fats, minerals, vitamins, and trace elements).

Because malnutrition is associated with a variety of complications of cancer and its therapy, it is believed that nutritional supportive care such as PN may help the patient to tolerate chemotherapy better and perhaps improve survival [AND1998].