Nutritional support and parenteral nutrition in cancer patients: an expert consensus report

Abstract

Background: Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life.

Methods: A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition convened to discuss the management of the nutritional support in cancer patients.

Results: Of the 18 questions addressed, 9 focused on nutritional support, 5 were related to parenteral nutrition (PN) and 4 about home PN (HPN). The panel of experts recommends using nutritional screening routinely, at diagnosis and throughout the disease course, for detecting the risk of malnutrition and, if it is positive, to perform a complete nutritional assessment, to diagnose malnutrition. Currently, there are different screening tools and methods that allow us to detect nutritional risk. Based on the evidence and experience, the panel stated that PN is indicated mainly when it is not possible to use the digestive tract and/or oral feeding and/or enteral nutrition is not sufficient or possible. The nutritional needs of the cancer patients, except in those cases where individualized measures are required, should be considered similar to healthy individuals (25-30 kcal/kg/day). The panel considers that the nutritional monitoring of the cancer patient should be multidisciplinary and adapted to the characteristics of each center. Additionally, the objective of the HPN is to improve or maintain the nutritional status of a patient at home.

Conclusions: This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer patients.

Keywords: Cancer; Enteral nutrition; Home parenteral nutrition; Nutrition; Nutritional support; Parenteral nutrition.