Enteral and parenteral nutrition in terminally ill cancer patients: a review of the literature.
Many terminally ill patients who are able to eat appear to be eating less than they should, losing weight, and becoming malnourished, and many others develop difficulties with eating. These symptoms and signs are usually a marker of advanced cancer, rather than the cause of decreasing functional status, and providing supplemental nutrition rarely changes the course of the disease. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with advanced cancer, including benefits, risks, and discomforts; how these types of nutrition are used and perceived, and how decisions are made; and how decision-making might be improved.
Dy
Sydney Morss
SM
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, USA. sdy@jhsph.edu
D000203:Activities of Daily Living; D003142:Communication; D003661:Decision Support Techniques; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D006801:Humans; D044342:Malnutrition / Q000209:etiology / Q000628:therapy*; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000523:psychology; D015596:Nutrition Assessment; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012107:Research Design; D012307:Risk Factors; D015996:Survival Rate; D013727:Terminal Care / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D019452:Terminally Ill; D016896:Treatment Outcome