What is the role of nutritional therapy in the management of cancer patients with the anorexia-cachexia syndrome?
a. Is there a benefit to nutritional support in the cancer patient who will have surgery? The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group studied 395 patients who underwent elective laparotomy or noncardiac thoracotomy. These patients were randomly assigned to receive parenteral nutrition versus a regular diet for one to two weeks prior to surgery. Patients with mild malnutrition did not benefit from parenteral nutrition. Patients with severe malnutrition who received parenteral nutrition had a lower incidence of complications related to healing. Muller et al. showed fewer complications in patients with upper gastrointestinal cancer who received preoperative parenteral nutrition.
