Nutrition in Advanced Cancer
Key Points for This Section
The goal of palliative care is to improve the quality of life of patients who have a serious or life-threatening disease. Palliative care is meant to prevent or treat symptoms, side effects, and psychological, social, and spiritual problems caused by a disease or its treatment.
It is common for patients with advanced cancer to want less food. Patients usually prefer soft foods and clear liquids. Those who have problems swallowing may do better with thick liquids than with thin liquids. Patients often do not feel much hunger at all and may need very little food.
In patients with advanced cancer, most foods are allowed. During this time, eating can be focused on pleasure rather than getting enough nutrients. Patients usually cannot eat enough of any food that might cause a problem. However, some patients may need to stay on a special diet. For example, patients with cancer that affects the abdomen may need a soft diet to keep the bowel from getting blocked.
Answering the following questions may help to make decisions about using nutrition support:
- What are the wishes and needs of the patient and family?
- Will the patient's quality of life be improved?
- Do the possible benefits outweigh the risks and costs?
- Is there an advance directive? An advance directive is a legal document that states the treatment or care a person wishes to receive or not receive if he or she becomes unable to make medical decisions. One type of advance directive is a living will.
Cancer patients and their caregivers have the right to make informed decisions. The healthcare team and a registered dietitian can explain the benefits and risks of using nutrition support for patients with advanced cancer. In most cases, there are more harms than benefits, especially with parenteral nutrition support. However, for someone who still has good quality of life but is unable to get enough food and water by mouth, enteral feedings may be best. The benefits and risks of enteral nutrition during advanced cancer include the following:
- May make the patient more alert.
- May be a comfort to the family.
- May relieve nausea.
- May make the patient feel more hopeful.
- Surgery may be needed to place a tube through the abdomen.
- May increase the amount of saliva in the mouth and throat. This may cause choking or pneumonia.
- May cause diarrhea or constipation.
- May cause nausea.
- May cause infection.
- Makes patient care harder for caregiver.