Nutritional support of the patient with cancer.

The role of nutritional support in the management of the critically ill patient has been a topic of much concern and research. Malnutrition experienced by patients with cancer can be related to the nutritional status of the patient before the development of cancer, to the tumor itself, and to cancer therapy. Aggressive treatment may increase the degree of malnutrition, and the combination of the effects of therapy and progressive malnutrition may be a frequent cause of death. The use of intensive nutritional support for some patients may promote weight gain and positive nitrogen balance, increase tolerance of cancer therapy, and improve immune response. The benefits of nutritional support in the patient with cancer may outweigh concerns of nutrition effects on tumor growth. The choice of nutritional support is dependent on the availability of and access to a functioning gastrointestinal tract, comfort and compliance of the patient, the toxicity of drugs, and site of radiation therapy. Extended length of treatment, availability of care givers, and costs are also factors considered in delivering nutrients. Nutrition requirements, nutritional tolerance, and immune status should be monitored by the nurse. The nurse can function as coordinator for treatments and care as well as act as interpreter, teacher, and counselor to coordinate medical and nutritional management of the patient's illness into overall high-quality nursing care.