Nutritional support of patients with cancer of the gastrointestinal tract

Malnutrition is common in patients with malignant disease of the gastrointestinal tract. Although the predominant factor is an imbalance between nutrient intake and host nutrient requirements, cancer cachexia can be related to tumor-induced abnormalities in intermediary metabolism of the host that are mediated by endogenously produced peptides such as tumor necrosis factor. Patients with severe malnutrition can benefit from nutritional intervention enterally, parenterally, or both. However, the value of nutritional support as an adjuvant to oncologic therapy in less severely malnourished cancer patients has not been unequivocally established.