Enteral and Parenteral Nutrition Support for Adults with Cancer

What is enteral nutrition support?

Sometimes, even when high-calorie and high-protein foods are offered, people with cancer have trouble eating enough to meet their nutritional needs. Tube feedings may be needed to supplement the diet or, when significant weight loss has happened, as the sole source of nutrition to prevent malnutrition. This can involve placing a small tube through the nose, down the esophagus and leaving it either in the stomach (nasogastric or NG tube) or duodenum (nasoduodenal), the first part of the small intestine. The gastrointestinal tract or "gut" must be functioning properly before a feeding tube can be placed.

Sometimes, a PEG (percutaneous endoscopic gastrostomy) tube is used instead. This is a tube inserted surgically through the skin of the stomach wall and placed directly into the stomach. It is used to give nutrients to patients who cannot swallow. Or a similar tube, known as a J-tube (for jejunostomy), can be surgically placed into the small intestine. These alternatives to oral feedings may be only temporary. Your healthcare provider or registered dietitian will discuss these choices with you if it is considered necessary to help you maintain your nutritional status during your cancer treatment.

What is parenteral nutrition support?

In some cases, people undergoing treatment for cancer need total parenteral nutrition (TPN) to help meet their nutritional needs. TPN is a special mixture of glucose, protein, fat, vitamins, and minerals that are given through an IV into the veins. This procedure is called intravenous feedings. A central venous catheter is typically used to give TPN. It is inserted into a large vein and can remain in place for an extended period of time. TPN provides necessary nutrients when someone is not tolerating food by mouth, not absorbing nutrients in the gut, or needing bowel rest. The TPN solution is usually taken in continuously over several hours of the day.

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