Home Parenteral Nutrition in Gastrointestinal Cancer Patients Improves Quality of Life

TPN may be the only option available to meet nutritional demands when the gastrointestinal tract is compromised, either temporarily or permanently.

There are several diagnoses or conditions that can cause alteration in absorption of nutrients by the GI tract to the extent that adequate nutrition is unattainable by the oral or enteral route. Since it is always better to provide nutrition via the GI tract whenever possible, TPN should be utilized as the sole source of nutrition only when a disruption in GI function prevents the introduction, absorption and metabolism, and/or elimination of nutrients and their by-products through the GI tract.

In a study published in the Journal of Pain and Symptom Management a group of scientist assessed the impact of home parenteral nutrition on the quality of life of the cancer patient, changes in nutritional status and evaluated the subjective perception of patient wellbeing.

The study included 370 patients with gastrointestinal cancer. Home parenteral nutrition was indicated for cancer related undernutrition in 89% of these patients. In 84% of these patients parenteral nutrition was used in addition to oral intake for at least 14 days. The physician, the patient and a family member completed questionnaires at inclusion and 28 days later. Quality of life was assessed by the patients using the Functional Assessment of Cancer Therapy-General questionnaire, at inclusion and 28 days later.

Results after 28 days of parenteral intake revealed that the global quality of life improved significantly, patient weight improved, nutritional risk screening decreased as well.

Patients with gastrointestinal cancer are at high risk for deterioration of nutrition and home parenteral nutrition could improve nutritional status and quality of life.

Reference:
A Prospective Observational Study Assessing Home Parenteral Nutrition in Patients With Gastrointestinal Cancer: Benefits for Quality of Life
http://www.jpsmjournal.com/article/S0885-3924(14)00310-8/abstract