Enteral and Parenteral Nutrition Support for Adults with Cancer

Why might a person with cancer need nutrition support?

Cancer and cancer treatment can make it hard to eat well and have a healthy diet. Some people with cancer find that they don't get hungry and just don't feel like eating.

Sometimes the cancer itself can cause changes that make a person unable to get the nutrients they need. For instance, tumors can block or damage any part of the gastrointestinal system (digestive system). This system of tubes and organs goes from the mouth to the anus. It breaks down and takes nutrients out of the foods and liquids you take in to keep your body healthy.

Cancer treatment can also cause side effects that make it hard to eat and drink enough to get the nutrients the body needs. Some of these side effects include pain, tiredness, mouth sores, swallowing problems, diarrhea, and vomiting.

There are many treatments that can be used to treat problems that affect nutrition. And nutritional counseling with a registered dietitian can help a lot of people. But sometimes, extra help is needed.

What is enteral nutrition support?

Enteral nutrition is a type of feeding that uses a person's gastrointestinal tract (gut), but it bypasses the mouth and the need to swallow. It might also be called a tube feeding.

If needed for only a few weeks, a nasogastric (NG) tube might be used. This thin tube is put in through the nose and ends in the stomach. Sometimes, feedings may need to be given for a longer time. A percutaneous endoscopic gastrostomy (PEG) tube is then used. This is a tube that's put in during surgery. It goes through the skin over the stomach and ends in the stomach. Another choice is a J-tube (for jejunostomy). It's much the same as a PEG tube. But it ends in the small intestine. 

Feeding tubes like these may be needed for a short or long time. Your healthcare provider or registered dietitian will talk with you about these choices if you need help to maintain your nutritional status during your cancer treatment.

What is parenteral nutrition support?

Parenteral nutrition is put in through a vein and goes right into the blood. Sometimes people need total parenteral nutrition (TPN) to help meet their nutritional needs during treatment.

TPN is a special mixture of sugar, protein, fat, vitamins, and minerals. It is given through an IV (intravenous) line into the blood. This is called intravenous feedings. A central venous catheter is used to give TPN. This thin, soft tube is put into a large vein and can stay in for a long period of time. 

TPN gives needed nutrients when someone cannot take in food by mouth, isn't absorbing nutrients in the gut, or needs bowel rest. TPN is often taken in continuously over several hours of the day. It might be needed for months or longer.