Cancer patients do not require a diet of special composition. In most cases, it is sufficient to offer a mixed, varied diet that is easy to digest and takes into account any aversions and preferences the patient may have (54, 56, 64, 70). On principle, patients should be informed that sufficient intake of food is important for their nutritional state and well-being and that a targeted diet is possible.
Dietary recommendations for cancer patients are currently based on reference values for the diet of a healthy person, like those established by the German Society of Nutrition (22). As there is evidence that certain nutrients (e.g., omega-3 fatty acids) influence the growth and metabolism of cells, the condition and regeneration of tissues, and also the modulation of immune defenses, attempts have been made to improve the nutritional state of cancer patients by means of such substances (77, 78). However, clear recommendations are not yet available.
The nutrition of cancer patients should be as physiological and free of complications as possible; hence, oral nutrition should be maintained as long as possible (Table 8.10). This is also important for normal function of the gastrointestinal tract.
Proper digestion and absorption are essential, and so is the mental willingness to eat (87).
If, for an extended period, adequate food intake is no longer possible, dietary drink mixes and supplements may be added to the diet. (An energy intake of less than 1200kcal/day no longer guarantees adequate intake of essential nutrients.) Individual needs of the patient can be addressed by a special composition of the diet (rich in energy and proteins, with or without fiber, with fats containing medium-chain triglycerides, without lactose). Formula diets are well suited, especially for patients who live on their own and, due to their disease, may not have the possibility, energy, or desire to cook a meal adjusted to their individual needs (77).
Only when all options for oral nutrition have been exhausted, or when the patient feels too much put under pressure, enteral or parenteral feeding is indicated. Both forms of artificial nutrition support can be performed at home. Basically, enteral feeding harbors fewer complications and stimulates normal digestion. Whenever possible, it should be preferred over parenteral feeding as long as the gastrointestinal tract is intact (52, 53).
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