Nutritional management of gastrointestinal malignancies : invited communication

The evidence connecting food and gastrointestinal cancers from epidemiological studies, case-control studies, and prospective observational studies, indicates that determining the independent effects of specific nutrients is extremely difficult, given the many potential environmental factors to consider. The nutritional management of a patient with gastrointestinal cancer first begins with an appropriate nutritional assessment, seeing that several factors could affect the patient's nutritional status. The most significant dietary advice for cancer patients in general, is to consume a significant amount of energy daily to maintain current body weight, as well as a liberal amount of protein. In cancer patients requiring gastrointestinal surgery, the benefit of delaying surgery to attain improved nutritional status needs to be determined for improved outcomes. Postoperatively, severely malnourished cancer patients, and patients with an anticipated inadequate nutritional intake for seven days or longer, will benefit from postoperative TEN, given within 48 hours after surgery. Regular monitoring and adjustments to nutritional prescriptions is imperative in order to improve the cancer patien's nutritional status within the context of the prognosis.