Health Questions and Answers

Question: What relationship does malnutrition have to surgical therapy for cancer?

Answer:

It is well established that cancer patients with severe malnutrition have worse surgical outcomes than patients who are adequately nourished. They have a higher rate of mortality, a higher rate of major complications, and more infectious complications. These complications include impaired wound healing, anastomotic leaks, abscess formations, infections, fistulas, and postoperative pneumonia. Malnourished cancer patients have impaired immunocompetence. Surgical therapy will further deplete the malnourished cancer patient. The stress response following surgery taxes depleted energy reserves. The patient is often unable to eat for several days after an operation, which further reduces energy reserves. A large cooperative study has demonstrated that in patients with severe malnutrition who must be operated on for cancer, use of perioperative total parenteral nutrition (TPN) can decrease complications and reduce mortality.

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