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Oncology Patients

Example cases for nutrition support

Cancer Anorexia Nutrtion support

Tube feeding in cancer patients

Malnutrition is a frequent problem in cancer patients and it is often accompanied by the loss of muscle mass. Both are closely connected to reduced physical activity and a poor dietary intake, but also to catabolic metabolic derangements. The consequence can be a negative clinical outcome.1
Approximately half of all cancer patients are at risk of developing a syndrome of cachexia, which results in losing body fat and muscle mass as well as being anorexic. This not only leads to a decreasing Quality of Life of the patient, but can also have a negative impact on chemotherapy treatment response and survival rate.2

 

The following four example cases illustrate how patients with different types of cancer may benefit from tube feeding:

Clinical summary: Presentation/Clinical history

 

Mr E, 32 years, welder and father of two children, current weight: 79.8 kg (BMI 27.9 kg/m2)

 

Diagnoses: T3N1Mx squamous cell base of tongue tumour 

PEG was sited during surgery prior to adjuvant chemoradiotherapy due to expected odynophagia, dysphagia and weight loss

 

Mr E - patient with head and neck cancer

The nutrition support was able to meet Mr E's high energy and protein requirements to aid his daily activities and allow him to attend radiotherapy without the need of feeding during the day.

Outcome: 1-month post treatment

  • Oral intake improving following treatment (soft diet and normal consistency fluids) and feed reduced to 500 ml Fresubin Energy Fibre
  • Feeding tube likely to be out in next 1–2 weeks as progressing quickly and continues to tolerate 2 x Supportan DRINK daily
  • Current weight: 80.1 kg

 

 

Download the complete and detailed patient case here

Patient case Head and Neck cancer.pdf

Download the complete and detailed patient case here

Filename
Patient case Head and Neck cancer.pdf
Size
1 MB
Format
pdf

Clinical summary: Presentation/Clinical history

 

Mrs F, 42 years, current weight: 54.8 kg (BMI: 20.1 kg/m2)

 

Diagnoses: T2N0M0 left non-small cell lung cancer

After a left pneumonectomy she developed a chest infection

Her oral intake has been poor and identified by screening as a high nutritional risk

Mrs F - lung cancer patient

Mrs F receives short-term nasogastric feeding to meet requirements during period of acute ill health.

Outcome: After 10 days

  • Outpatient, living at home independently with her husband
  • Her oxygen therapy continues as required following strenuous physical activity
  • Fresubin ONS continue 2 x daily to help meet nutritional requirements and Mrs F is being followed up by the community dietician in clinic

 

 

Download the complete and detailed patient case here

Patient case Lung cancer.pdf

Download the complete and detailed patient case here

Filename
Patient case Lung cancer.pdf
Size
1 MB
Format
pdf

Clinical summary: Presentation/Clinical history

 

 Mr G, 68 years, veterinarian, current weight: 78.6 kg (BMI: 26.3 kg/m2)

 

Diagnoses: T4aN1M0 oesophageal carcinoma

After neo-adjuvant chemotherapy at surgery jejunostomy tube was sited

Weight loss since diagnosis: 7.2%

 

Mr G - patient with oesophageal cancer

Tube feeding has helped Mr G to maintain his hydration status and to minimise depletion in his nutritional status.

Outcome: 

  • Mr G has been unable to progress with oral intake following surgery and his jejunostomy feeding has reduced pressure on oral intake following surgery and during palliative chemotherapy
  • Feeding via jejunostomy had minimal impact on nausea and vomiting
  • Fresubin HP Energy was able to meet Mr G's full nutritional needs in only 1500 ml

 

 

Download the complete and detailed patient case here

Patient case Oesophageal cancer.pdf

Download the complete and detailed patient case here

Filename
Patient case Oesophageal cancer.pdf
Size
1 MB
Format
pdf

Clinical summary: Presentation/Clinical history

 

Miss H, 25 years, mechanical engineer, current weight: 68.3 kg (BMI: 22.8 kg/m2)

 

Diagnoses: Hodgkin’s lymphoma with chemotherapy, stem cell transplant and stem cells replacement

Naso-jejunal tube admitted due to on-going vomiting and poor nutritional status

Weight loss since diagnosis: 6.6%

Miss H - patient with stem cell transplant

After 12 days Miss H's weight was stablised, the oral intake continues to improve and nausea resolved. 

Outcome: 

  • Miss H was discharged home following a successful stem cell transplant
  • Weight stable at 69.3 kg
  • Supplemental Fresubin ONS continues to maintain nutritional status. A good nutritional status is vital for reducing the risk of complications after an in-patient stay

 

 

Download the complete and detailed patient case here

Patient cases Stem cell tranplant.pdf

Download the complete and detailed patient case here

Filename
Patient cases Stem cell tranplant.pdf
Size
1 MB
Format
pdf

 

Download the comprehensive booklet here with the four example cases mentioned above

These 4 example cases illustrate how patients with different types of cancer may benefit from tube feeding:

  • Tube feeding during radical chemoradiation for head and neck cancer
  • Short-term naso-gastric tube feeding following lung cancer diagnosis
  • Jejunostomy feeding in oesophageal cancer
  • Short-term feeding following stem cell transplant

Tube feeding in cancer patients.

What Fresubin can do for your patients.

Filename
Patient cases Oncology.pdf
Size
5 MB
Format
pdf

What Fresubin can do for your patients.

References:

1) Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11–48.
2) Aoyagi T, Terracina KP, Raza A, Matsubara H, Takabe K. Cancer cachexia, mechanism and treatment. World J Gastrointest Oncol. 2015;7(4):17–29.

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