One of the prime nutritional concerns in
cancer patients is
cachexia and deteriorating nutritional status.
Cachexia can occur as a result of either treatment or the
tumor itself. The progressive
malnutrition ultimately affects performance status and organ function. Tolerance to treatment may thus be decreased, which, in turn, may adversely affect toxicity and response. In addition, the deleterious effects of
malnutrition on the immune system can increase susceptibility to
infection. The weakness and
fatigue related to muscle wasting and changes in metabolism affect physical appearance, leading to a loss of self-esteem. Thus, the vicious cycle of
cachexia severely impacts on every aspect of daily life. Providing
nutritional support and effective treatment may reverse the
cachexia. Studies involving caloric supplements alone have not been encouraging. Conversely, studies using
megestrol acetate have shown that
cancer patients
gain weight and that their sense of well-being improves. However, the mechanisms of
weight gain remain unknown, and further studies are needed to determine the mechanisms by which appetite is stimulated or catabolism is inhibited or both. Nursing interventions to stimulate appetite and promote greater food intake, coupled with the use of agents that alter metabolism, such as
megestrol acetate, may reverse the trend of
cachexia and thus provide an increased sense of well-being and improved quality of life.