Enteral and Parenteral Nutrition Support for Adults with Cancer
What is enteral nutrition support?
Sometimes, even when high-calorie and high-protein foods are offered, people with
cancer have trouble eating enough to meet their nutritional needs. Tube feedings may
be needed to supplement the diet or, when significant weight loss has happened, as
the sole source of nutrition to prevent malnutrition. This can involve placing a small
tube through the nose, down the esophagus and leaving it either in the stomach (nasogastric
or NG tube) or duodenum (nasoduodenal), the first part of the small intestine. The
gastrointestinal tract or "gut" must be functioning properly before a feeding tube
can be placed.
Sometimes, a PEG (percutaneous endoscopic gastrostomy) tube is used instead. This
is a tube inserted surgically through the skin of the stomach wall and placed directly
into the stomach. It is used to give nutrients to patients who cannot swallow. Or
a similar tube, known as a J-tube (for jejunostomy), can be surgically placed into
the small intestine. These alternatives to oral feedings may be only temporary. Your
healthcare provider or registered dietitian will discuss these choices with you if
it is considered necessary to help you maintain your nutritional status during your
What is parenteral nutrition support?
In some cases, people undergoing treatment for cancer need total parenteral nutrition
(TPN) to help meet their nutritional needs. TPN is a special mixture of glucose, protein,
fat, vitamins, and minerals that are given through an IV into the veins. This procedure
is called intravenous feedings. A central venous catheter is typically used to give TPN. It is inserted into a large
vein and can remain in place for an extended period of time. TPN provides necessary
nutrients when someone is not tolerating food by mouth, not absorbing nutrients in
the gut, or needing bowel rest. The TPN solution is usually taken in continuously
over several hours of the day.