Parenteral Nutrition Therapy in Patients With Incurable Cancer

Summary

Parenteral nutrition (PN) treatment in patients with incurable cancer is understudied and the level of evidence for clinical meaningful effects is weak. Guidelines give few specific recommendations regarding which patients with incurable cancer that should be offered PN treatment. According to the Norwegian prescription database, the use of parenteral nutrition has more than doubled in the period 2004-2015. These numbers do not separate between diagnoses and medical conditions, so the current use of medical nutrition in cancer patients in Norway is not known. The decision to initiate parenteral nutrition is taken at hospitals, whereupon the patient returns home to their respective municipalities and receives follow-up by the home care service. There are often uncertainties about the duration of treatment, as patients' clinical condition can change rapidly. One major challenge health care professionals face is to decide when to end medical nutrition therapy. Patients and relatives may experience fear that discontinuation of medical nutrition accelerates death, while health care professionals often experience that nutrition in many cases does not help and inflicts negatively on patients' condition. This makes communication concerning end of nutritional treatment between health care professionals at several health care levels, patients and their relatives challenging.

There is a need for a stronger evidence base considering the effect of medical nutrition in patients with incurable cancer. To be able to study the effect of PN treatment, more studies on clinical practice of PN treatment to patients with incurable cancer is needed. Aspects like indication for use, dosage and duration of PN treatment is poorly described in the available literature. Thus, the aim of this study is to describe indications for use of PN, duration of treatment, reasons for discontinuation, method of administration, possible benefits and complications as well as survival.

Conditions

• Neoplasms
• Terminal Illness

Interventions

OTHER

Parenteral nutrition

Parenteral nutrition treatment in palliative care

Sponsors & Collaborators

• St. Olavs Hospital

  collaborator OTHER

• Sykehuset i Vestfold HF

  collaborator OTHER

• Sykehuset Telemark

  collaborator OTHER_GOV

• Haukeland University Hospital

  collaborator OTHER

• University of Bergen

  collaborator OTHER

• Oslo University Hospital

  collaborator OTHER

• Norwegian University of Science and Technology

  lead OTHER

Principal Investigators

• Trude Rakel Balstad, phd · Norwegian University of Science and Technology

• Torstein Baade Rø, md phd · Norwegian University of Science and Technology, IKOM

• Arne Solberg, md phd · Cancer Clinic, St. Olavs hospital, Trondheim University hospital

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-11-01

Primary Completion

2023-05-01

Completion

2023-05-01

Countries

• Norway

Study Locations