Indications for parenteral nutrition in cancer supportive care: An acknowledgement of cultural interplay in decision-making

Parenteral nutrition can be effectively prescribed in cancer patients who are severely malnourished or at risk for severe malnutrition and about to undergo potentially curative therapy. Cancer patients with incurable disease are generally not considered good candidates for parenteral nutrition, as it can cause harm under these circumstances. This review provides justification for these recommendations and also briefly discusses immunonutrition. Importantly, however, despite a growing body of clinical trial evidence that supports the indications advanced here, there continues to be a cultural interplay - that involves patients, their families, and their healthcare providers - when final decisions are made. This review makes the point that, despite the findings of clinical research, an acknowledgement of this cultural interplay is important when taking care of cancer patients and when making a final decision with them and their family about whether to prescribe nutrition suppor