Specialized Conditions

It is always desirable for cancer patients to take food by mouth, however, for some individuals this is not possible. Patients who are receiving treatments for head, neck, throat (esophagus) or stomach cancer sometimes can’t eat. One approach to ensuring maximal nourishment for such patients is through the use of what is known as enteral feeding, which refers to the introduction of nutrients through a tube placed directly into a patient’s stomach or intestine. In these situations, nutrients are delivered in liquids that contain proteins, vitamins, water, minerals, carbohydrates, etc.

Enteral feeding is generally accomplished through a tube that is inserted into the nose and then into the stomach or intestine. While many patients are able to tolerate this method of tube insertion, others are not. An alternative is to insert a feeding tube directly into the stomach or lower digestive tract through a small surgical opening known as a stoma that will be located in the patient’s abdomen.

The liquid delivery of nutrients through either enteral method may be delivered on a continual basis or in timed intervals, depending on each patient’s specific treatment or ability to tolerate nourishment. Specialized liquid formulas are designed for patients with specific dietary needs or restrictions such as might apply to patients with diabetes or other conditions. While enteral feeding may be suitable for some cancer patients, it is not an option for those patients listed below:

• Patients with bowel blockage or obstructions
• Patients whose stomach or gastrointestinal systems are damaged or have been removed
• Patients who suffer from extreme nausea, vomiting or diarrhea
• Patients who suffer from blood disorders such as low counts of platelets, white or red blood cells
• Patients with sores of the mouth and/or the esophagus or who are experiencing severe weight loss

For the above patients, parenteral feeding can be used. Parenteral feeding delivers nutrients directly into the bloodstream through a catheter that is placed beneath the skin and then into a large vein in the patient’s upper chest. This catheter placement is usually performed by a surgeon, and it is typically used when a long-term feeding solution is required. For short-term nutrient introduction, a catheter is placed in a vein in the arm, a procedure that can be performed by nurses or other medical professionals. While enteral and parenteral patient feeding typically take place in a medical setting, it can also happen in a home or hospice situation, though, careful monitoring of possible complications such as blood clots, infections, collapsed veins, etc., must be employed.

Enteral feeding is generally accomplished through a tube that is inserted into the nose and then into the stomach or intestine. While many patients are able to tolerate this method of tube insertion, others are not. An alternative is to insert a feeding tube directly into the stomach or lower digestive tract through a small surgical opening known as a stoma that will be located in the patient’s abdomen.

The liquid delivery of nutrients through either enteral method may be delivered on a continual basis or in timed intervals, depending on each patient’s specific treatment or ability to tolerate nourishment. Specialized liquid formulas are designed for patients with specific dietary needs or restrictions such as might apply to patients with diabetes or other conditions. While enteral feeding may be suitable for some cancer patients, it is not an option for those patients listed below:

• Patients with bowel blockage or obstructions

• Patients whose stomach or gastrointestinal systems are damaged or have been removed

• Patients who suffer from extreme nausea, vomiting or diarrhea

• Patients who suffer from blood disorders such as low counts of platelets, white or red blood cells

• Patients with sores of the mouth and/or the esophagus or who are experiencing severe weight loss

For the above patients, a form of nutrient delivery known as parenteral feeding is used. Parenteral feeding delivers needed nutrients directly into the bloodstream through a catheter that can be placed beneath the skin and then into a large vein in the patient’s upper chest region. This catheter placement is usually performed by a surgeon, and it is typically used when a long-term feeding solution is required. For short-term nutrient introduction, a catheter is placed in a vein in the arm, a procedure that can be performed by nurses or other medical professionals. While enteral and parenteral patient feeding is typically undergone in a medical setting, it can also be utilized in a home or hospice situation as well, though, careful monitoring of possible complications such as blood clots, infections, collapsed veins, etc., must be employed.