Nutritional problems associated with gastrointestinal and genitourinary cancer
Shils, M.E.
Cancer Research 37(7 Pt 2): 2366-2372
1977
ISSN/ISBN: 0008-5472 PMID: 324614 Document Number: 111973
Cancer involving the alimentary tract may produce significant effects on the nutritional status of the patient. The organs in the gastrointestinal system are among the most metabolically active in the body. Consequently, food deprivation may adversely affect absorptive capacity and contribute to malabsorption by its effect on intestinal mucosal enzymes. Mucosal changes associated with malnutrition may occur in the presence of cancers outside the alimentary tract ("cancer enteropathy"), but such changes seem to be the result of and not the cause of cachexia. Long-term pre-existing coeliac disease is associated with the development of intestinal lymphoma and carcinoma. Intestinal lymphoma itself can appear as a coeliac syndrome. The most common direct effect of alimentary tract neoplasms on nutritional status relates to partial or complete obstruction at one or more sites. In addition to impaired food intake, fluid and electrolyte and acid base problems may result from persistent vomiting or diarrhoea or both. Impaired digestion and malabsorption may occur as a result of gastric hypersecretion, pancreatic exocrine insufficiency or bile insufficiency. The malabsorption from those conditions can lead to deficiencies of nutrients. Hepatoma may be associated with severe hypoglycaemia; liver failure leads to progressive malnutrition. Ovarian tumours exert an adverse effect with the development of ascites or intestinal obstruction. Cervical and bladder carcinoma may obstruct the ureters causing renal dysfunction.