Total parenteral nutrition for patients with advanced life-limiting cancer: Decision-making in the face of conflicting evidence

Total parenteral nutrition (TPN) offers a method for ensuring adequate nutritional intake in patients whose eating is compromised; for reasons related to treatment side effects and their disease itself, end-stage cancer patients comprise a significant proportion of patients on TPN. In patients with advanced life-limiting cancer, at or near the end of life, the benefit of TPN is unclear. Conflicting research evidence spanning several decades both supports and refutes the use of TPN. In this paper, we suggest one approach to TPN at the end of life, acknowledging that there are many unresolved medical, ethical, and moral issues surrounding the use of TPN in palliative/end-of-life patients. We encourage the field of palliative medicine to use the TPN controversy as a forum in which to discuss the challenges of applying evidence-based practice principles to palliative medicine. © 2008 W.S. Maney & Son Ltd.

Duke Scholars

Author Alison Suzanne Clay Medical Education