Nutritional Management of the Childhood Cancer Patient

Owing to the progress made in recent years, childhood cancers are now generally treatable. This progress is particularly evident in the treatment of lymphoblastic leukemia, lymphomas, and Wilms’ tumor; in fact most of these patients remain in remission for such long periods that they may reasonably be considered cured. Much effort has been made to improve support treatment for these patients with the aim of ensuring the best chance of therapeutic success; two examples of this are the notable advances achieved in the treatment of infections and in transfusional regimens. The importance of the nutritional status of cancer patients in obtaining the best possible treatment results has also been stressed in recent years, and numerous studies have been performed in different centers with the aim of clarifying the mechanisms of the protein-energy malnutrition (PEM) that often occurs in these patients. As a result, useful and sophisticated techniques have been developed to investigate nutritional status, and the use of techniques such as total parenteral nutrition (TPN) has been rationalized and widened. TPN has been shown to be fundamental in some patient categories at high risk, such as recipients of bone marrow transplants and subjects with gastrointestinal cancers.