Nutritional Consequences of Cancer Chemotherapy and Immunotherapy

The nutritional consequences of major cancer chemotherapeutic and immunotherapeutic agents are reviewed. In addition, nutritional approaches to cancer treatment are discussed. Effects on host nutrition are related to two primary drug functions, i.e., biochemical interaction with the target tissues and pharmacological action on the host. Treatments with these agents result in profound effects on the gastrointestinal, central nervous, cardiopulmonary, renal, musculoskeletal, hematopoietic, and constitutional systems of cancer patients who have already been nutritionally compromised. Prevention and treatment of the nutritional consequences of chemotherapy and immunotherapy include specific treatment against particular agents and nonspecific symptomatic or supportive therapy. A modern concept of parenteral nutrition combined with chemotherapy and immunotherapy is one example of a nonspecific approach with a high promise for general use. More importantly, increasing success in the long-term control of leukemia, Hodgkin's disease, and certain other neoplasms has interrupted the vicious cycle promulgated on the host nutrition by neoplasia and toxic agents. New concepts of chemotherapy, e.g., short intensive treatment instead of prolonged treatment, and surgical adjuvant treatment instead of therapy of patients with advanced cancer, have minimized the nutritional consequences of chemotherapeutic and immunotherapeutic agents.