[Metabolic and Nutritional Management for Cancer Cachexia].

There are 4 purposes in the nutritional management for cancer patient. At first, we had better perform the early metabolic recovery from several invasive damages by some cancer treatments. At second, we give some special nutritional management for improvement from cancer cachexia. At third, we consider palliative nutritional management to terminal cancer patients based on pathophysiology of cachexia, their life styles and ethics. Finally, we give the social nutritional management for keeping high quality of life through well eating until the end of life. In this paper, we explained about the metabolic influences to normal tissues during cancer treatments such as surgical operation, chemotherapy and radiotherapy. The mechanism and pathophysiology of cancer cachexia due to tumor expanding and metabolic disorders could be clear by our experimental results and other literatures. Also the nutritional management and metabolic regulation to control of symptoms and development of cachexia could be shown with prevention of sarcopenia. Administration of protein and amino acids, especially, branched chain amino acids, and some other micro nutrients should be useful for prevention of sarcopenia and cachexia. However, 3-4 weeks before death, the energy expenditure should decrease at the stage of refractory cachexia. Thus, in this point, we can recommend to reduce the total mounts of energy and solution at the nutritional management without overloading.