[Metabolic problems of malnutrition in cancer patients and the treatment by parenteral substitution (author's transl)].

The central and primary metabolic disturbance of the host's turnover by the tumor introducing a malnutrition syndrome is the increased energy expenditure of the tumor within an uneconomical glycolysis and lactate recycling and an increased amino acid requirement in consequence of an uncontrolled protein synthesis and of an amino acid consumption by gluconeogenesis. These are the explanations of the early signs of malnutrition for instance deficit of albumin and consumption of the energy depots. In contrast further reasons of the malnutrition (anorexia, gastrointestinal passage and resorption decreasing) are to be considered as secondary. If there are objective findings of malnutrition is to postulate a nutritional correction by substitution before the tumor therapy is beginning. Therefore the parenteral infusion of amino acid solutions without carbohydrates and possible in combination with fat solutions is to be recommended. Besides tolerability and efficiency of chemotherapy or radiotherapy can be improved by such parenteral substitution.