Nutritional support

Cancer, or the effects of cancer treatments, can sometimes cause malnutrition and weight loss.

Malnutrition is when the body is not getting enough vitamins, minerals and nutrients from your diet , such as protein, to keep healthy and maintain weight. This may be because you have a reduced appetite, or have symptoms such as difficulty swallowing or a sore mouth.

These problems may only happen for a short time. Making changes to your diet or adding nutritious drinks or supplements is sometimes all you need.

But for some people, this will not be enough to keep to a healthy weight. If someone cannot swallow or is having difficulty swallowing, they may need additional support.

If you cannot eat or drink enough to maintain your weight, your cancer doctors or dietitian may suggest artificial nutritional support. This is when you are given nutrients through a tube (artificial feeding). This tube may go either into the stomach or bowel, or into a vein. It can be used to help people who are not able to eat or drink in the usual way.

This can seem overwhelming at first. But when people feel the benefits of having nutritional support, they usually start to feel less worried.

Tube feeding may be used if you:

• have difficulty swallowing and your mouth is sore
• lost a lot of weight (usually 10% or more of your body weight) and dietary supplements and nutrition support strategies have not helped
• are unable to eat or drink enough, and dietary supplements have not helped.

Many people can have tube feeding at home. Having parenteral nutrition (PN) is more difficult to deal with than having enteral nutrition (EN), such as NG or PEG feeding. You may need to be referred to a specialist hospital to be shown how to manage the PN feeds at home.

The thought of having tube feeding at home may make you feel anxious. Before you are discharged from hospital, you will be shown how to manage your feeding system. If you have a carer, they will be shown too. You are usually given written instructions to help when you are at home.

Home tube feeding for nutritional support will not start until you, and your carer if you have one, feel confident in dealing with the tube and the feeds.

A team of healthcare professionals will also help to support you at home. The support offered to people may vary, but your GP, district nurse and dietitian can help you.

NHS trusts often work in partnership with specialist home-care companies to make sure people who go home with feeding have the support they need.