Skip to main content

Advertisement

SpringerLink
Log in

Malignant disease: nutritional implications of disease and treatment

  • Published:
Cancer and Metastasis Reviews Aims and scope Submit manuscript

Abstract

Protein-energy malnutrition (PEM) is common in cancer patients and may develop into the syndrome known as ‘cancer cachexia’. This is characterised by complex disturbances in carbohydrate, lipid, protein, and electrolyte metabolism. The actiology is equally complex, with host and therapeutic factors contributing to the reduced food intake and effects on host tissues. Anorexia is of prime importance, differing in its cause from one patient to another and often presenting a barrier to successful nutritional support. Further research is necessary to elucidate the interaction of central and peripheral factors that may be involved in the aetiology of anorexia. Because of the interplay of biochemical, physiological, and psychological consequences of cancer, the nutritional support of the patient presents a considerable challenge to the caring professions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Blackburn GL, Bothe A: Assessment of malnutrition in cancer patients. Cancer Bull 30: 88–93. 1978

    Google Scholar 

  2. Soukop M, Calman KC: Nutritional support in patients with malignant disease. J Hum Nutr 33: 179–188. 1979

    Google Scholar 

  3. Brennan MF: Total parenteral nutrition in the cancer patient. New Engl J Med 305: 375–382, 1981

    Google Scholar 

  4. Landel AM, Hammond WG, Meguid MM: Aspects of amino acid and protein metabolism in cancer-bearing states. Cancer 55 Suppl: 230–237, 1985

    Google Scholar 

  5. Harvey KB, Bothe A, Blackburn GL: Nutritional assessment and patient outcome during oncological therapy. Cancer 43: 2065–2069, 1979

    Google Scholar 

  6. DeWys WD: Nutritional care of the cancer patient. J Amer Med Ass 244: 374–376, 1980

    Google Scholar 

  7. Shils ME: Nutritional problems induced by cancer. Med Clin Nth Am 63: 1009–1025, 1977

    Google Scholar 

  8. Lundholm K, Holm G, Schersten T: Insulin resistance in patients with cancer. Cancer Res 38: 4665–4670, 1978

    Google Scholar 

  9. Lundholm K, Edstrom S, Karlberg I, Ekman L, Schersten T: Glucose turnover, gluconeogenesis from glycerol and estimation of net glucose cycling in cancer patients. Cancer 50: 1142–1150, 1982

    Google Scholar 

  10. Stein TP, Oram-Smith JC, Leskiw MJ, Wallace HW, Miller EE: Tumour-caused changes in host protein synthesis under different dietary situations. Cancer Res 36: 3926–3940, 1976

    Google Scholar 

  11. Norton JA, Shamberger R, Stein TP, Milne GWA, Brennan MF: The influence of tumour bearing on protein metabolism in the rat. J Surg Res 30: 456–462, 1981

    Google Scholar 

  12. Mider GB: Some aspects of nitrogen and energy metabolism in cancerous subjects: a review. Cancer Res 11: 821–829, 1951

    Google Scholar 

  13. Begg RW, Lotz F: Clearing factor and hyperlipidaemia in tumour bearing rats. Proc Amer Ass Cancer Res 2: 93–97, 1956

    Google Scholar 

  14. Begg RW, Lotz F: Further studies on clearing activity in tumour bearing rats. Proc Amer Ass Cancer Res 2: 187–195, 1957

    Google Scholar 

  15. Theologides A: The anorexia-cachexia syndrome: a new hypothesis. Ann NY Acad Sci 230: 14–22, 1974

    Google Scholar 

  16. Morrison SD: Control of food intake in cancer cachexia: a challenge and a tool. Physiol Behav 17: 705–711, 1976

    Google Scholar 

  17. Heber D, Byerly LO, Chlebowski RT: Metabolic abnormalities in the cancer patient. Cancer 55 Suppl: 225–229, 1985

    Google Scholar 

  18. Theologides A: Cancer cachexia. Cancer 43: 2004–2013, 1979

    Google Scholar 

  19. Waterhouse C, Kemperman JH: Carbohydrate metabolism in subjects with cancer. Cancer Res 31: 1273–1278

  20. Holroyde CP, Gabuzda TG, Putnam RC, Paul P, Reichard GA: Altered glucose metabolism in metastatic carcinoma. Cancer Res 35: 3710–3714, 1975

    Google Scholar 

  21. Beutler B, Cerami A: Cachectin and tumour necrosis factor as two sides of the same biological coin. Nature 110: 584–588, 1986

    Google Scholar 

  22. Beutler B, Milsark AW, Cerami A: Passive immunisation against cachectin/tumour necrosis factor protects mice from the lethal effect of endotoxin. Science 229: 869–871, 1985

    Google Scholar 

  23. Kawakami M, Cerami A: Studies of endotoxin induced decrease in lipoprotein lipase activity. J Exp Med 154: 631–639, 1981

    Google Scholar 

  24. Torti FM, Dieckmann B, Beutler B, Cerami A, Ringold GM: A macrophage factor inhibits adipocyte gene expression: an in vitro model of cachexia. Science 229: 867–869, 1985

    Google Scholar 

  25. Pekala P, Kawakami M, Vine W, Lane MD, Cerami A: Studies of insulin resistance in adipocytes induced by macrophage mediator. J Ex Med 157: 1360–1365, 1983

    Google Scholar 

  26. Calman KC: Cancer cachexia. Brit J Hosp Med 27: 28–34, 1982

    Google Scholar 

  27. Creamer B: Malignancy and the small intestinal mucosa. Brit Med J 2: 1435–1436, 1964

    Google Scholar 

  28. Wangel AG, Deller DJ: Malabsorption syndrome associated with carcinoma of the bronchus. Gut 6: 73–76, 1966

    Google Scholar 

  29. Erlich AN, Stalder G, Geller W, Sherlock P: Gastrointestinal manifestations of malignant lymphoma. Gastroenterol 54: 1115–1121, 1968

    Google Scholar 

  30. Waldman TA, Broder S, Strober W: Protein-losing enteropathies in malignancy. Ann NY Acad Sci 230: 306–317, 1974

    Google Scholar 

  31. Barry RE: Malignancy, weight loss and the small intestinal mucosa. Gut 15: 562–570, 1974

    Google Scholar 

  32. Viteri FE, Schneider RE: Gastrointestinal alterations in protein caloric malnutrition. Med Clin Nth Am 58: 1487–1491, 1974

    Google Scholar 

  33. Wesdorp RIC, Krause R, VonMeyendfeldt MF: Cancer cachexia and its nutritional implications. Brit J Surg 70: 352–355, 1983

    Google Scholar 

  34. Theologides A: Anorexia-producing intermediary metabolites. Am J Clin Nutr 29: 552–558, 1976

    Google Scholar 

  35. Morrison SD: Limited capacity for motor activity as a cause for declining food intake in tumour bearing rats. Natl Cancer Inst 51: 153–157, 1973

    Google Scholar 

  36. Holland JCB, Rowland J, Plumb M: Psychological aspects of anorexia in cancer patients. Cancer Res 37: 3425–3428, 1977

    Google Scholar 

  37. Young VR, Munro HR: N-methylhistidine (3-methyl-histidine) and muscle protein turnover: an overview. Fed Proc 37: 2291–2300, 1978

    Google Scholar 

  38. Milward DJ, Bates PC: 3-methylhistidine turnover in the whole body and the contribution of skeletal muscle and intestine to urinary 3-methylhistidine excretion in the adult rat. Biochem J 214: 607–615, 1983

    Google Scholar 

  39. Donaldson SS, Lenon R: Alterations of nutritional status: impact of chemotherapy and radiotherapy. Cancer 43: 2036–2052, 1979

    Google Scholar 

  40. McAllister RA, Soukop M, Calman KC: Metabolic changes in liver of tumour bearing animals (Abstr). Brit J Cancer 34: 312, 1976

    Google Scholar 

  41. Calman KC, McAllister RA, Soukop M: Correction of changes in liver metabolites of mice following curative tumour resection (Abstr). Brit J Cancer 34: 405, 1977

    Google Scholar 

  42. Wurtmann RJ: When-and why-should nutritional state control neurotransmitter synthesis? J Neurol Transm 15 Suppl: 69–72, 1979

    Google Scholar 

  43. Theologides A: Cancer and anorexia. NY State J Med 78: 1514–1557, 1978

    Google Scholar 

  44. Leibelt RA, Leibelt AG, Johnston HM: Lipid mobilisation and food intake in experimentally obese mice bearing transplanted tumours. Proc Soc Exp Biol Med 138: 482–490 1971

    Google Scholar 

  45. Baillie P, Millar FF, Pratt AW: Food and water intake and Walker tumour growth in rats with hypothalamic lesions. Am J Physiol 209: 293–297, 1965

    Google Scholar 

  46. Lytle LD: Control of Eating Bchavior. In: Wurtman JJ Wurtmann JJ (eds) Nutrition and the Brain, Vol. 2 Raven Press. New York, 1977, pp 1–145

    Google Scholar 

  47. Kruk ZL: Dopamine and 5-hydroxytryptamine inhibit feeding in rats. Nature New Biol 246: 52–57, 1976

    Google Scholar 

  48. Lehr D, Goldman W: Continued pharmacologic analysis of consummatory behaviour in the albino rat. Euro J Pharmacol 23: 197–200, 1973

    Google Scholar 

  49. Briesch ST, Zemlam FP, Hoebel BG: Hyperphagia and obesity following serotonin depletion by intraventricular p-chlorophenylalanine. Science 192: 382–384, 1976

    Google Scholar 

  50. Saller CF, Stricker EM: Hyperphagia and increased growth in rats after intraventricular injection of 5,7-dihydroxytryptamine. Science 192: 385–387, 1976

    Google Scholar 

  51. Krause R, James JH, Ziparo V, Fischer JE: Brain tryptophan and the neoplastic anorexia-cachexia syndrome. Cancer 44: 1003–1008, 1979

    Google Scholar 

  52. Krause R, James JH, Humphrey C, Ziparo V, Fischer JE: Plasma and brain amino acids in Walker-256 carcino-sarcoma bearing rats. Cancer Res 39: 3065–3069, 1979

    Google Scholar 

  53. VonMeyendfeldt MF, Chance WT, Fischer JE: Investigation of serotonergic influence on cancer induced anorexia. Soc Neurose Abstr 6: 525–526, 1980

    Google Scholar 

  54. Chance WT, VonMeyendfeldt M, Fischer JE: Serotonin depletion by 5–7-dihydroxytryptamine or para-chloroamphetamine does not affeet cancer anorexia. Pharmacol Biochem Behav 18: 115–121, 1983

    Google Scholar 

  55. Leathwood PD, Ashley DV, Moennoz DV: Anorexia and cachexia in cancer. Nestle Research New 1985/85. Nestec Ltd., Switzerland, 1986

    Google Scholar 

  56. Schmale AH: Psychological aspects of anorexia. Cancer 43: 2013–2019, 1979

    Google Scholar 

  57. Plumb M, Holland J, Park S, Dykstia L, Holmes J: Depression of symptoms in patients with advanced cancer: a controlled assessment (Abstr). Psychosomat Med 36: 459, 1976

    Google Scholar 

  58. DeWys WD: Anorexia as a general effect of cancer. Cancer 43: 2013–2019, 1979

    Google Scholar 

  59. DeWys WD, Walters K: Abnormalities of taste sensation in cancer patients. Cancer 36: 1888–1896, 1975

    Google Scholar 

  60. DeWys WD: Changes in taste sensation and feeding behaviour in cancer patients. J Hum Nutr 32: 447–453, 1978

    Google Scholar 

  61. Hambidge KM, Hambidge C, Jacobs M, Baum JD: Low levels of zine in hair, anorexia, poor growth and hypogeusia in children. Paediat Res 6: 868–876, 1972

    Google Scholar 

  62. Wolman SC, Anderson GH, Marliss EB: Zine in total parenteral nutrition; requirements and metabolic effects. Gastroenterol 76: 548–552, 1979

    Google Scholar 

  63. Schwartz MK: Role of trace elements in cancer. Cancer Res 35: 3481–3487, 1975

    Google Scholar 

  64. Bernstein IL, Bernstein ID: Learned food aversions and cancer anorexia. Cancer Treat Rep 65 Suppl: 43–47, 1981

    Google Scholar 

  65. Bolles RC: Learning Theory. Rinehart and Wilson, New York. 1975

    Google Scholar 

  66. Garcia J, Henkins WG, Rusinisk KW: Behavioural regulation of the milieu internae in man and rat. Science 185: 824–831, 1974

    Google Scholar 

  67. Elkins RL: Conditioned flavour aversions in familiar tapwater in rats: an adjustment with implications for aversion therapy treatment of alcoholism and obesity. J Abnorm Psychol 83: 411–417, 1974

    Google Scholar 

  68. Lawson DH, Richmond A, Nixon DW, Rudman D: Metabolic approaches to cancer cachexia. Ann Rev Nutr 2: 277–301, 1982

    Google Scholar 

  69. Warnold I, Lundholm K, Schersten T: Energy balance and body composition in cancer patients. Cancer Res 38: 1801–1807, 1978

    Google Scholar 

  70. Bramante PO, Nunn AS, Steiner NC, Beaulieu DE: A method of quantification of oxygen consumption in tumour bearing rats. J Appl Physiol 18: 216–220, 1977

    Google Scholar 

  71. Mider GB, Fenninger LD, Haven FL, Morten JJ: The energy expenditure of rats bearing Walker carcinoma 256. Cancer Res 11: 731–734, 1951

    Google Scholar 

  72. Fenninger LD, Mider GB: Energy and nitrogen metabolism in cancer. Cancer Res 2: 229–232, 1952

    Google Scholar 

  73. Kleiber M, Chernikoff T: Metabolic rate of old rats with spontaneous breast cancer. J Gerontol 11: 140–141, 1956

    Google Scholar 

  74. Reichard GA, Moury NI, Mochella NJ, Patterson AL, Weinhouse S: Quantitative estimation of the Cori cycle in the human. J Biol Chem 238: 495–501, 1963

    Google Scholar 

  75. Waterhouse C, Jeanpetre N, Keilson J: Gluconeogenesis from alanine in patients with progressive malignant disease. Cancer Res 39: 1968–1972, 1979

    Google Scholar 

  76. Young VR: Energy metabolism and requirements in the cancer patient. Cancer Res 37: 2336–2347, 1977

    Google Scholar 

  77. Marks PA, Bishop JS: The glucose metabolism of patients with malignant disease and of normal subjects as studied by means of an intravenous glucose tolerance test. J Clin Invest 36: 254–257, 1957

    Google Scholar 

  78. Carter AC, Lefkon BW, Farlin M, Feldman ED: Metabolic parameters with metastatic breast cancer. J Clin Endocrinol Metab 40: 260–264, 1975

    Google Scholar 

  79. Lundholm K, Bylund AC, Schersten T: Glucose metabolism in relation to skeletal muscle enzyme activities in cancer patients. Scand J Clin Lab Invest 37: 267–272, 1977

    Google Scholar 

  80. Bishop JS, Marks PA: Studies on carbohydrate metabolism in patients with neoplasia. Studies II Response to insulin administration. J Clin Invest 38: 668–672, 1959

    Google Scholar 

  81. Warnold I, Lundholm K, Schersten T: Energy balance and body composition in cancer patients. Cancer Res 38: 1801–1807, 1978

    Google Scholar 

  82. Lundholm K, Edstrom S, Karlberg I, Ekman L, Schersten T: Glucose turnover, gluconeogenesis from glycerol, and estimation of net glucose cycling in cancer patients. Cancer 50: 1142–1150, 1982

    Google Scholar 

  83. Shils ME: Impaired nutrition in the cancer patient: causation, prevention and therapy. Nestle Research News 1984/ 1985, Nestec Ltd, Switzerland, 1986, pp 83–90

    Google Scholar 

  84. Stein TP: Cachexia, gluconcogenesis and progressive weight loss in cancer patients. J Theor Biol 73: 51–56, 1978

    Google Scholar 

  85. Busch H, Fujiwara G, Firszt DG: Studies on the metabolism of radioactive albumin in tumour bearing rats. Cancer Res 21: 371–377, 1961

    Google Scholar 

  86. Sidransky H, Verney E: Effect of nutritional alterations on protein synthesis in transplantable hepatomas and host livers of rats. Cancer Res 39: 1995–2000, 1979

    Google Scholar 

  87. Jeevanandam M, Horowitz GD, Lowry SE, Brennan MF: Cancer cachexia and protein metabolism. Lancet 1: 1423–1426, 1975

    Google Scholar 

  88. Brennan MF: Uncomplicated starvation versus cancer cachexia. Cancer Res 37: 2359–2364, 1977

    Google Scholar 

  89. Raines GE, Calman KC, Fleck A, Trotter JM, Caine S, Gordon S, Bell J, McAuley G, Willcox J: Albumin metabolism in cancer. In: Wesdorp RIC, Soeters PB (eds) Clinical Nutrition '81. Churchill Livingstone, Edinburgh, 1982, Section 4, pp 160–165

    Google Scholar 

  90. Shapot VS, Blinon VA: Blood glucose levels and gluconeogenesis in animals bearing transplantable tumours. Cancer Res 34: 1827–1832, 1974

    Google Scholar 

  91. Rothschild MA, Oratz M, Schreiber M: Albumin synthesis. In: Rosenoer VM, Oratz M, Rothschild MA (eds) Albumin Structure, Function and Uses. Pergamon Press, New York, 1977

    Google Scholar 

  92. Picou D, Waterlow JC: The effect of malnutrition on the metabolism of plasma protein. Clin Sci 22: 459–462, 1962

    Google Scholar 

  93. Steinfield JL: Albumin degradation in patients with neoplastic diseases. Cancer 13: 974–978, 1960

    Google Scholar 

  94. Waldmann TA, Gordon RS, Rosse W: Studies on the metabolism of serum proteins and lipids in a patient with analbuminaemia. Amer J Med 37: 960–968, 1964

    Google Scholar 

  95. Costa G, Bernbeck P: Metabolic studies with albumin. Proc Amer Ass Cancer Res: 15–32, 1966

  96. Mariani G, Strober W, Keiser H, Waldmann TA: Pathophysiology of hypoalbuminaemia associated with carcinoid tumour. Cancer 38: 854–860, 1976

    Google Scholar 

  97. Rossing N: Albumin metabolism in neoplastic diseases. Scand J Clin Invest 22: 211–216, 1968

    Google Scholar 

  98. Dickerson JWT: Nutrition in the cancer patient: a review. J Roy Soc Med 77: 309–315, 1984

    Google Scholar 

  99. Moore PJ, Mangnall D, Clark RG: The significance of hypoalbuminaemia. In: Wesdorp RIC, Soeters PC (eds) Clinical Nutrition '81. Churchill Livingstone, Edinburgh, 1982, Section 6.1, pp 227–232

    Google Scholar 

  100. Watson WS, Sammon AM: Body composition in cachexia resulting from malignant and nonmalignant diseases. Cancer 46: 2041–2046, 1980

    Google Scholar 

  101. Cohn SH, Gartenhaus A, Sawitsky A, Rai K, Zanzi I, Vaswani A, Ellis KJ, Yasamura S, Cortes E, Vartsky D: Compartmental body composition of cancer patients by measurements of total body nitrogen, potassium and water metabolism. Metabolism 30: 222–229, 1981

    Google Scholar 

  102. McEwan HD: Effects of tumours on lipids. Proc Can Cancer Conf 1: 141–148, 1955

    Google Scholar 

  103. Begg RW: Tumour host relations. Adv Cancer Res 5: 1–54, 1978

    Google Scholar 

  104. LePage GA, Henderson FJ: Biochemistry of tumours. Exp Tum Res 1: 441–476, 1960

    Google Scholar 

  105. Stewart AG, Begg RW: Systemic effects of tumours in force fed rats II. Effect on weight of carcass, adrenals, thymus, liver and spleen. Cancer Res 13: 556–559, 1953

    Google Scholar 

  106. Stewart AG, Begg RW: Systemic effects of tumours in force fed rats III. Effect on the composition of the carcass and liver and on the plasma lipids. Cancer Res 13: 560–565, 1953

    Google Scholar 

  107. Mider GB, Fenninger LD, Haven FL, Morton JJ: The energy expenditure of rats bearing Walker carcinoma 256. Cancer Res 11: 731–736, 1951

    Google Scholar 

  108. Waterhouse S, Nye WHR: Metabolic effects of infused triglycerides. Metabolism 10: 403–414, 1961

    Google Scholar 

  109. Weinhouse S: Glycolysis, respiration and anomalous gene expression in experimental hepatoma. Cancer Res 32: 2007–2016, 1961

    Google Scholar 

  110. Buzby GP, Mullen JL, Stein TP, Miller EE, Hobbes CL, Rosato EF: Host tumour interactions and nutrient supply. Cancer 45: 2940–2948, 1980

    Google Scholar 

  111. Weil R, Stetten D: The urinary excretion of a fat mobilising agent. J Biol Chem 168: 129–132, 1947

    Google Scholar 

  112. Chalmers TM, Kekwick A, Pawan GLS: On the fat mobilising activity of human urine. Lancet 1: 866–869, 1981

    Google Scholar 

  113. Rudman D, Delrio AE, Garcia LA, Barnett J, Howard CN, Walker W, Moore G: Isolation of two lipolytic pituitary peptides. Biochem 9: 99–107, 1970

    Google Scholar 

  114. Lee YW, Lichton IJ: Partial purification of rat urinary anorexigenic substance. J Nutr 103: 1616–1624, 1973

    Google Scholar 

  115. Redding TW, Schally AV: Lipid mobilising factor from the hypothalamus. Metabolism 19: 641–652, 1970

    Google Scholar 

  116. Mueller PS, Watkin DM: Plasma unesterified fatty acid concentration in neoplastic disease. J Lab Clin Med 57: 95–108, 1961

    Google Scholar 

  117. Schein PS, MacDonald JS, Waters C, Haidak D: Nutritional complications of cancer and its treatment. Semin Oncol 2: 337–347, 1975

    Google Scholar 

  118. Hoffman FA: Micronutrient requirements of cancer patients. Cancer (Suppl) 55: 295–300, 1985

    Google Scholar 

  119. Calman KC: Nutritional support in malignant disease. Proc Nutr Soc 37: 87–93, 1978

    Google Scholar 

  120. Dickerson JWT: Nutrition of elderly patients with cancer. In: Kemm JR, Ancill RJ (eds) Vitamin Deficiency in the Elderly. Blackwell Scientific Publications, Oxford, 1985, Chapter 10, pp 138–144

    Google Scholar 

  121. Basu TK, Aksoy M, Dickerson JWT, Williams DC: Leucocyte ascorbic acid and urinary hydroxyproline levels in patients bearing breast tumour with skeletal metastases. Europ J Cancer 19: 507–511, 1974

    Google Scholar 

  122. Cameron E, Pauling L: Supplemental ascorbate in the supportive treatment of cancer: prolongation of survival in terminal human cancer. Proc Natl Acad Sci 73: 3685–3689, 1976

    Google Scholar 

  123. Stitch HF, Karim J, Koropatrick J, Lo L: Mutagenic action of ascorbic acid. Nature 260: 722–724, 1976

    Google Scholar 

  124. Krasner N, Dymock I. Ascorbic acid deficiency in malignant diseases: a clinical and biochemical study. Brit J Cancer 30: 142–145, 1974

    Google Scholar 

  125. Anthony H, Schorah CJ: Severe hypovitaminosis C in lung cancer patients: the utilisation of vitamin C in surgical repair and lymphocyte related host resistance. Brit J Cancer 46: 354–357, 1982

    Google Scholar 

  126. Wilson C: Clinical pharmacologic aspects of ascorbic acid. Ann N Y Acad Sci 258: 355–376, 1975

    Google Scholar 

  127. Poulter JM, White WF, Dickerson JWT: Ascorbic acid supplementation and five year survival rates in women with early breast cancer. Acta Vitaminologica Enzymologica 6: 175–182, 1985

    Google Scholar 

  128. Creagan ET, Moertel CG, O'Fallon JR, Schult AJ, O'Connell MJ, Rubin J, Frytak S: Failure of high dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer: a controlled trial. New Engl J Med 301: 687–690, 1979

    Google Scholar 

  129. Moertal CG, Fleming TR, Creagan ET, Rubin J, O'Connel MJ, Ames MM: High dose vitamin C versus placebo with treatment of patients with advanced cancer who have had no prior radiotherapy. New Engl J Med 312: 137–141, 1985

    Google Scholar 

  130. Cairns J: Mutation, selection and the natural history of cancer. Nature 255: 197–200, 1975

    Google Scholar 

  131. Moore T: Effect of vitamin A deficiency in animals. In: Sebrell WH, Harris RS (eds) The Vitamins-Volume 2 (2nd Edition). Academic Press, New York, 1967, pp 245–266

    Google Scholar 

  132. Sporn MB, Dunlop NM, Newton DL, Smith JM: Prevention of chemical carcinogenesis by vitamin A and its synthetic analogues (retinoids). Fed Proc 35: 1332–1338, 1976

    Google Scholar 

  133. Wald N, Idle M, Boreham J, Baly A: Low serum vitamin A and subsequent risk of cancer. Preliminary results of a prospective study. Lancet 2: 813–815, 1980

    Google Scholar 

  134. Bjelke E: Dietary vitamin A and lung cancer. Int J Cancer 15: 561–565, 1975

    Google Scholar 

  135. Mettlin C, Graham S, Wwanson M: Vitamin A and lung cancer. J Natl Cancer Inst 62: 1435–1438, 1979

    Google Scholar 

  136. Mettlin C, Graham S: Dietary risk factors in human bladder cancer. Am J Epidemiol 110: 255–263, 1979

    Google Scholar 

  137. Peto R, Doll R, Buckley JD, Sporn MB: Can dietary beta carotene materially reduce human cancer rates? Nature 290: 201–208, 1981

    Google Scholar 

  138. Modan B, Chuckle H, Lubin F: A note on the role of dietary retinol and carotene in human gastrointestinal cancer. Int J Cancer 28: 421–424, 1981

    Google Scholar 

  139. Bright-See E: Vitamin C and E (or fruits and vegetables) and the prevention of human cancer. Presented at the 2nd Bristol Myers Symposium, Washington D.C., 1982

  140. Stich HF, Chan PKL, Rosin MP: Inhibitory effect of phenolics, teas and saliva on the formation of mutagenic nitrosation products of salted fish. Cancer 30: 719–724, 1982

    Google Scholar 

  141. Basu TK, Donaldson D, Jenner RM, Williams DC, Sakula A: Plasma vitamin A in patients with bronchial carcinoma. Brit J Cancer 33: 119–121, 1976

    Google Scholar 

  142. Atukorala S, Basu TK, Dickerson JWT, Donaldson S, Sakula A: Vitamin A, zinc and lung cancer. Brit J Cancer 40: 927–931, 1979

    Google Scholar 

  143. Chaudy NA, Jafarey NA, Ibrahim K: Plasma vitamin A and carotene levels in relation to the clinical stage of carcinoma of the oral cavity and oropharynx. J Pakistan Med Ass 30: 221–223, 1980

    Google Scholar 

  144. Tyler HA, Notley RG, Schweitzer FAW, Dickerson JWT: Vitamin A status and bladder cancer. Europ Surg Oncol 12: 35–41, 1986

    Google Scholar 

  145. Tyler HA: Studies on vitamin A and human cancer. PhD thesis, University of Surrey, 1986

  146. Kark JD, Smith AH, Switzer BR, Hames CG: Serum vitamin A (retinol) and cancer in Evans County, Georgia. J Natl Cancer Inst 66: 7–16, 1981

    Google Scholar 

  147. Stahelin MB, Buess E, Rosel F, Widmer LK: Vitamin A, cardiovascular risk factors and mortality. Lancet 1: 394–395, 1982

    Google Scholar 

  148. Hicks RM: The scientific basis for regarding vitamin A and its analogues as anti-carcinogenic agents. Proc Nutr Soc 42: 82–93, 1983

    Google Scholar 

  149. Goodwin TW: Mammals. In: The Biochemistry of the Carotenoids: Volume 2, Animals (2nd edition). Chapman Hall, London, 1984, pp 173–195

    Google Scholar 

  150. Levine N, Meyskens FL: Topical vitamin A acid therapy for cutancous metastatic melanoma. Lancet 2: 224–226, 1980

    Google Scholar 

  151. Berretti B, Grupper CL, Edelson Y, Bermejo D: Aromatic retinoids in the treatment of multiple superficial basal cell carcinoma, arsenic keratosis and kerato-acanthoma. In: Orfanes CE (ed) Retinoids. Springer Verlag, Berlin, 1981, pp 397–399

    Google Scholar 

  152. Rustin GJS, Bagshawe KD: Trial of an aromatic retinoid in patients with solid tumour. Brit J Cancer 45: 304–308, 1982

    Google Scholar 

  153. Rivlin RS: Riboflavin and cancer: a review. Cancer Res 33: 1977–1986, 1973

    Google Scholar 

  154. Basu TK, Dickerson JWT: The thiamine status of early cancer patients with particular reference to those with breast and bronchial carcinoma. Oncology 33: 250–252, 1976

    Google Scholar 

  155. Aksoy M, Basu TK, Brient J, Dickerson JWT: Thiamine status of patients treated with drug combinations containing 5-fluorouracil. Europ J Cancer 16: 1041–1045, 1980

    Google Scholar 

  156. Blakely RL: The reaction of tetrahydropteroyl-L-glutamic acid and related hydropterines with formaldehyde. Biochem J 72: 707–710, 1959

    Google Scholar 

  157. Chanarin I. The Megaloblastic Anaemias (2nd edition), Blackwell Scientific Publications, Oxford, 1979, pp 540–565

    Google Scholar 

  158. Rose DP: Folic acid deficiency in leukaemia and lymphomas. J Clin Pathol 19: 29–32, 1966

    Google Scholar 

  159. Magnus FM: Folate activity in serum and red cells of patients with cancer. Cancer Res 27: 490–493, 1967

    Google Scholar 

  160. Salch AM, Pheasant AE, Blair JA, Allan BN, Walters J: Folate metabolism in man: the effects of malignant disease. Brit J Cancer 46: 346–353, 1982

    Google Scholar 

  161. Kayden H, Hatam L, Traber M: Reduced tocopherol content of B cells from patients with chronic lymphocytic leukaemia. Blood 63: 213–215, 1985

    Google Scholar 

  162. Mbawaike I, Rizzoni W, Rose M: Effect of K3T3 sarcomas on tissue concentrations of vitamin E. Nutr and Cancer 4: 140–145, 1982

    Google Scholar 

  163. Swick R, Baumann C: Tocopherol in tumour tissues and effects of tocopherol on the development of liver tumors. Cancer Res 11: 948–953, 1951

    Google Scholar 

  164. Forbes A. The Bristol diet: a get well and stay well eating plan. Century Publishing, London, 1984

    Google Scholar 

  165. Cutler EA, Palmer J, Kontras SB: Chemotherapy and possible zine deficiency. New Engl J Med 297: 168–169, 1977

    Google Scholar 

  166. Willson R: Iron metabolism. CIBA Foundation Symp NS 51: 331–335, 1977

    Google Scholar 

  167. Beamish M, Jones P, Trevett D: Iron metabolism in Hodgkin's disease. Brit J Cancer 26: 444–452, 1972

    Google Scholar 

  168. Halstead J, Smith J, Irwin M: Zinc requirements in man. J Nutr 104: 345–378, 1974

    Google Scholar 

  169. Mason K: Copper metabolism and requirements in Man. J Nutr 109: 1979–2066, 1979

    Google Scholar 

  170. DeWys W, Pories W: Inhibition of a spectrum of animal tumours by dietary zinc deficiency. J Natl Cancer Inst 48: 375–381, 1972

    Google Scholar 

  171. Bates J, McClain C: The effect of severe zinc deficiency on serum levels of albumin, transferrin and prealbumin in man. Am J Clin Nutr 34: 1655–1660, 1981

    Google Scholar 

  172. Burk R: Selenium in nutrition. World Rev Nutr Diet 30: 88–106, 1978

    Google Scholar 

  173. Helzlsouer K: Selenium and cancer prevention. Semin Oncol 10: 305–310, 1983

    Google Scholar 

  174. Yu S, Wang L: Different effects of selenium on cyclic AMP metabolism in hepatoma cells and normal cells. Biol Trace Elements Res 5: 9–16, 1983

    Google Scholar 

  175. Craig AB, Waterhouse C: Body composition changes in patients with advanced cancer. Cancer 10: 1106–1109, 1957

    Google Scholar 

  176. Kleeman CR: Hyperosmolar syndromes secondary to impaired water exeretion. Ann Rev Med 21: 259–262, 1970

    Google Scholar 

  177. Coombes RC, Ward MK, Greenberg PB, Hillyard CJ, Tulloch BV, Morrison R, Joplin GF: Calcium metabolism in cancer. Studies using calcium isotopes and immunoassays for parathyroid hormone and calcitonin. Cancer 38: 2111–2120, 1976

    Google Scholar 

  178. Coombes RC: Metabolie manitestations of cancer. Brit J Hosp Med 27: 21–27, 1982

    Google Scholar 

  179. Tashjian AH, Melvin KEW: Medullary carcinoma of the thyroid gland. Studies of thyrocalcitonin in plasma and tumour extracts. New Engl J Med 279: 279–282, 1968

    Google Scholar 

  180. Williams LR, Cohen MH: Altered taste thresholds in lung cancer. Am J Clin Nutr 31: 122–126, 1978

    Google Scholar 

  181. Baylin SB. Heaven MA, Engelman K: Elevated histaminase activity in medullary carcinoma of the thyroid gland. New Engl J Med 283: 1239–1242, 1970

    Google Scholar 

  182. Gray TK, Bieberdorf JF, Fordtran JS: Thyrocalcitonin and the jejunal absorption of calcium, water and electrolytes in normal subjects. J Clin Invest 52: 3084–3085, 1973

    Google Scholar 

  183. Ammann RW, Vetter D, Doyhle P. Gastrointestinal involvement in systemic mastocystosis. Gut 17: 107–110, 1976

    Google Scholar 

  184. Klein DC, Raisz LG, 1970. In: Coombes RC (ed) The Metabolic Manifestations of Cancer. Brit J Hosp Med 27: 21–27, 1982

  185. O'Regan S, Carson S, Chesney RW, Drummond KN: Electrolyte and acid-base disturbances in the management of leukaemia. Blood 49: 345–353, 1979

    Google Scholar 

  186. Blackburn GL, Maini BS, Bistrian BR, McDermott WV: The effect of cancer on nitrogen, electrolyte and mineral metabolism. Cancer Res 37: 2348–2353, 1979

    Google Scholar 

  187. Theologides A: Pathogenesis of cachexia in cancer: a review and hypothesis. Cancer 29: 484–488, 1972

    Google Scholar 

  188. Kinney JM: Metabolic response to injury. In: Winters RW, Green HL (eds) Nutritional Support in the Seriously III Patient. Academic Press, New York, 1983, pp 5–12

    Google Scholar 

  189. Pittam MR, Janes E, Palmer BV: Postoperative enteral tube feeding in patients with squamous carcinoma of the head and neek. Nutr Support Serv 2: 6–10, 1982

    Google Scholar 

  190. Shils ME: The oesophagus, the vagi and fat absorption. Surg Gynecol Obstet 132: 709–713, 1971

    Google Scholar 

  191. Lawrence W: Nutritional consequences of surgical resection of the gastrointestinal tract for cancer. Cancer Res 37: 2379–2384, 1977

    Google Scholar 

  192. Lawrence W, Vanamee P, Peterson AS: Alterations in fat and nitrogen metabolism after total and subtotal gastreetomy. Surg Gynecol Obstet 110: 601–604, 1960

    Google Scholar 

  193. Shrock TR, Way LW: Total gastrectomy. Am J Surg 135: 348–355, 1978

    Google Scholar 

  194. Chen K: Massive resection of the small intestine. Surgery 65: 931–938, 1969

    Google Scholar 

  195. Weinstein LD, Shoemaker CP, Hersh T: Enhanced intestinal absorption after small bowel resection in man. Arch Surg 99: 560–566, 1969

    Google Scholar 

  196. Weser E: Intestinal adaptation to small bowel resection. Am J Clin Nutr 24: 133–135, 1971

    Google Scholar 

  197. Hofmann AF, Poley JR: Cholestyramine treatment of diarrhoeas associated with ileal resection. New Engl J Med 281: 397–399, 1969

    Google Scholar 

  198. Dobbins JW, Brooks JR: Importance of the colon in enteric hyperoxaluria. New Engl J Med 296: 298–301, 1977

    Google Scholar 

  199. Hicks RE, Brooks JR: Total pancreatectomy for ductal carcinoma. Surg Gynecol Obstet 133: 16–20, 1971

    Google Scholar 

  200. ReMine WH: The surgical management of malignant lesions of the pancreas. In: Najarian JS, Delaney JP (eds) Hepatic, Biliary and Pancreatic Surgery. Symposium Specialists, Inc, Miami, 1980, pp 381–380

    Google Scholar 

  201. Pilam MB, ReMine WH: Further evaluation of total pancreatectomy. Arch Surg 110: 506–511, 1975

    Google Scholar 

  202. Shils ME: Effects on nutrition of surgery on the liver, pancreas and genitourinary tract. Cancer Res 37: 2387–2394, 1977

    Google Scholar 

  203. Monge JJ, Judd EJ, Gage R: Radical pancreatico-duodenectomy: a 22 year experience with complications, mortality rate and survival rate. Ann Surg 160: 711–719, 1964

    Google Scholar 

  204. Warren KW, Veidenheimer MS, Pratt HS: Pancreatico-duodenectomy for periampullary cancer. Surg Clin Nth Am 47: 639–645, 1967

    Google Scholar 

  205. Aston SD, Longmire WP: Management of the pancreas after pancreatico-duodenectomy. Ann Surg 179: 322–327, 1974

    Google Scholar 

  206. Donaldson SS: Nutritional consequences of radiotherapy. Cancer Res 35: 2407–2413, 1977

    Google Scholar 

  207. Mitchell EP, Schein PS: Gastrointestinal toxicity of chemotherapeutic agents. Semin Oncol 9: 52–64, 1982

    Google Scholar 

  208. Cockel R: Antiemetics. The Practitioner 206: 56–62, 1961

    Google Scholar 

  209. Holland JF, Sharlau C, Gailani S, Krant MJ, Olson RB, Horton J, Shnider BI, Lynch JJ, Owens A, Carbone PP, Colsky J, Grob D, Miller SP, Hall TC: Vineristine treatment of advanced cancer: a co-operative study of 392 cases. Cancer Res 33: 1258–1264, 1973

    Google Scholar 

  210. Weiss H, Walker M, Wiernik P: Neurotoxicity of commonly used antincoplastic agents. New Engl J Med 291: 75–81, 1974

    Google Scholar 

  211. Rosenthal S, Kaufman S: Vincristine neurotoxicity. Ann Int Med 80: 733–737, 1975

    Google Scholar 

  212. Revusky SH, Bedarf EW: Association of illness with prior ingestion of novel foods. Science 155: 219–220, 1967

    Google Scholar 

  213. Douglass W, Leonard JC: Malabsorption following radiotherapy. Quart J Med 135: 139–329, 1972

    Google Scholar 

  214. Mennie AT, Dallev VM, Dinneen LL, Collier HOV: Treatment of radiation induced gastrointestinal distress with acetylsalicylate. Lancet 2: 942–943, 1975

    Google Scholar 

  215. Bruch H. Eating Disorders. Basic Books, New York, 1973

    Google Scholar 

  216. Padilla GV, Grant MM, Wong H, Hansen BW, Hanson RL, Bergstrom N, Kubo WR: Subjective distresses of nasogastric tube feeding. J Parent Ent Nutr 3: 53–57, 1979

    Google Scholar 

  217. Copeland EM, Souchon EA, MacFadyen BV, Rapp MA, Dudrick SJ: Intravenous hyperalimentation as an adjunct to radiation therapy. Cancer 39: 609–616, 1977

    Google Scholar 

  218. Meguid MM, Eldar S, Wahba A: The delivery of nutritional support: a potpourri of new devices and methods. Cancer (Suppl) 55: 279–229, 1985

    Google Scholar 

  219. Dudrick SJ, MacFadyen BV, Souchon EA, Englert DM, Copeland EM: Parenteral nutrition techniques in cancer patients. Cancer Res 37: 244–245, 1977

    Google Scholar 

  220. Shils ME: A program for total parenteral nutrition at home. Am J Clin Nutr 28: 1429–1432

  221. VanEys J: Effect of nutritional status on response to therapy. Cancer Res (Suppl) 42: 747–753, 1982

    Google Scholar 

  222. Holmes S: Malnutrition, well being and quality of life. In: Holmes S (ed) Proceedings Nutrition in Nursing Practice. Division of Nursing Studies. University of Surrey, Guildford, U.K., 1986, pp 30–35

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nursing Studies, Department of Biochemistry, University of Surrey, Guildford, U.K.

    Susan Holmes

  2. Division of Nutrition and Food Science, Department of Biochemistry, University of Surrey, Guildford, U.K.

    John W. T. Dickerson

Authors
  1. Susan Holmes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John W. T. Dickerson
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Address for offprints: Department of Biochemistry University of Surrey, Guildford, Surrey GU2 5XH, United Kingdom

Rights and permissions

Reprints and permissions

About this article

Cite this article

Holmes, S., Dickerson, J.W.T. Malignant disease: nutritional implications of disease and treatment. Cancer Metast Rev 6, 357–381 (1987). https://doi.org/10.1007/BF00144270

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00144270

Key words

Search

Navigation