Which of the following statements is true?
It is reasonable to stop nutrition support in this patient as he has a short life expectancy, and poor performance status.
Correct! There is no benefit of nutrition support in very advanced disease or patients who are actively dying. ACG guidelines state that the decision to place a gastrostomy tube in an end-of-life situation should be determined by patient autonomy and the wishes of that patient and their family, but the clinician is not obligated to provide hydration and nutrition therapy in end-of-life situations. It is reasonable to withdraw or withold nutrition support from patients with Karnofsky Performance score (KPS) <50 or Eastern Cooperative Oncology Group (ECOG) performance status of 3 or 4.
For patients with advanced cancer who are expected to pass in days- weeks, nutrition support is not indicated for the purpose of maintaining weight.
Correct! Increased ease of providing nutrition, hydration, and medications, or to facilitate transfer out of the hospital setting to a facility closer to home rather than weight maintenance should be the priority for patients who have very advanced disease.
The patient should be switched to parenteral nutrition instead, as this is associated with less complications.
Try again! If requested, nutrition therapy in end-stage malignancy should be provided by the enteral route.Use of parenteral nutrition in this setting may cause net harm (fluid overload, blood stream infections related to central lines and venous thrombosis) and should be aggressively discouraged
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