Effectiveness of Supplemental Parenteral Nutrition on Fatigue and Physical Function in Cancer Patients: An Observational Case Series
Rohiat Parveez
Department of Clinical Nutrition and Dietetics, HCG Cancer Hospitals, Bengaluru, India.
Syeda Farhat Afreen
Department of Clinical Nutrition and Dietetics, HCG Cancer Hospitals, Bengaluru, India.
Esther Sathiaraj *
Department of Clinical Nutrition and Dietetics, HCG Cancer Hospitals, Bengaluru, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Cancer-related fatigue is one of the most prevalent and distressing symptoms experienced by cancer patients, often persisting beyond the completion of active treatment. Nutritional deficiencies during cancer treatment may contribute to fatigue and decreased physical function. Parenteral nutrition (PN), containing amino acids, glucose, and a mix of medium- and long-chain triglycerides, may help address these deficits.
Aims: To evaluate the effectiveness of supplemental PN in managing fatigue, nutritional achievement status, and physical function in adult cancer patients undergoing treatment.
Study Design: This was an observational case series.
Methodology: This case series with 11 patients was aimed to evaluate the effectiveness of supplemental PN in managing fatigue, nutrition and physical functions among adult cancer patients. Eleven patients (mean age: 61± 16.36 years) receiving specialized parenteral nutrition as part of their nutritional management during cancer treatment were included. Fatigue levels were assessed at baseline, Day 3, and Day 7 using the Cancer Fatigue Scale. Physical function was also measured using the stand-to-sit (STS) test and hand grip strength at baseline, Day 3, and Day 7. Patient’s response to PN formulation, the adverse effects and the median time to achieve full caloric intake were also evaluated. Changes from baseline were examined using repeated-measures ANOVA (R-ANOVA) or paired t-tests.
Results: A significant improvement in fatigue scores was observed over time points (P=0.002), with statistical improvement from baseline (44.36 ± 15.68) to Day 7 (28.36 ± 14.03, P =0.007), indicating the positive impact of parenteral nutrition formulation on fatigue. While STS results showed no significant change, hand grip strength significantly improved from baseline (9.45 ± 5.61 kg) to Day 7 (12.00 ± 4.93 kg, P =0.003), suggesting enhanced physical strength. The median time to achieve full caloric intake was 3 days. 72.7% rated their response to PN as “significant improvement”, while 27.3% rated it as “moderate improvement”. No adverse effects related to PN were reported.
Conclusion: Supplementary parenteral nutrition was well tolerated, safely achieving full caloric intake within three days. Significant improvements in fatigue and hand grip strength demonstrate enhanced patient well-being and physical function, with no PN-related adverse events reported.
Keywords: Cancer, parenteral nutrition, fatigue, physical activity, exercise