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Nutrition Therapy Issues in Esophageal Cancer

  • Nutrition and Obesity (S McClave, Section Editor)
  • Published:
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Abstract

Esophageal cancer has traditionally been a disease with poor long term outcomes in terms of both survival and quality of life. In combination with surgical and pharmacologic therapy, nutrition support has been demonstrated to improve patient tolerance of treatment, quality of life, and longterm outcomes. An aggressive multi-disciplinary approach is warranted with nutrition support remaining a cornerstone in management. Historically, nutrition support has focused on adequate caloric provision to prevent weight loss and allow for tolerance of treatment regimens. Alterations in metabolism occur in these patients making their use of available calories inefficient and the future of nutritional support may lie in the ability to alter this deranged metabolism. The purpose of this article is to review the current literature surrounding the etiology, treatment, and role of nutrition support in improving outcomes in esophageal cancer.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Van CE, Arends J. The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs. 2005;9 Suppl 2:S51–63.

    Google Scholar 

  2. Heslin MJ, Latkany L, Leung D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy. Ann Surg. 1997;226:567–77.

    Article  PubMed  CAS  Google Scholar 

  3. Sikora SS, Ribeiro U, Kane III JM, et al. Role of nutrition support during induction chemoradiation therapy in esophageal cancer. JPEN J Parenter Enteral Nutr. 1998;22:18–21.

    Article  PubMed  CAS  Google Scholar 

  4. Reynolds JV, Kanwar S, Welsh FK, et al. Harry M. Vars Research Award. Does the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery? JPEN J Parenter Enteral Nutr. 1997;21:196–201.

    Article  PubMed  CAS  Google Scholar 

  5. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29.

    Article  PubMed  Google Scholar 

  6. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  7. Wang KK, Sampliner RE. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. Am J Gastroenterol. 2008;103:788–97.

    Article  PubMed  Google Scholar 

  8. Pottern LM, Morris LE, Blot WJ, et al. Esophageal cancer among black men in Washington, D.C. I. Alcohol, tobacco, and other risk factors. J Natl Cancer Inst. 1981;67:777–83.

    PubMed  CAS  Google Scholar 

  9. Pandeya N, Williams G, Green AC, et al. Alcohol consumption and the risks of adenocarcinoma and squamous cell carcinoma of the esophagus. Gastroenterology. 2009;136:1215–2.

    Article  PubMed  CAS  Google Scholar 

  10. Islami F, Fedirko V, Tramacere I, et al. Alcohol drinking and esophageal squamous cell carcinoma with focus on light-drinkers and never-smokers: a systematic review and meta-analysis. Int J Cancer. 2011;129:2473–84.

    Article  PubMed  CAS  Google Scholar 

  11. Kong CY, Nattinger KJ, Hayeck TJ, et al. The impact of obesity on the rise in esophageal adenocarcinoma incidence: estimates from a disease simulation model. Cancer Epidemiol Biomarkers Prev. 2011;20:2450–6.

    Article  PubMed  Google Scholar 

  12. Nason KS, Wichienkuer PP, Awais O, et al. Gastroesophageal reflux disease symptom severity, proton pump inhibitor use, and esophageal carcinogenesis. Arch Surg. 2011;146:851–8.

    Article  PubMed  Google Scholar 

  13. Parkin DM, Laara E, Muir CS. Estimates of the worldwide frequency of sixteen major cancers in 1980. Int J Cancer. 1988;41:184–97.

    Article  PubMed  CAS  Google Scholar 

  14. Navarro Silvera SA, Mayne ST, Risch H, et al. Food group intake and risk of subtypes of esophageal and gastric cancer. Int J Cancer. 2008;123:852–60.

    Article  PubMed  Google Scholar 

  15. Gonzalez CA, Jakszyn P, Pera G, et al. Meat intake and risk of stomach and esophageal adenocarcinoma within the European Prospective Investigation Into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 2006;98:345–54.

    Article  PubMed  Google Scholar 

  16. Mulholland HG, Murray LJ, Anderson LA, et al. Vitamin D, calcium and dairy intake, and risk of oesophageal adenocarcinoma and its precursor conditions. Br J Nutr. 2011;106:732–41.

    Article  PubMed  CAS  Google Scholar 

  17. Kim JY, Kwon O. Garlic intake and cancer risk: an analysis using the Food and Drug Administration's evidence-based review system for the scientific evaluation of health claims. Am J Clin Nutr. 2009;89:257–64.

    Article  PubMed  CAS  Google Scholar 

  18. Bravi F, Edefonti V, Randi G, et al. Dietary patterns and the risk of esophageal cancer. Ann Oncol. 2012;23:765–70.

    Article  PubMed  CAS  Google Scholar 

  19. Ibiebele TI, Hughes MC, Whiteman DC et al. Dietary patterns and risk of oesophageal cancers: a population-based case–control study. Br J Nutr. 2011;1–10.

  20. Freedman ND, Park Y, Subar AF, et al. Fruit and vegetable intake and esophageal cancer in a large prospective cohort study. Int J Cancer. 2007;121:2753–60.

    Article  PubMed  CAS  Google Scholar 

  21. Lin CS, Chang SC, Wei YH, et al. Prognostic variables in thoracic esophageal squamous cell carcinoma. Ann Thorac Surg. 2009;87:1056–65.

    Article  PubMed  Google Scholar 

  22. Peyre CG, Hagen JA, DeMeester SR, et al. Predicting systemic disease in patients with esophageal cancer after esophagectomy: a multinational study on the significance of the number of involved lymph nodes. Ann Surg. 2008;248:979–85.

    Article  PubMed  Google Scholar 

  23. Mariette C, Piessen G, Briez N, et al. The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent. Ann Surg. 2008;247:365–71.

    Article  PubMed  Google Scholar 

  24. Ajani JA, Barthel JS, Bentrem DJ, et al. Esophageal and esophagogastric junction cancers. J Natl Compr Canc Netw. 2011;9:830–87.

    PubMed  Google Scholar 

  25. Dewys WD, Begg C, Lavin PT, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69:491–7.

    Article  PubMed  CAS  Google Scholar 

  26. Riccardi D, Allen K. Nutritional Management of Patients With Esophageal and Esophagogastric Junction Cancer. Cancer Control. 1999;6:64–72.

    PubMed  Google Scholar 

  27. Daly JM, Weintraub FN, Shou J, et al. Enteral nutrition during multimodality therapy in upper gastrointestinal cancer patients. Ann Surg. 1995;221:327–38.

    Article  PubMed  CAS  Google Scholar 

  28. Gupta R, Ihmaidat H. Nutritional effects of oesophageal, gastric and pancreatic carcinoma. Eur J Surg Oncol. 2003;29:634–43.

    Article  PubMed  CAS  Google Scholar 

  29. Sanders PM, Tisdale MJ. Role of lipid-mobilising factor (LMF) in protecting tumour cells from oxidative damage. Br J Cancer. 2004;90:1274–8.

    Article  PubMed  CAS  Google Scholar 

  30. Bozzetti F, Braga M, Gianotti L, et al. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial. Lancet. 2001;358:1487–92.

    Article  PubMed  CAS  Google Scholar 

  31. Murphy PM, Modi P, Rahamim J, et al. An investigation into the current peri-operative nutritional management of oesophageal carcinoma patients in major carcinoma centres in England. Ann R Coll Surg Engl. 2006;88:358–62.

    Article  PubMed  CAS  Google Scholar 

  32. Gibbs J, Cull W, Henderson W, et al. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg. 1999;134:36–42.

    Article  PubMed  CAS  Google Scholar 

  33. Ryan AM, Hearty A, Prichard RS, et al. Association of hypoalbuminemia on the first postoperative day and complications following esophagectomy. J Gastrointest Surg. 2007;11:1355–60.

    Article  PubMed  Google Scholar 

  34. Chang AC, Ji H, Birkmeyer NJ, et al. Outcomes after transhiatal and transthoracic esophagectomy for cancer. Ann Thorac Surg. 2008;85:424–9.

    Article  PubMed  Google Scholar 

  35. Song L, Liu Y, Wang Z, et al. Curative effect comparision between ivor-lewis esophagectomy and left transthoracic esophagectomy in treatment of middle thoracic esophagus carcinoma. Hepatogastroenterology. 2012;59:738–41.

    PubMed  Google Scholar 

  36. D'Journo XB, Ouattara M, Loundou A et al. Prognostic impact of weight loss in 1-year survivors after transthoracic esophagectomy for cancer. Dis Esophagus. 2011.

  37. • Mariette C, De Botton ML, Piessen G. Surgery in Esophageal and Gastric Cancer Patients: What is the Role for Nutrition Support in your Daily Practice? Ann Surg Oncol. 2012. Recent review detailing the etiology of malnutrition in patients with esophageal and gastric cancer as well as a practical approach/ algorithm for managing perioperative nutrition support.

  38. Okamoto H, Sasaki M, Johtatsu T, et al. Resting energy expenditure and nutritional status in patients undergoing transthoracic esophagectomy for esophageal cancer. J Clin Biochem Nutr. 2011;49:169–73.

    Article  PubMed  CAS  Google Scholar 

  39. • Haverkort EB, Binnekade JM, Busch OR, et al. Presence and persistence of nutrition-related symptoms during the first year following esophagectomy with gastric tube reconstruction in clinically disease-free patients. World J Surg. 2010;34:2844–52. Interesting questionnaire based study (60 patients) examining the high incidence of nutrition-related symptoms and weight loss demonstrated in patients one year after esophagectomy in both malignant and benign disease.

    Article  PubMed  CAS  Google Scholar 

  40. Braga M, Gianotti L, Gentilini O, et al. Early postoperative enteral nutrition improves gut oxygenation and reduces costs compared with total parenteral nutrition. Crit Care Med. 2001;29:242–8.

    Article  PubMed  CAS  Google Scholar 

  41. Markides GA, Alkhaffaf B, Vickers J. Nutritional access routes following oesophagectomy–a systematic review. Eur J Clin Nutr. 2011;65:565–73.

    Article  PubMed  CAS  Google Scholar 

  42. Ryan AM, Rowley SP, Healy LA, et al. Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit. Clin Nutr. 2006;25:386–93.

    Article  PubMed  Google Scholar 

  43. Gupta V. Benefits versus risks: a prospective audit. Feeding jejunostomy during esophagectomy. World J Surg. 2009;33:1432–8.

    Article  PubMed  Google Scholar 

  44. Fenton JR, Bergeron EJ, Coello M, et al. Feeding jejunostomy tubes placed during esophagectomy: are they necessary? Ann Thorac Surg. 2011;92:504–11.

    Article  PubMed  Google Scholar 

  45. Mudge L, Isenring E, Jamieson GG. Immunonutrition in patients undergoing esophageal cancer resection. Dis Esophagus. 2011;24:160–5.

    Article  PubMed  CAS  Google Scholar 

  46. Senkal M, Zumtobel V, Bauer KH, et al. Outcome and cost-effectiveness of perioperative enteral immunonutrition in patients undergoing elective upper gastrointestinal tract surgery: a prospective randomized study. Arch Surg. 1999;134:1309–16.

    Article  PubMed  CAS  Google Scholar 

  47. • Ryan AM, Reynolds JV, Healy L, et al. Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial. Ann Surg. 2009;249:355–63. Double blind randomized controlled trial (53 patients) demonstrating preservation of lean body mass in patients undergoing esophagectomy when given eicosapentaenoic acid (EPA) enriched enteral nutrition versus standard enteral formulas.

    Article  PubMed  Google Scholar 

  48. Sakurai Y, Masui T, Yoshida I, et al. Randomized clinical trial of the effects of perioperative use of immune-enhancing enteral formula on metabolic and immunological status in patients undergoing esophagectomy. World J Surg. 2007;31:2150–7.

    Article  PubMed  Google Scholar 

  49. Braga M, Gianotti L, Vignali A, et al. Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer. Surgery. 2002;132:805–14.

    Article  PubMed  Google Scholar 

  50. Maruyama T, Mimura K, Izawa S, et al. Immunonutritional diet modulates natural killer cell activation and Th17 cell distribution in patients with gastric and esophageal cancer. Nutrition. 2011;27:146–52.

    Article  PubMed  CAS  Google Scholar 

  51. Nakamura M, Iwahashi M, Takifuji K, et al. Optimal dose of preoperative enteral immunonutrition for patients with esophageal cancer. Surg Today. 2009;39:855–60.

    Article  PubMed  CAS  Google Scholar 

  52. Waitzberg DL, Saito H, Plank LD, et al. Postsurgical infections are reduced with specialized nutrition support. World J Surg. 2006;30:1592–604.

    Article  PubMed  Google Scholar 

  53. McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2009;33:277–316.

    Article  PubMed  Google Scholar 

  54. Fujita T, Daiko H, Nishimura M. Early Enteral Nutrition Reduces the Rate of Life-Threatening Complications after Thoracic Esophagectomy in Patients with Esophageal Cancer. Eur Surg Res. 2012;48:79–84.

    Article  PubMed  CAS  Google Scholar 

  55. Seike J, Tangoku A, Yuasa Y, et al. The effect of nutritional support on the immune function in the acute postoperative period after esophageal cancer surgery: total parenteral nutrition versus enteral nutrition. J Med Invest. 2011;58:75–80.

    Article  PubMed  Google Scholar 

  56. Casaer MP, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med. 2011;365:506–17.

    Article  PubMed  CAS  Google Scholar 

  57. Rubenstein EB, Peterson DE, Schubert M, et al. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer. 2004;100:2026–46.

    Article  PubMed  Google Scholar 

  58. Odelli C, Burgess D, Bateman L, et al. Nutrition support improves patient outcomes, treatment tolerance and admission characteristics in oesophageal cancer. Clin Oncol (R Coll Radiol). 2005;17:639–45.

    Article  CAS  Google Scholar 

  59. Smedley F, Bowling T, James M, et al. Randomized clinical trial of the effects of preoperative and postoperative oral nutritional supplements on clinical course and cost of care. Br J Surg. 2004;91:983–90.

    Article  PubMed  CAS  Google Scholar 

  60. • Miyata H, Yano M. Yasuda T et al. Clin Nutr: Randomized study of clinical effect of enteral nutrition support during neoadjuvant chemotherapy on chemotherapy-related toxicity in patients with esophageal cancer; 2011. Randomized trial (91 patients) comparing administration of parenteral nutrition (PN) to enteral nutrition (EN) during neoadjuvant chemotherapy demonstrating significant increases in hematologic toxicities in the PN group.

    Google Scholar 

  61. Ohnmacht GA, Allen MS, Cassivi SD, et al. Percutaneous endoscopic gastrostomy risks rendering the gastric conduit unusable for esophagectomy. Dis Esophagus. 2006;19:311–2.

    Article  PubMed  CAS  Google Scholar 

  62. Stockeld D, Fagerberg J, Granstrom L, et al. Percutaneous endoscopic gastrostomy for nutrition in patients with oesophageal cancer. Eur J Surg. 2001;167:839–44.

    Article  PubMed  CAS  Google Scholar 

  63. Panagiotakis PH, DiSario JA, Hilden K, et al. DPEJ tube placement prevents aspiration pneumonia in high-risk patients. Nutr Clin Pract. 2008;23:172–5.

    Article  PubMed  Google Scholar 

  64. Choi K, Lee SS, Oh SJ, et al. The effect of oral glutamine on 5-fluorouracil/leucovorin-induced mucositis/stomatitis assessed by intestinal permeability test. Clin Nutr. 2007;26:57–62.

    Article  PubMed  CAS  Google Scholar 

  65. Nose S, Wasa M, Tazuke Y, et al. Cisplatin upregulates glutamine transport in human intestinal epithelial cells: the protective mechanism of glutamine on intestinal mucosa after chemotherapy. JPEN J Parenter Enteral Nutr. 2010;34:530–7.

    Article  PubMed  CAS  Google Scholar 

  66. Rotovnik KN, Kompan L, Soeters P, et al. Oral glutamine supplementation during preoperative radiochemotherapy in patients with rectal cancer: a randomised double blinded, placebo controlled pilot study. Clin Nutr. 2011;30:567–70.

    Article  Google Scholar 

  67. Membrive CI, Reig CA, de DN Rodriguez, et al. Prevention of acute radiation enteritis: efficacy and tolerance of glutamine. Clin Transl Oncol. 2011;13:760–3.

    Article  Google Scholar 

  68. Hardman WE, Avula CP, Fernandes G, et al. Three percent dietary fish oil concentrate increased efficacy of doxorubicin against MDA-MB 231 breast cancer xenografts. Clin Cancer Res. 2001;7:2041–9.

    PubMed  CAS  Google Scholar 

  69. Plumb JA, Luo W, Kerr DJ. Effect of polyunsaturated fatty acids on the drug sensitivity of human tumour cell lines resistant to either cisplatin or doxorubicin. Br J Cancer. 1993;67:728–33.

    Article  PubMed  CAS  Google Scholar 

  70. Germain E, Bonnet P, Aubourg L, et al. Anthracycline-induced cardiac toxicity is not increased by dietary omega-3 fatty acids. Pharmacol Res. 2003;47:111–7.

    Article  PubMed  CAS  Google Scholar 

  71. Bougnoux P, Hajjaji N, Ferrasson MN, et al. Improving outcome of chemotherapy of metastatic breast cancer by docosahexaenoic acid: a phase II trial. Br J Cancer. 2009;101:1978–85.

    Article  PubMed  CAS  Google Scholar 

  72. • Allum WH, Blazeby JM, Griffin SM, et al. Guidelines for the management of oesophageal and gastric cancer. Gut. 2011;60:1449–72. Thorough, well referenced guidelines based review of the literature by the British Society of Gastroenterology regarding current diagnosis, staging, and treatment strategies in gastric and esophageal malignancies.

    Article  PubMed  CAS  Google Scholar 

  73. Kim JH, Song HY, Shin JH, et al. Palliative treatment of unresectable esophagogastric junction tumors: balloon dilation combined with chemotherapy and/or radiation therapy and metallic stent placement. J Vasc Interv Radiol. 2008;19:912–7.

    Article  PubMed  Google Scholar 

  74. Vakil N, Morris AI, Marcon N, et al. A prospective, randomized, controlled trial of covered expandable metal stents in the palliation of malignant esophageal obstruction at the gastroesophageal junction. Am J Gastroenterol. 2001;96:1791–6.

    Article  PubMed  CAS  Google Scholar 

  75. Brown RE, Abbas AE, Ellis S, et al. A prospective phase II evaluation of esophageal stenting for neoadjuvant therapy for esophageal cancer: optimal performance and surgical safety. J Am Coll Surg. 2011;212:582–8.

    Article  PubMed  Google Scholar 

  76. Bower M, Jones W, Vessels B, et al. Role of esophageal stents in the nutrition support of patients with esophageal malignancy. Nutr Clin Pract. 2010;25:244–9.

    Article  PubMed  Google Scholar 

  77. Dubecz A, Watson TJ, Raymond DP, et al. Esophageal stenting for malignant and benign disease: 133 cases on a thoracic surgical service. Ann Thorac Surg. 2011;92:2028–32.

    Article  PubMed  Google Scholar 

  78. Battersby NJ, Bonney GK, Subar D, et al. Outcomes following oesophageal stent insertion for palliation of malignant strictures: A large single centre series. J Surg Oncol. 2012;105:60–5.

    Article  PubMed  Google Scholar 

  79. Pellen MG, Sabri S, Razack A, et al. Safety and efficacy of self-expanding removable metal esophageal stents during neoadjuvant chemotherapy for resectable esophageal cancer. Dis Esophagus. 2012;25:48–53.

    Article  PubMed  CAS  Google Scholar 

  80. Siddiqui AA, Glynn C, Loren D, et al. Self-expanding plastic esophageal stents versus jejunostomy tubes for the maintenance of nutrition during neoadjuvant chemoradiation therapy in patients with esophageal cancer: a retrospective study. Dis Esophagus. 2009;22:216–22.

    Article  PubMed  CAS  Google Scholar 

  81. Zopf Y, Rabe C, Bruckmoser T, et al. Percutaneous endoscopic jejunostomy and jejunal extension tube through percutaneous endoscopic gastrostomy: a retrospective analysis of success, complications and outcome. Digestion. 2009;79:92–7.

    Article  PubMed  CAS  Google Scholar 

  82. Fan AC, Baron TH, Rumalla A, et al. Comparison of direct percutaneous endoscopic jejunostomy and PEG with jejunal extension. Gastrointest Endosc. 2002;56:890–4.

    Article  PubMed  Google Scholar 

  83. Allen JW, Ali A, Wo J, et al. Totally laparoscopic feeding jejunostomy. Surg Endosc. 2002;16:1802–5.

    Article  PubMed  CAS  Google Scholar 

  84. Jenkinson AD, Lim J, Agrawal N, et al. Laparoscopic feeding jejunostomy in esophagogastric cancer. Surg Endosc. 2007;21:299–302.

    Article  PubMed  CAS  Google Scholar 

  85. Wood GJ, Shega JW, Lynch B, et al. Management of intractable nausea and vomiting in patients at the end of life: "I was feeling nauseous all of the time.. nothing was working". JAMA. 2007;298:1196–207.

    Article  PubMed  CAS  Google Scholar 

  86. Bentley A, Boyd K. Use of clinical pictures in the management of nausea and vomiting: a prospective audit. Palliat Med. 2001;15:247–53.

    Article  PubMed  CAS  Google Scholar 

  87. Stephenson J, Davies A. An assessment of aetiology-based guidelines for the management of nausea and vomiting in patients with advanced cancer. Support Care Cancer. 2006;14:348–53.

    Article  PubMed  Google Scholar 

  88. Morrow GR, Hickok JT, Andrews PL, et al. Reduction in serum cortisol after platinum based chemotherapy for cancer: a role for the HPA axis in treatment-related nausea? Psychophysiology. 2002;39:491–5.

    Article  PubMed  Google Scholar 

  89. Ziegler TR, Young LS, Manson JM, et al. Metabolic effects of recombinant human growth hormone in patients receiving parenteral nutrition. Ann Surg. 1988;208:6–16.

    Article  PubMed  CAS  Google Scholar 

  90. Cicoira M, Kalra PR, Anker SD. Growth hormone resistance in chronic heart failure and its therapeutic implications. J Card Fail. 2003;9:219–26.

    Article  PubMed  CAS  Google Scholar 

  91. Basaria S, Wahlstrom JT, Dobs AS. Clinical review 138: Anabolic-androgenic steroid therapy in the treatment of chronic diseases. J Clin Endocrinol Metab. 2001;86:5108–17.

    Article  PubMed  CAS  Google Scholar 

  92. Berenstein EG, Ortiz Z. Megestrol acetate for the treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev 2005;CD004310.

  93. Morley JE, Thomas DR, Wilson MM. Cachexia: pathophysiology and clinical relevance. Am J Clin Nutr. 2006;83:735–43.

    PubMed  CAS  Google Scholar 

  94. Gonzalez-Rosales F, Walsh D. Intractable nausea and vomiting due to gastrointestinal mucosal metastases relieved by tetrahydrocannabinol (dronabinol). J Pain Symptom Manage. 1997;14:311–4.

    Article  PubMed  CAS  Google Scholar 

  95. Hall W, Christie M, Currow D. Cannabinoids and cancer: causation, remediation, and palliation. Lancet Oncol. 2005;6:35–42.

    PubMed  CAS  Google Scholar 

  96. Kamiji MM, Inui A. The role of ghrelin and ghrelin analogues in wasting disease. Curr Opin Clin Nutr Metab Care. 2008;11:443–51.

    Article  PubMed  CAS  Google Scholar 

  97. Wynne K, Giannitsopoulou K, Small CJ, et al. Subcutaneous ghrelin enhances acute food intake in malnourished patients who receive maintenance peritoneal dialysis: a randomized, placebo-controlled trial. J Am Soc Nephrol. 2005;16:2111–8.

    Article  PubMed  CAS  Google Scholar 

  98. Nagaya N, Moriya J, Yasumura Y, et al. Effects of ghrelin administration on left ventricular function, exercise capacity, and muscle wasting in patients with chronic heart failure. Circulation. 2004;110:3674–9.

    Article  PubMed  CAS  Google Scholar 

  99. Nagaya N, Itoh T, Murakami S, et al. Treatment of cachexia with ghrelin in patients with COPD. Chest. 2005;128:1187–93.

    Article  PubMed  CAS  Google Scholar 

  100. Garcia JM, Polvino WJ. Pharmacodynamic hormonal effects of anamorelin, a novel oral ghrelin mimetic and growth hormone secretagogue in healthy volunteers. Growth Horm IGF Res. 2009;19:267–73.

    Article  PubMed  CAS  Google Scholar 

  101. Hiura Y, Takiguchi S, Yamamoto K et al. Fall in plasma ghrelin concentrations after cisplatin-based chemotherapy in esophageal cancer patients. Int J Clin Oncol. 2011.

  102. • Hiura Y, Takiguchi S, Yamamoto K et al. Effects of ghrelin administration during chemotherapy with advanced esophageal cancer patients: A prospective, randomized, placebo-controlled phase 2 study. Cancer 2012. Small prospective randomized controlled trial (42 patients) examining administration of ghrelin to patients receiving cisplatin based chemotherapeutics which demonstrated significant increases in caloric intake when compared to placebo.

  103. Cox CL, Ahluwalia S. Enhancing clinical effectiveness among clinical nurse specialists. Br J Nurs. 2000;9(16):1064–5, 1068–70, 1071–3.

    Google Scholar 

  104. Morita T, Fujimoto K, Namba M, et al. Palliative care needs of cancer outpatients receiving chemotherapy: an audit of a clinical screening project. Support Care Cancer. 2008;16:101–7.

    Article  PubMed  Google Scholar 

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  1. Department of Surgery, University of Louisville, 530 South Jackson, Louisville, KY, 40202, USA

    Keith R. Miller & Matthew C. Bozeman

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Miller, K.R., Bozeman, M.C. Nutrition Therapy Issues in Esophageal Cancer. Curr Gastroenterol Rep 14, 356–366 (2012). https://doi.org/10.1007/s11894-012-0272-6

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