Nutrition in Advanced Disease and End of Life Cancer Care

Objectives: This paper addresses nutritional challenges in advanced cancer and at the end of life and implications for oncology nursing practice.

Methods: Recent literature and position statements regarding nutritional support in advanced disease and at the end of life were reviewed and case studies were developed to illustrate the nutritional issues facing patients and family members.

Results: The literature and case examples illustrate the many issues confronting patients, families, and clinicians related to nutritional support including balancing the goals of comfort versus prolonged survival. Patients and families often face difficult decisions regarding the use of medically assisted nutrition and hydration while considering potential burdens and harms. Principles of ethics can be applied in the process of making these decisions.

Conclusions: Providing nutrition is one of the most important aspects of care provided by families for patients with advanced disease with deep meaning in these relationships, especially at the end of life. Oncology nurses provide valuable guidance in these decisions and offer support to both patients and families to ensure quality of life across the trajectory of cancer.

Implications for nursing practice: Nurses can apply skills in patient and family caregiver education, communication, and support to help navigate nutritional decisions.