Nutrition and cancer in children.

The information generated to date regarding the nutritional status of children with cancer indicates that malnutrition is seen in patients in the later stages of their malignant disease or is iatrogenic because of their intensive therapy. Malnourished children suffer from inadequate growth, including the potential of delayed cerebral development, and they are more susceptible to infection. Nutritional therapy has been shown to reverse the malnutrition independent of the cancer treatment. In doing so, the nutritional support aids in the delivery of and tolerance to the antitumor therapy. What is not possible, however, is making ineffective or marginally effective anticancer therapies effective by nutritional support. Therapy that is ineffective, such as chemotherapy for Stage III or IV neuroblastoma in children, cannot be altered by nutritional support. However, a patient's nutritional state may affect the disease outcome in that complication rates are much higher in malnourished patients. In such children with PCM, nutritional support may make delivery of therapy possible, but it will not affect the ultimate disease outcome unless the anticancer therapy is inherently successful. A well-nourished child is easier to treat and is physiologically more stable. Such children, therefore, have an improved prognosis and lower morbidity and mortality, provided effective therapy is available for the cancer.