Effects of therapy on nutritional status of the pediatric cancer patient.

Children with cancer are at high risk for major nutrition problems both from the tumor itself and from the treatment administered. Overt malnutrition is seen in as many as 17% of children with newly diagnosed localized tumors and 37% of those with metastatic disease. Weight loss in children with cancer is directly correlated with a poor nutritional status at the time of diagnosis and with a low serum albumin. Massive surgical resections are a common source of nutritional problems and are usually not indicated as primary therapy in children with cancer. Both radiotherapy and chemotherapy are associated with recognized acute and long-term complications which may have an impact upon the nutritional status of the child. The majority of childhood cancers are best managed by a multidisciplinary approach including limited surgery, irradiation, and chemotherapy. This combined modality approach requires careful management including monitoring for known sequelae such that optimistic cure rates can be achieved without compromising the nutritional status of a child with cancer.