[Home parenteral nutrition for terminal cancer patients--when should we tell the truth about their disease and return them to their home with HPN].

Home parenteral nutrition (HPN) is a significant way to enable terminally ill cancer patients to live with high quality of life at home. However, the most important condition to perform HPN is the patients' desire to return to their home. For this purpose, we should consider in informing them of the truth of their disease. We had three terminal cancer patients who returned to their home with HPN. Cas 1: 52-year-old woman, recurrent stomach cancer. She did not know her cancer. She stayed at home for 45 days with HPN. Case 2: 46-year-old woman, recurrent stomach cancer. She did not know her recurrence of cancer. She stayed at home for only 15 days with HPN. Case 3: 45-year-old woman, recurrent pancreatic head cancer. She knew her disease and her life expectancy. She had 6-year-old daughter and desired to return home. She stayed at home with HPN for 8 months. As we told Case 3 truth of her disease when she was diagnosed as recurrence of cancer, she lived at home with HPN for 8 months. From the experience of three cases, we may concluded that, the sooner the patients are informed the truth about their disease, the longer they can stay at home with HPN and spend their limited time with high QOL.