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Energy Metabolism and Requirements in the Cancer Patient¹

Department of Nutrition and Food Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139

As a basis for assessing energy metabolism and requirements in cancer patients, selected aspects of whole-body energy metabolism are considered, with particular reference to basal energy metabolism and factors that affect it. The importance of protein metabolism in relation to wholebody energy metabolism is emphasized. The need to consider the intimate relationships between protein and energy nutrition and metabolism in the comprehensive evaluation of the energy needs of cancer patients also is stressed. Published data on the basal metabolic rate of patients with malignant disease are difficult to evaluate for their metabolic and nutritional significance. Quantitative estimates of the utilization of major fuel sources in cancer patients are still quite limited, but the available data suggest that there may be a change in the pattern of fuel utilization, with lipid sources predominating, an altered regulation of glucose metabolism, and a reduced efficiency of energy utilization in some, but not all, cancer patients. The best balance of the major exogenous energy sources and level of total energy intake sufficient to meet the energy demands of organs and the whole body cannot be easily predicted and, therefore, only crude guidelines can be suggested.

¹ Based on a paper presented at the Conference on Nutrition and Cancer Therapy, November 29 to December 1, 1976, Key Biscayne, Fla.