Nutritional medical therapy in cachexia patient with oesophageal adenocarcinoma metastases on dexamethasone therapy: A case report.

Shiela Stefani, Diyah Eka Andayani

JPMA. The Journal of the Pakistan Medical Association 2021 Feb

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Gastroesophageal adenocarcinomas have a high risk of brain metastases. Patients with oesophageal cancer often present with symptoms of gastrointestinal (GI) obstruction and bleeding. On the other hand, high-dose steroids are used to supress brain oedema in cases of brain tumour, resulting in a drastic rise in appetite. Parenteral nutrition appears to reduce the appetite of humans, so it can be used in palliative patients who receive hypocaloric food to combat hunger. A man, 53 years old with intracranial metastasis space-occupying lesions (SOL) from oesophageal adenocarcinoma and cachexia, received 3x10 mg dexamethasone followed by tapering. Acute upper GI bleeding occurred during hospitalisation; thus, enteral feeding was delayed, and intravenous feeding was otherwise given. After two weeks of hospitalisation, we found that there was a decrease in hunger, change in clinical condition, tolerance to food, and functional ability.

Citation

Shiela Stefani, Diyah Eka Andayani. Nutritional medical therapy in cachexia patient with oesophageal adenocarcinoma metastases on dexamethasone therapy: A case report. JPMA. The Journal of the Pakistan Medical Association. 2021 Feb;71(Suppl 2)(2):S143-S145