The Relationship between Energy Expenditure and Type or Stage of Cancer

Abstract

Malnutrition commonly occurs in patients with cancer. This situation can be associated with increased morbidity and mortality. The etiology is not clearly understood but decreased energy intake and increased energy expenditure may be involved. We aimed to investigate the energy metabolic status including energy expenditure in patients with various cancers. The clinical features and energy metabolic status measured by indirect calorimetry of 74 patients with cancer (50 men and 24 women; mean age, 64.7 years) were obtained from the medical records. Hypermetabolism was more common and REE/kg (resting energy expenditure / kg body weight) seems to be more reliable in estimating the true energy expenditure than %REE (measured REE / predicted REE). The REE/kg and VO₂ /kg (oxygen consumption per minute / kg body weight) varied among cancer types, i.e., they were significantly higher in gastric cancer than in hepatocellular carcinoma. Moreover, REE/kg and VO₂/kg was significantly higher in cancer stage IV than in stage I, or stages I and II. Patients with or at risk for malnutrition should receive appropriate nutritional support, which has to be personalized according to tumor site, tumor stage, and the nutritional status of the patient. This nutritional support should improve not only the patients' quality of life but also their survival.