Survival of the starving cancer patient: a food for thought for oncologists

Patients with untreated malignant bowel obstruction usually survive less than 1 month and death is accounted by 3 components: the tumour, the obstruction and the starvation. The potential benefit of total parenteral nutrition cannot be investigated, for ethical reasons, through RCT which would include a non-fed control arm. We hypothesized that if literature would consistently confirm that untreated malignant small bowel obstruction patients survive less than 1 month, there would be no need of randomised clinical trial to study the effect of total parenteral nutrition in these patients and such approach could potentially become part of the armamentarium of the oncologist.