Introduction

HE IDEA of an annual symposium on nutrition was T launched with caution four years ago. The enthu- siastic response to this idea by the attendees and partici- pants was most encouraging and has propagated the con- tinuation of these meetings. The purpose of this, the Fourth Annual Nutrition Symposium, as with the pre- vious symposia, was to gather a group of investigators in the lush and congenial surroundings of the Huntington Sheraton in Pasadena, so conducive to an educational, enlightening, and beneficial interchange of current de- velopments in the practical field of clinical nutrition. As Course Director of the symposia, I had the privilege of developing the format for these annual meetings which covered specific topics in clinical nutrition. The aim of the symposium was the education of physicians, dieti- tians, nurses, pharmacists, and other allied health scien- tists in clinical nutrition, which is both an important and desirable goal.

The theme for this year’s symposium was “Current Concepts in Nutritional Management of the Patient With Cancer.” Dr. Donald S. McLaren of Edinburgh University and Dr. Lyn Howard of Albany Medical Col- lege, both active participants in previous meetings, pro- vided the initial ideas for the planning of this sympo- sium. I am indebted to their continued interest, friendship, and support throughout the planning of the meeting.

The theme, as the title suggests, is the nutritional man- agement of the patient with cancer. Nutrition and cancer can be viewed from two prospectives. The first is the role that nutrients play in the initiation or the induction of cancer, which gains an understanding of the significance of dietary factors in cancer prevention. I predict that, increasingly, future research lies in this area, which seems cost effective and which would place the “disease of cancer” into the appropriate domain of preventive public health. The second is the use of nutrient support as an adjunct in the biological treatment of cancer. Cur- rent emphasis of clinical research lies in this area and is the central theme of the symposium.

A symposium on “Current Concepts in Nutritional

Management of The Patient With Cancer” seemed timely because in the last few years, the science and art of clinical nutrition has developed rapidly and will un- doubtedly continue to expand, as major advances in the techniques of enteral and parenteral feeding continue to be developed. At this stage in the development of the subject, it is important to have an opportunity of sum- marizing current knowledge and exchange information, to review critically the underlying theories and assump- tions, and to examine the new opportunities opened by the questions raised. As can be seen from the articles published in this supplement, the spectrum encom- passes the definition of malnutrition, its prevalence in hospitalized cancer patient, the critical evaluation of the current status of nutritional support during various mo- dalities of treatment, and its sequelae and the variety of methods and devices available to deliver nutritional support. These presentations emphasize the interdisci- plinary character of the science and practice of clinical nutrition in relation to oncologic patients. The interdis- ciplinary nature of the fields of clinical nutrition and oncology provide a promising field, since major ad- vances in science occur frequently at the interface of two or more disciplines.

This supplement covers the highlights of the Fourth Annual Nutrition Symposium, including a number of articles by contributors who were unable to participate. I am fortunate to be joined in my editorial task by Drs. Freddie Ann Hoffman of the National Cancer Institute, and Ashe Wahba, the President and Chairman of West- ern Nutrition Education and Cancer Research Founda- tion. Working together has been enriching.

We hope this supplement and the symposium on which it is based will stimulate research and launch pro- ductive connections, and perhaps collaboration, among members who constitute the interdisciplinary team.

Michael M. Meguid, MD, PhD Ashe Wahba, RPh Freddie Ann Hoffman, MD

Since inception of this project, Dr. Meguid has accepted a position of Professor of Surgery, Director of Surgical Nutrition Service, Department of Surgery, University Hospital, Upstate Medical Center, Syracuse, New York. -Ed.

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