Enteral access for cancer patients Hitoshi Kondo, M.D., Ph.D. Chief, The Center for Digestive Diseases, Tonan Hospital Sapporo, Japan The administration techniques and devices of enteral feeding have been developed for the delivery of enteral formula. Percutaneous endoscopic gastrostomy/jejunostomy (PEGJ) has become more common procedure in patients with a functionally intact gastrointestinal tract, especially in patients with head and neck cancer. Very recently, percutaneous transesophageal gastrotubing (PTEG) has introduced for the patient who is unable to obtain transabdominal approach. These technological advances have facilitate enteral feeding, although it is still difficult to demonstrate the clinical efficacy of providing nutritional support to most cancer patients. Here, enteral feeding for cancer patient was classified into the following three groups and summarized including our experience: nutritional support in terminally ill patients with advanced cancer, nutritional support of perioperative period, and nutritional support in patients with head and neck cancer. An important question about the option of nutritional access, enteral or parenteral, will be also discussed. Parenteral nutrition is an effective method of delivering nutrients directly into blood in patients with gastrointestinal problems. But, many studies have shown that enteral feeding is more physiological, safer and less expensive, and the routine use of parenteral access is now limited. The nutritional approach for cancer patients should be determined by a careful integration of patients' condition and clinical expertise in nutritional therapy, cancer treatment, and access techniques. From "The 6th Congress of the PENSA Program & Abstract" Taipei, Taiwan, November 9-12, 2000 Page : 71