The protein nutritional status affects hope of patients in the terminal phase of cancer

Progressive destruction of the patient's body in the terminal phase of cancer intensifies the breakdown of muscle tissue proteins, producing neurotoxic ammonia and urea. These metabolites negatively affect the brain function and are more difficult to remove from the cancer-ravaged body than from better-nourished patients. Developing cachexia impairs the functioning of all body organs, including the excretory function of the kidneys, including the removal of neurotoxic metabolites. Elevated concentrations of ammonia and urea in the brain leads to cerebral dysfunction involving a spectrum of neuropsychiatric and neurological symptoms. This may negatively affect the perception of patient's existential situation, and the experience of hope. Improving the protein nutritional status of patients in the terminal phase of cancer may decrease the muscle tissue breakdown, improve the functioning of internal organs and the efficiency of removing neurotoxic metabolites from the body. According to this, we hypothesize that the hope of patients in the terminal phase of cancer may significantly depend on their protein nutritional status. Patients less malnourished with protein experience greater hope and cope better with their existential situation than those more malnourished. We propose a clinical trial to investigate the relation between protein nutritional status and hope experience in patients in the terminal phase of cancer. The verification of this hypothesis may contribute to better and more holistic patients' care, both professional and non-professional, which may improve the quality of their life in the last days.