Ketogenic nutrition support terminology either parenteral nutrition or enteral feedings concept is applied to patients with intractable seizure and some cases in inborn error of metabolism like carbohydrate disorder metabolism and characterized by high fat, low carbohydrate, and maintenance protein contents.
The goal of nutrition support in cancer patients is to minimize wasting but not for ideally nutrition repletion and gaining weight.
Furthermore, the goal of nutrition support in a patient with cancer (adult) maintenance support which is between 23- 25 Kcal/kg/day, not anabolic support as theoretically high calories providing may feed cancer cells as stated in some studies.
The idea behind ketogenic diets is relatively simple. If glucose is the primary fuel for cancer, then lower carbohydrate intake and replace carbohydrates with other sources of fuel, such as fats, in order to push the body’s metabolism into ketosis.
Preclinical and case report studies indicated that the restricted ketogenic diet can be an effective “metabolic therapy” for managing malignant cancer in children and adults.
Addition of Carnitine should be considered along with a high-fat or ketogenic PN solution. Carnitine is a nonessential amino acid that facilitates the transport of fatty acids from long-chain fats into the mitochondria. It is also essential in certain conditions, such as liver disease, trauma, sepsis, and organ failure, and is advised when the major source of calories are derived from fat.
Selenium is an essential trace mineral that is generally included in PN solutions when used longer than four weeks.
I hope this helps.