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van Veen MR, Mols F, Smeets L, Kampman E, Beijer S. Colorectal cancer survivors' beliefs on nutrition and cancer; correlates with nutritional information provision. Support Care Cancer 2019; 28:1255-1263. [PMID: 31227989 PMCID: PMC6989414 DOI: 10.1007/s00520-019-04934-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/07/2019] [Indexed: 12/11/2022]
Abstract
Purpose To investigate CRC survivors’ beliefs on nutrition and cancer and the association with nutritional information provision by (kind and number) of health professionals and to inquire about foods that CRC survivors believed either had a positive or negative influence on their cancer. Methods A total of 326 CRC survivors of an ongoing prospective cohort study filled out questionnaires 1 month after surgery on whether they had received nutritional information from health professionals. Also, their beliefs that nutrition influences (1) feelings of well-being, (2) complaints after treatment, (3) recovery and (4) cancer recurrence were investigated. Prevalence ratios were calculated (using Cox proportional hazard regression analysis) to study associations between information provision and the four beliefs adjusted for age, gender and cancer stage. Results Sixty-two percent of respondents received information about nutrition from one or more health professionals. Most respondents who received information strongly believe nutrition influences feelings of well-being (59%) and recovery after cancer (62%). Compared with those who did not receive information, respondents who received information from three professionals showed the strongest beliefs on the influence of nutrition on complaints after treatment (PR 3.4; 95% CI 1.6–7.4), recovery after treatment (PR 2.0; 95% CI 1.2–3.3) and recurrence (PR 2.8; 95% CI 1.3–6.2). Conclusion Nutritional information provision by health professionals positively influences the beliefs of CRC survivors on the influence of nutrition on cancer outcomes: stronger beliefs occur when respondents received information from three health professionals.
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Affiliation(s)
- Merel R van Veen
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands. .,Department of Research & Development Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
| | - Floortje Mols
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lian Smeets
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Sandra Beijer
- Department of Research & Development Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Kawabata H, Kakihara N, Nishitani Y, Asano K, Nose M, Takanashi A, Kanda E, Nishimura M, Tokunaga E, Matsurugi A, Fujimura K, Nishikawa M, Taga C, Ikawa O, Yamaguchi M, Masuda K. A Soup Service for Advanced Digestive Cancer Patients with Severe Anorexia in Palliative Care. J Palliat Med 2017; 21:380-382. [PMID: 29172993 DOI: 10.1089/jpm.2017.0369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND/AIMS The palliative care team (PCT), nutrition support team (NST), and department of nutrition in our hospital developed a special soup service for patients with terminal cancer. We evaluated the usefulness of this soup service for improving the mood in patients with advanced digestive cancer with severe anorexia. MATERIAL AND METHODS We retrospectively reviewed the clinical data of 18 patients with advanced cancer originating in digestive organs who received soup service at our institution between 2015 and 2016. Members of the PCT, NST, and a licensed cook visited the bedside of each patient and served them a cup of soup twice a week. RESULTS Fifteen patients (83%) were able to taste the soup with no adverse events, and 11 (73%) of them enjoyed the taste of the soup. In the five patients who died in our hospital during the service, the time between their last soup intake and death ranged from two to seven days (median three days). CONCLUSION Even terminally ill patients suffering from advanced digestive cancer with severe anorexia were able to enjoy the taste of the soup served to them. The establishment of special meal service, such as this soup service, may not only relieve their stress but also support the strength of living and help improve their spiritual quality of life.
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Affiliation(s)
- Hideaki Kawabata
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Naoki Kakihara
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Yoko Nishitani
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Kota Asano
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Mariko Nose
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Asami Takanashi
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Eiichiro Kanda
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Masako Nishimura
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Eiko Tokunaga
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Ayako Matsurugi
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Keiko Fujimura
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | | | - Chiaki Taga
- 1 Palliative Care Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Osamu Ikawa
- 2 Nutrition Support Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Makiko Yamaguchi
- 2 Nutrition Support Team, Kyoto Second Red Cross Hospital , Kyoto, Japan
| | - Katsuhiko Masuda
- 3 Department of Nutrition, Kyoto Second Red Cross Hospital , Kyoto, Japan
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Chasen M, Bhargava R. Gastrointestinal symptoms, electrogastrography, inflammatory markers, and PG-SGA in patients with advanced cancer. Support Care Cancer 2011; 20:1283-90. [DOI: 10.1007/s00520-011-1215-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 06/06/2011] [Indexed: 11/29/2022]
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Sasso G, Rambaldi P, Sasso FS, Cuccurullo V, Murino P, Puntieri P, Marsiglia HR, Mansi L. Scintigraphic evaluation of oesophageal transit during radiotherapy to the mediastinum. BMC Gastroenterol 2008; 8:51. [PMID: 18986522 PMCID: PMC2611991 DOI: 10.1186/1471-230x-8-51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 11/05/2008] [Indexed: 11/20/2022] Open
Abstract
Background To quantitatively evaluate radiation-induced impaired oesophageal transit with oesophageal transit scintigraphy and to assess the relationships between acute oesophagitis symptoms and dysmotility. Methods Between January 1996 and November 1998, 11 patients affected by non-small-cell carcinoma of the lung not directly involving the oesophagus, requiring adjuvant external beam radiotherapy (RT) to the mediastinum were enrolled. Oesophageal transit scans with liquid and semisolid bolus were performed at three pre-defined times: before (T0) and during radiation at 10 Gy (T1) and 30 Gy (T2). Two parameters were obtained for evaluation: 1) mean transit time (MTT); and 2) ratio between peak activity and residual activity at 40 seconds (ER-40s). Acute radiation toxicity was scored according to the joint EORTC-RTOG criteria. Mean values with standard deviation were calculated for all parameters. Analysis of variance (ANOVA) tests and paired t-Tests for all values were performed. Results An increase in the ER-40s from T0 to T1 or T2 was seen in 9 of 11 patients (82%). The mean ER-40s value for all patients increased from 0.8306 (T0) to 0.8612 (T1) and 0.8658 (T2). These differences were statistically significant (p < 0.05) in two paired t-Tests at T0 versus T2 time: overall mean ER-40s and upright ER-40s (p = 0.041 and p = 0.032, respectively). Seven patients (63%) showed a slight increase in the mean MTT value during irradiation but no statistically significant differences in MTT parameters were found between T0, T1 and T2 (p > 0.05). Conclusion Using oesophageal scintigraphy we were able to detect early alterations of oesophageal transit during the third week of thoracic RT.
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Affiliation(s)
- Giuseppe Sasso
- Radiation Oncology Department, Second University of Naples, Naples, Italy.
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The prevalence of nutrition impact symptoms and their relationship to quality of life and clinical outcomes in medical oncology patients. Support Care Cancer 2008; 17:83-90. [PMID: 18551322 DOI: 10.1007/s00520-008-0472-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Accepted: 05/22/2008] [Indexed: 10/22/2022]
Abstract
GOALS OF WORK The aims of this secondary analysis were to determine the prevalence of nutrition impact symptoms in medical oncology patients at 1, 6, and 12 months after commencement of chemotherapy and to investigate the relationship of these symptoms to quality of life (QoL) and performance status. MATERIALS AND METHODS A prospective longitudinal survey was conducted in 219 medical oncology patients who had commenced chemotherapy in the past month. The Rotterdam Symptom Assessment scale assessed the number and distress level of symptoms. The association between symptoms and global QoL and performance status as measured by the Life Satisfaction Scale was investigated. MAIN RESULTS Symptom prevalence as determined by the proportion of patients experiencing at least one nutrition impact symptom was 79% and 72% at 1 and 6 months after starting chemotherapy. Even at 12 months, symptom prevalence was 46%. The most common symptoms included dry mouth, nausea, and constipation with the most distressing symptoms reported as dry mouth, diarrhea, and stomach pain. A higher number of symptoms was associated with lower QoL (T1: r = -0.35, n = 217, P < 0.05; T2: r = -0.406, n = 194, P < 0.001; T3: r = -0.353, n = 157, P < 0.001). Patients experiencing more symptoms were more likely to have lower performance status at T2 and T3 (T2: n = 189, P = 0.019; T3: n = 143, P = 0.003). CONCLUSION Nutrition impact symptoms were commonly experienced, even 12 months following commencement of chemotherapy, and were associated with poorer QoL and performance status. This highlights the importance of early identification and management of nutrition impact symptoms with adequate follow-up in order to provide optimal care for people with cancer.
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Walsh D, Rybicki L. Symptom clustering in advanced cancer. Support Care Cancer 2006; 14:831-6. [PMID: 16482450 DOI: 10.1007/s00520-005-0899-z] [Citation(s) in RCA: 182] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2004] [Accepted: 09/29/2005] [Indexed: 11/12/2022]
Abstract
A major goal of palliative medicine is to control symptoms that interfere with quality of life. Identification of symptoms that occur together (cluster) may aid in symptom management, resulting in greater therapeutic benefit to the patient. An analysis of 25 symptoms from 922 patients with advanced cancer was undertaken to determine if symptom clusters could be identified. Cluster analysis was done using an agglomerative hierarchical method with average linkage; the absolute value of the correlation between pairs of symptoms was used as the measure of similarity. A correlation of >or=0.68 was used to define the final clusters. Seven clusters were identified: (1) fatigue: anorexia-cachexia; (2) neuropsychological; (3) upper gastrointestinal; (4) nausea and vomiting; (5) aerodigestive; (6) debility; (7) pain. Recognition of symptom clusters should help understand symptom pathophysiology and target therapies that perhaps can be used to relieve multiple symptoms in that cluster. This could result in improved quality of life for patients with advanced cancer and perhaps reduce polypharmacy, lessen drug side effects, and have pharmacoeconomic benefits.
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Affiliation(s)
- Declan Walsh
- The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, OH, USA.
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Cerchietti LCA, Navigante AH, Peluffo GD, Diament MJ, Stillitani I, Klein SA, Cabalar ME. Effects of celecoxib, medroxyprogesterone, and dietary intervention on systemic syndromes in patients with advanced lung adenocarcinoma: a pilot study. J Pain Symptom Manage 2004; 27:85-95. [PMID: 14711473 DOI: 10.1016/j.jpainsymman.2003.05.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Systemic syndromes characterized by a persistent activity of circulating mediators (cytokines) are frequently present with advanced cancer. We grouped under the general heading of "Systemic Immune-Metabolic Syndrome (SIMS)" a particular variety of distressing systemic syndrome characterized by dysregulation of the psycho-neuro-immune-endocrine homeostasis, with overlapping clinical manifestations. SIMS may include cachexia, anorexia, nausea, early satiety, fatigue, tumor fever, cognitive changes and superinfection. The aim of this study was to ameliorate some of the SIMS symptoms in a homogeneous group of lung adenocarcinoma patients using a multitargeted therapy. Fifteen patients with evidence of SIMS were studied. SIMS was defined as the presence of weight loss, anorexia, fatigue performance status>/=2 and acute-phase protein response. Patients received medroxyprogesterone (MPA) (500 mg twice daily), celecoxib (200 mg twice daily), plus oral food supplementation for 6 weeks. After treatment, 13 patients either had stable weight (+/- 1%) or had gained weight. There were significant differences in improvement of body-weight-change rate, nausea, early satiety, fatigue, appetite and performance status. Patients who had any kind of lung infection showed higher levels of IL-10 compared to non-infected patients (P=0.039). Our results suggest that patients with advanced lung adenocarcinoma, treated with MPA, celecoxib and dietary intervention, might have considerable improvement in certain SIMS outcomes. This multitargeted symptomatic approach deserves further study.
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Affiliation(s)
- Leandro C A Cerchietti
- Supportive Care Division, Angel H. Roffo Cancer Institute, University of Buenos Aires, Buenos Aires, Argentina
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LeGrand SB, Walsh D, Nelson KA, Davis MP. A syllabus for fellowship education in palliative medicine. Am J Hosp Palliat Care 2003; 20:279-89. [PMID: 12911073 DOI: 10.1177/104990910302000410] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Recent years have seen significant growth in palliative medicine training programs and positions. There are plans to pursue palliative medicine specialty status with the American Board of Medical Specialties and accreditation of fellowship programs with the American College of Graduate Medical Education. A work group of program directors, supported initially by the Cleveland Clinic and then by the American Board of Hospice and Palliative Medicine, has recently published standards for fellowship training. Despite this, fundamental questions remain about defining the field and delineating the knowledge and skills expected following completion of specialty training. In this article, we describe the first fellowship program in palliative medicine (PMP) in the United States, developed and supported by the Cleveland Clinic Foundation. The program has been implemented as part of the Harry R. Horvitz Center for Palliative Medicine, founded in 1987 as the first comprehensive integrated US program in this field. This training program, in existence since 1989, features a traditional rotational structure with an inpatient primary care service, inpatient consult services, and an outpatient consult/hospice service. This article outlines the syllabus developed for this fellowship, given what we believe to be the essential knowledge base for the field of palliative medicine.
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Affiliation(s)
- Susan B LeGrand
- Palliative Medicine Fellowship Program, The Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio, USA
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Rousseau PC. Recent Literature. J Palliat Med 2001; 4:239-241. [PMID: 11730517 DOI: 10.1089/109662101750290308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Paul C. Rousseau
- Department of Geriatrics and Extended Care, VA Medical Center, Phoenix, AZ 85012
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