Can nutritional status influence the quality of life of cancer patients?

Phase angle, physical quality of life and functionality in cancer patients undergoing chemotherapy

INTRODUCTION

Nutritional deficiency, especially malnutrition, is frequent in cancer patients and is associated with changes in body composition, such as low muscle mass. Phase angle (PhA) has been used as a prognostic indicator and may be related to nutritional status, functionality, and quality of life in these patients. The objectives of this study were to assess the effect of chemotherapy treatment on PhA values, comparing the PhA variation before and after treatment, and to evaluate the PhA correlation, as a muscle mass surrogate, with the physical domain of quality of life, functionality, and nutritional risk in a sample of patients with cancer.

METHODS

A longitudinal study was conducted in patients with cancer undergoing chemotherapy for the first time. All patients aged 18 years or older, newly diagnosed, and undergoing chemotherapy for the first time were included. To analyze the difference in the PhA means according to the different classification variables, the t-test - or ANOVA - was used. The variation of the final and initial PhA was evaluated through the linear regression test.

RESULTS

A total of 175 patients were analyzed, of which 66.3% were female. The mean PhA of the initial assessment was significantly higher when compared to the final assessment of the patients PhA (p = 0.018). In both the initial and final assessments, PhA was correlated with the physical domain (r = 0.29; p < 0.001 and r = 0.19; p = 0.021) and with the functionality score (r = - 0.32; p < 0.001 and r = - 0.30; p < 0.001) and total PG-SGA (r = - 0.31; p < 0.001 and r = - 0.23; p = 0.006).

CONCLUSION

PhA can be considered a predictor of physical quality of life and functionality in cancer patients receiving chemotherapy treatment.

Malnutrition and the Survival of Cervical Cancer Patients: A Prospective Cohort Study Using the PG-SGA Tool

BACKGROUND

Cervical cancer is the second most common cancer among women in developing countries. Malnutrition is associated with poor prognosis and early detection of malnutrition and timely nutritional interventions can improve the outcome for cervical cancer patients. The study was aimed to assess the association between the nutritional status and survival of cervical cancer patients.

METHODS

A prospective cohort study design was used. Overall 175 cervical cancer patients were followed over one year period with (median 8.5 mo, range (3.6-12).

RESULTS

The prevalence of malnutrition determined by means of the PG-SGA was 17.7% at admission and 47.1% at the end of follow-up. According to the SGA, one in three (29.7%) patients required nutritional intervention at the end of follow-up. Patients who were malnourished (PG-SGA-B and C) had an increased risk of mortality (Hazard Ratio [HR]: 3.12, 95% CI: 1.23 - 7.86) as compared to those who were well nourished (PG-SGA-A). Patients from rural areas had an increased risk of mortality (HR: 6.99, 95% CI: 2.07 - 23.58) compared to patients from urban areas.

CONCLUSION

In the context of developing country setting and COVID19 outbreak, malnutrition significantly decreases cervical cancer survival. A thorough nutrition assessment using scored PG-SGA is needed.

Providing nutrition advice in the oncology setting: A survey of current practice, awareness of guidelines and training needs of Irish healthcare professionals in three hospitals

OBJECTIVE

To determine the current practices of Irish healthcare professionals working in the oncology setting of three hospitals in the north-west of Ireland with regard to nutrition screening, provision of nutrition advice and training needs.

METHODS

This cross-sectional study distributed a questionnaire to healthcare professionals in the oncology departments of three hospitals between November 2018 and April 2019. Data were analysed using SPSS, and one open-ended question underwent thematic analysis.

RESULTS

Fifty-one individuals completed the survey. 98.1% rated nutrition as very or critically important in cancer management. 74.5% nutritionally screen inpatients while only 17.6% screen outpatients. The majority (86.3%) provide nutrition advice to patients, yet only 19.6% collect data on nutrition status. Doctors and nurses report low levels of confidence and lack of awareness of guidelines. 78.4% of respondents were interested in further training in oncology nutrition, preferably through a conference study day. Respondents reported that early nutrition intervention and integration into current practice is important, there is a current lack of resources and they recognised a need for different interventions depending on cancer type and stage.

CONCLUSION

Current practice varies; however, positive attitudes towards nutrition and interest in additional training were found.

Influence of chemoradiotherapy on nutritional status, functional capacity, quality of life and toxicity of treatment for patients with cervical cancer

AIM

Assess the influence of chemoradiotherapy on the nutritional status, functional capacity and quality of life (QoL), associating these indicators at baseline with toxicity and interruption of oncologic treatment in women with cervical cancer.

METHODS

Prospective cohort study performed on 49 women diagnosed with cervical cancer, who underwent treatment between August 2015 and January 2016. For data collection, two appointments were conducted by the lead researcher: the first occurred the day before the first chemotherapy session (T0) and the other at the end of chemotherapy session (T1). Nutritional status was measured by anthropometry (weight, height, mid-upper arm circumference and triceps skinfold thickness) and computed tomography (skeletal muscle index-SMI), functional capacity by handgrip strength (HGS) and Karnofsky Performance Status (KPS), and application of QoL questionnaire (EORTC QLQ-C30).

RESULTS

The average age was 45 ± 13.8 years and 81.6% of the women were diagnosed in stages II and III. There was significant reduction in HGS, KPS and QoL between T0 and T1, in addition to a significant QoL reduction according to worsening nutritional status. The interruption of chemotherapy was significantly associated with the variables of nutritional status assessed at baseline. Women who interrupted treatment due to acute toxicity also had a significant lower median SMI than those who concluded the treatment and 83% of these patients presented cachexia.

CONCLUSIONS

Chemoradiotherapy treatment in patients with cervical cancer had changed negative nutritional parameters, function capacity and QoL, and poor nutritional status at baseline was associated with chemotherapy interruption.