The prevalence of nutrition impact symptoms and their relationship to quality of life and clinical outcomes in medical oncology patients
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.
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).
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.
KeywordsNutrition Oncology Cancer Chemotherapy Symptoms Patient-generated subjective global assessment
- 6.Grosvenor M, Bulcavage L, Chlebowski R (1989) Symptoms potentially influencing weight loss in a cancer population. Cancer 63:330–334, Medline. DOI 10.1002/1097-0142(19890115)63:2<330::AID-CNCR2820630221>3.0.CO;2-U PubMedCrossRefGoogle Scholar
- 10.Isenring E, Cross G, Daniels L, Kellett E, Koczwara B (2006) Validity of the malnutrition screening tool as an effective predictor of nutritional risk in oncology outpatients receiving chemotherapy. Support Care Cancer 14:1152–1156, Medline. DOI 10.1007/s00520-006-0070-5 PubMedCrossRefGoogle Scholar
- 18.Ottery FD (2000) Patient-generated subjective global assessment. In: McCallum P, Polisena C (eds) The clinical guide to oncology nutrition. The American Dietetic Association, Chicago, pp 11–23Google Scholar
- 23.Schuit KW, Sleijfer DT, Meijler WJ, Otter R, Schakenraad J, Van den Bergh FCM, Jong BM (1998) Symptoms and functional status of patients with disseminated cancer visiting outpatient departments. Journal of Pain and Symptom Management 16:290–297, Medline. DOI 10.1016/S0885-3924(98)00091-8 PubMedCrossRefGoogle Scholar
- 24.Stein KD, Denniston M, Baker F, Dent M, Hann DM, Bushhouse S, West M (2003) Validation of a modified Rotterdam symptom checklist for use with cancer patients in the United States. Journal of Pain and Symptom Management 26(5):975–989, Medline. DOI 10.1016/S0885-3924(03)00321-X PubMedCrossRefGoogle Scholar