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Changes in hunger among pediatric patients with cancer and hematopoietic stem cell transplantation recipients

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Abstract

Purpose

Change in hunger is a common and bothersome symptom among pediatric patients receiving cancer treatments. Objectives were to describe how children and adolescents receiving cancer treatments experience changes in hunger, factors associated with both increases and decreases in hunger, and coping strategies used by these patients.

Methods

We enrolled children and adolescents 4–18 years of age with cancer or hematopoietic stem cell transplantation (HSCT) recipients who were actively receiving treatment or who had completed therapy. Using a single, qualitative, semi-structured interview, we asked participants about the experience of increases or decreases in hunger, including characteristics of the change and identified coping strategies.

Results

There were 50 children enrolled; 25 (50%) were 4–10 years of age and 33 (66%) were boys. Most often, patients associated an increase in hunger with corticosteroid administration, while other treatments, accompanying symptoms, inactivity, and the hospital environment were associated with a decrease in hunger. Many reported that no coping strategies were successful. For those who did report successful strategies to manage an increase in hunger, these included sleep and having food available. Strategies used to manage a decrease in hunger included anti-emetic medications, increased caloric intake, varied food choices, encouragement to eat, scheduling or tracking of meals, and physical activity.

Conclusions

Both increases and decreases in hunger were commonly described. Some coping strategies were reported to be successful. Further research should identify and test interventions to manage changes in hunger in pediatric cancer patients.

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Authors and Affiliations

  1. Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada

    Robyn Loves, Erin Plenert, Vivian Tomlinson, Sasha Palmert, Deborah Tomlinson, Emily Vettese, L. Lee Dupuis & Lillian Sung

  2. Division of Clinical Dietetics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada

    Gloria Green

  3. Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada

    Gloria Green, Tal Schechter, Sue Zupanec & Lillian Sung

  4. Department of Pharmacy, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada

    L. Lee Dupuis

  5. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada

    L. Lee Dupuis

Authors
  1. Robyn Loves
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  2. Erin Plenert
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  3. Vivian Tomlinson
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  4. Sasha Palmert
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  5. Gloria Green
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  6. Tal Schechter
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  7. Deborah Tomlinson
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  8. Emily Vettese
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  9. Sue Zupanec
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  10. L. Lee Dupuis
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  11. Lillian Sung
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Contributions

All authors contributed to the study design, interpreted the data, and critically revised the manuscript for important intellectual content. In addition, RL collected the data, analyzed the data, and drafted the manuscript; EP collected the data, analyzed the data, and drafted the manuscript; VT and SP collected the data; and LS analyzed the data and drafted the manuscript.

Corresponding author

Correspondence to Lillian Sung.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Research involving human participants

This study obtained research ethics approval from The Hospital for Sick Children’s Research Ethics Board (#100060182). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent or assent was obtained from all individual child participants and their parents who were included in the study.

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Loves, R., Plenert, E., Tomlinson, V. et al. Changes in hunger among pediatric patients with cancer and hematopoietic stem cell transplantation recipients. Support Care Cancer 28, 5795–5801 (2020). https://doi.org/10.1007/s00520-020-05425-w

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  • DOI: https://doi.org/10.1007/s00520-020-05425-w

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