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Determination of malnourishment in the head and neck cancer patient: assessment tools and nutrition education of radiation oncologists

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Abstract

Purpose

The purpose of this study is to evaluate current assessment practices of malnourishment by radiation oncologists among the head and neck cancer patient population.

Methods

A cross-sectional descriptive study was conducted. A 14-question survey was mailed to 333 radiation oncologists self-identified as “interested in the treatment of head and neck cancer.”

Results

About 87% of radiation oncologists indicated that they used bodyweight as the sole determinant of malnourishment in head and neck cancer patients at initial consultation. Radiation oncologists with 0 to 10 years experience were found to have a higher level of formal nutrition education than those with 11 to 20 years (p = 0.0052). A significant difference was found between radiation oncologists with formal nutrition education vs. those without, in answering whether nutrition interventions play a significant role in the prognosis of such cancer patients (p = 0.0013). In addition, a significant difference was noted in methods used to determine proper caloric intake when the oncologists were stratified by their beliefs about nutrition being a significant variable affecting the prognosis of head and neck cancer patients (p = 0.0024).

Conclusion

Assessment or screening for malnourishment in the head and neck cancer patient should be a routine part of the initial consultation. Radiation oncologists and their medical team, including nutritionists, should use an appropriate nutrition screening and assessment tool in addition to the body weight as an indicator of malnourishment. Nutrition education provided to radiation oncologists should be improved to better communicate the positive effects of nutrition interventions on prognosis.

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References

  1. Isenring EA, Bauer JD, Capra S (2007) Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake with standard practices. J Am Diet Assoc 107(3):412–415

    Article  Google Scholar 

  2. National Cancer Institute (2008) Nutrition implications of cancer therapies. Available via DIALOG. http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/HealthProfessional/50.cdr#Section_50 Accessed 10 Sept 2008

  3. Cohen J, Lefor AT (2001) Nutrition support and cancer. Nutrition 17:698–699

    Article  CAS  PubMed  Google Scholar 

  4. Langstein HN, Norton JA (1991) Mechanisms of cancer cachexia. Hematol Oncol Clin North Am 5(1):103–123

    CAS  PubMed  Google Scholar 

  5. Bruera E (1997) ABC of palliative care. Anorexia, cachexia, and nutrition. Br Med J 315(7117):1219–1222

    CAS  Google Scholar 

  6. Inui A (2008) A cancer journal for clinician: anorexia-cachexia syndrome. Atlanta, GA

  7. Delmore G (1997) Assessment of nutritional status in cancer patients: widely neglected? Support Care Cancer 5(5):376–380

    Article  CAS  PubMed  Google Scholar 

  8. Berger V, Le Morzadec C, Cellier P, Tuchais C, Delva R, Pabot Du, Chatelard P, Jaduad E, Lortholary A, Maillart P (2003) Predicting malnutrition in cancer patients. Proceedings of the American Society of Clinical Oncology 22: Abstract 3046

  9. Mihalynuk TV, Scott CS, Coombs JB (2003) Self-reported nutrition proficiency is positively correlated with the perceived quality of nutrition training of family physicians in Washington State. Am J Clin Nutr 77(5):1330–1336

    CAS  PubMed  Google Scholar 

  10. Mihalynuk TV, Coombs JB, Rosenfeld ME, Scott CS, Knopp RH (2008) Survey correlations: proficiency and adequacy of nutrition training of medical students. J Am Coll Nutr 27(1):59–64, was listed as not validated

    PubMed  Google Scholar 

  11. Adams KM, Lindell KC, Kohlmeier M, Zeisel SH (2006) Status of nutrition education in medical schools. Am J Clin Nutr 83(4 Suppl):941S–944S, was listed as not validated

    CAS  PubMed  Google Scholar 

  12. Zogbaum AT, Fitz P, Duffy VB (2004) Tube feeding may improve adherence to radiation treatment schedule in head and neck cancer: an outcomes study. Topics Clin Nutr 19:95–106, was listed as not validated

    Google Scholar 

  13. Basset MR, Dobie RA (1983) Patterns of nutritional deficiency in head and neck cancer. Otolaryngol Head and Neck Surgery 91:119–125

    Google Scholar 

  14. Reilly JJ (1990) Does nutrition management benefit the head and neck cancer patient? Oncology 4(6):105–115

    CAS  PubMed  Google Scholar 

  15. Todorov P, Curiuk P, McDevitt T, Coles B, Fearon K, Tisdale M (1996) Characterization of cancer cachetic factor. Nature 379:739–742

    Article  CAS  PubMed  Google Scholar 

  16. Bokhorst-de V, van der Schueron MAE, van Leeuwen PAM, Sauerwein HP, Kuik DJ, Snow GB, Quak JJ (1998) Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications. Head and Neck 19(5):419–425

    Google Scholar 

  17. Capuano G, Gentile PC, Bianciardi F, Tosti M, Palladino A, Di Palma M (2009) Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment. Support Care Cancer. doi:10.1007/s00520-009-0681-8

    PubMed  Google Scholar 

  18. Paccagnella A, Morello M, Da Mosto MC, Baruffi C, Marcon ML, Gava A, Baggio V, Lamon S, Babare R, Rosti G, Giometto M, Boscolo-Rizzo P, Kiwanuka E, Tessarin M, Caregaro L, Marchiori C (2009) Early nutritional intervention improves treatment tolerance and outcomes in head and neck cancer patients undergoing concurrent chemoradiotherapy. Support Care Cancer. doi:10.1007/s00520-009-0717-0

    PubMed  Google Scholar 

  19. Capuano G, Grosso A, Gentile PC, Battista M, Bianciardi F, Di Palma A, Pavese I, Satta F, Tosti M, Palladino A, Coiro G, Di Palma M (2007) Influence of weight loss on outcomes in patients with head and neck cancer undergoing concomitant chemoradiotherapy. Head Neck 30(4):503–508

    Article  Google Scholar 

  20. Unsal D, Mentes B, Akmansu M, Uner A, Oguz M, Pak Y (2006) Evaluation of nutritional status in cancer patients receiving radiotherapy: a prospective study. Am J Clin Oncol 29(2):183–188

    Article  PubMed  Google Scholar 

  21. Spiro A, Baldwin C, Patterson A, Thomas J, Andreyev HJ (2006) The views and practices of oncologists toward nutritional support in patients receiving chemotherapy. Br J Cancer 95(4):431–434

    Article  CAS  PubMed  Google Scholar 

  22. Mateus C, Cacheux W, Lemarié E, Michalet M, de Montreuil Beauvillain, Hébuterne X, Goldwasser F, French Nutrition Oncology Study Group (2007) Relationship between performance status and malnutrition in non-selected cancer patients: a nation-wide one day survey. J Clin Oncol 25(18S):9126, was listed as not validated

    Google Scholar 

  23. Laky B, Janda CG, Obermair A (2008) Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr 87(6):1678–1685

    CAS  PubMed  Google Scholar 

  24. Martin C (2000) Calorie, protein, fluid, and micronutrient requirements. In: McCallum PD, Polisena CG (eds) The clinical guide to oncology nutrition. The American Dietetic Association, Chicago, pp 45–52

    Google Scholar 

  25. National Nutritional Monitoring and Related Research Act of 1990. Public law 1101-45/HR 1608, section 302, 1990

  26. Oveson L, Hannibal J, Mortensen RL (1993) The interrelation of weight loss, dietary intake, and quality of life in ambulatory patients with cancer of the lung, breast, and ovary. Nutr Cancer 19(2):159–167

    Article  Google Scholar 

  27. Ottery FD (1995) Supportive nutrition to prevent cachexia and improve quality of life. Semin Oncol 22:98–111

    CAS  PubMed  Google Scholar 

  28. Andreyev HJN, Norman AR, Oates J, Cunningham D (1998) Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer 34:503–509

    Article  CAS  PubMed  Google Scholar 

  29. Ross PJ, Ashley S, Norton A, Priest K, Waters JS, Eisen T, Smith IE, O’Brien MER (2004) Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancer? Br J Cancer 90:1905–1911

    Article  CAS  PubMed  Google Scholar 

  30. Pearson TA, Stone EJ, Grundy SM, McBride PE, Van Horn L, Tobin BW, NAA Collaborative Group (2001) Translation of nutritional sciences into medical education: the Nutrition Academic Award Program. Am J Clin Nutr 74(2):164–170

    CAS  PubMed  Google Scholar 

  31. Endevelt R, Shahar DR, Henkin Y (2006) Development and implementation of a nutrition education program for medical students: a new challenge. Educ Health 19(3):321–330

    Article  Google Scholar 

  32. Creative Research Systems (2008) Sample size calculator. Available via DIALOG. http://www.surveysystem.com/sscalc.htm Accessed 14 Sept 2008

  33. Monson ER, Van Horn L (2008) Research: successful applications (3rd ed.). Atlanta, GA

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Acknowledgments

We would like to thank a number of people who have assisted and supported the performance of this study including Dr. Hani Ashamalla, Radiation Oncology Department of Methodist Hospital (Brooklyn, NY, USA), Xander Kastan, and Anthony Davino. Additional gratitude for their support and encouragement goes to Alyssa DeCicco, Concetta DeCicco, and Joann Sauchelli.

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Authors and Affiliations

  1. Elite Fitness and Sports Training, 237 Millburn Avenue, Millburn, NJ, 07041, USA

    Paul V. DeCicco

  2. Department of Health and Nutrition Sciences, Montclair State University, University Hall, Room 4018, One Normal Avenue, Montclair, NJ, 07043, USA

    Shahla M. Wunderlich

  3. Department of Radiation Oncology, New York Methodist Hospital, 506 Sixth Street, Brooklyn, NY, 11215, USA

    Joana S. Emmolo

Authors
  1. Paul V. DeCicco
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  2. Shahla M. Wunderlich
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  3. Joana S. Emmolo
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Correspondence to Paul V. DeCicco.

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DeCicco, P.V., Wunderlich, S.M. & Emmolo, J.S. Determination of malnourishment in the head and neck cancer patient: assessment tools and nutrition education of radiation oncologists. Support Care Cancer 19, 123–130 (2011). https://doi.org/10.1007/s00520-009-0796-y

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  • DOI: https://doi.org/10.1007/s00520-009-0796-y

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