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Symptoms in advanced pancreatic cancer are of importance for energy intake

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Abstract

Purpose

Cancer cachexia and low energy intake (EI) probably contribute to weight loss in advanced pancreatic cancer (PC). However, little is known about the actual EI in this disease. Aims were to assess EI, weight loss and symptoms during the disease course and investigate associations between symptoms and EI.

Methods

Thirty-nine patients (21 males) with advanced PC were consecutively included and followed every 4 weeks until the end of life. A 24-h dietary recall was used to assess EI. The Edmonton Symptom Assessment System (ESAS) and the PC-specific health-related quality of life questionnaire (QLQ-PAN26) were used for symptom assessment.

Results

Median age was 62 years (48–88), WHO performance status 1 (0–2) and survival 5 months (1–25). Seventeen (44 %) patients had unresectable cancer, 16 (41 %) metastatic and six (15 %) recurrent disease. Upon inclusion, 37 (95 %) reported weight loss (median 4.0 kg per month). During follow-up, median weight loss per month was <1.0 kg. Forty to 65 % had EI <29 kcal/kg/day (cut-off value for weight maintenance) during the observation period but they did not lose more weight than patients with EI ≥ 29 kcal. Strong negative correlations (r range) were found between EI and pain (0.51–0.61), fatigue (0.54–0.67), oral dryness (0.61–0.64) and loss of appetite (0.53–0.71).

Conclusion

In this study, several symptoms influenced EI negatively. Low EI did not completely explain weight loss in this patient group, but careful monitoring and early follow-up of symptoms may be important interventions to reduce weight loss in advanced PC.

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Acknowledgments

The authors wish to thank the clinical staff at the Department of Oncology and the Palliative Medicine Unit at Oslo University Hospital for their cooperation. We also want to thank Jurate Saltyte-Benth, Institute of Clinical Medicine, University of Oslo for all statistical assistance.

Conflict of Interest

The authors report no conflicts of interest. The authors alone have full control of all primary data and agree to allow the journal to review the data if requested.

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Authors and Affiliations

  1. Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Oslo, Norway

    Asta Bye, Marit S. Jordhøy & Marianne Jensen Hjermstad

  2. Department of Health, Nutrition and Management, Oslo and Akershus University College of Applied Sciences, Box 4, St. Olavs plass, 0130, Oslo, Norway

    Asta Bye, Grete Skjegstad & Oddlaug Ledsaak

  3. The Cancer Unit, Innlandet Hospital Trust, Gjøvik, Norway

    Marit S. Jordhøy

  4. Department of Nutrition, University of Oslo, Oslo, Norway

    Per Ole Iversen

  5. Department of Hematology, Oslo University Hospital, Oslo, Norway

    Per Ole Iversen

  6. European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Marianne Jensen Hjermstad

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  1. Asta Bye
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Correspondence to Asta Bye.

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Bye, A., Jordhøy, M.S., Skjegstad, G. et al. Symptoms in advanced pancreatic cancer are of importance for energy intake. Support Care Cancer 21, 219–227 (2013). https://doi.org/10.1007/s00520-012-1514-8

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  • DOI: https://doi.org/10.1007/s00520-012-1514-8

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