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Supportive Care in Cancer

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01-08-2019 | Original Article

Eating-related distress in advanced cancer patients with cachexia and family members: a survey in palliative and supportive care settings

Authors: Koji Amano, Tatsuya Morita, Saori Koshimoto, Teruaki Uno, Hirofumi Katayama, Ryohei Tatara

Published in: Supportive Care in Cancer | Issue 8/2019

Abstract

Purpose

Few studies have investigated nutrition impact symptoms and eating-related distress among advanced cancer patients and their families. This is a questionnaire survey to examine the severity of nutrition impact symptoms and the prevalence of eating-related distress among them in palliative and supportive care settings.

Methods

Questionnaires for patients and their families were preliminarily developed. We selected 16 common symptoms of advanced cancer, i.e., 9 symptoms of the ESAS-r and 7 of the PG-SGA. Each questionnaire concerning eating-related distress consisted of 12 items.

Results

A total of 140 out of 147 patients responded (95.2%). They were classified into two groups: (1) non-cachexia/pre-cachexia (n = 57) and (2) cachexia/refractory cachexia (n = 83). The top 3 out of 16 symptoms in all patients were feeling of well-being, lack of appetite, and tiredness. Significant differences were observed in 8 symptoms between the two groups: tiredness (p = 0.007), drowsiness (p = 0.007), lack of appetite (p < 0.001), early satiety (p = 0.001), diarrhea (p = 0.025), abnormal taste (p = 0.02), difficulty swallowing (p = 0.002), and feeling of well-being (p = 0.003). Regarding eating-related distress in patients, significant differences were observed in all items, except for 2, between the two groups. Concerning eating-related distress in families, significant differences were observed in all items between the two groups.

Conclusion

Advanced cancer patients with cachexia have more severe nutrition impact symptoms than those without cachexia, and patients with cachexia and their families have greater eating-related distress than those without cachexia.

Fearon KC, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495CrossRef

Tisdale MJ (2009) Mechanisms of cancer cachexia. Physiol Rev 89:381–410CrossRefPubMed

Radbruch L, Elsner F, Trottenberg P et al (2010) Clinical practice guidelines on cancer cachexia in advanced cancer patients with a focus on refractory cachexia: European clinical guidelines. Department of Palliative Medicine/European Palliative Care Research Collaborative, Aachen

Fearon K, Glass DJ, Guttridge DC (2012) Cancer Cachexia: mediators, signaling, and metabolic pathways. Cell Metab 8:153–166CrossRef

Amano K, Maeda I, Morita T et al (2016) Clinical implications of C-reactive protein as a prognostic marker in advanced cancer patients in palliative settings. J Pain Symptom Manag 51(5):860–867CrossRef

Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hütterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Mühlebach S, Muscaritoli M, Oldervoll L, Ravasco P, Solheim T, Strasser F, de van der Schueren M, Preiser JC (2017) ESPEN guidelines on nutrition in cancer patients. Clin Nutr 36:11–48CrossRefPubMed

Amano K, Maeda I, Morita T, Baba M, Miura T, Hama T, Mori I, Nakajima N, Nishi T, Sakurai H, Shimoyama S, Shinjo T, Shirayama H, Yamada T, Ono S, Ozawa T, Yamamoto R, Yamamoto N, Shishido H, Kinoshita H (2017) C-reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care. J Cachexia Sarcopenia Muscle 8:457–465CrossRefPubMedPubMedCentral

Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH (2018) Cancer-associated cachexia. Nat Rev Dis Primers 4. https://doi.org/10.1038/nrdp.2017.105

Oberholzer R, Hopkinson JB, Baumann K, Omlin A, Kaasa S, Fearon KC, Strasser F (2013) Psychosocial effects of cancer cachexia: a systematic literature search and qualitative analysis. J Pain Symptom Manag 46(1):77–95CrossRef

10.

Hopkinson JB (2014) Psychosocial impact of cancer cachexia. J Cachexia Sarcopenia Muscle 5:89–94CrossRefPubMedPubMedCentral

11.

Amano K, Maeda I, Morita T, Tatara R, Katayama H, Uno T, Takagi I (2016) Need for nutritional support, eating-related distress and experience of terminally ill cancer patients: a survey in an inpatient hospice. BMJ Support Palliat Care 6(3):373–376CrossRefPubMed

12.

Amano K, Maeda I, Morita T, Okajima Y, Hama T, Aoyama M, Kizawa Y, Tsuneto S, Shima Y, Miyashita M (2016) Eating-related distress and need for nutritional support of families of advanced cancer patients: a nationwide survey of bereaved family members. J Cachexia Sarcopenia Muscle 7(5):527–534CrossRefPubMedPubMedCentral

13.

Amano K, Morita T, Miyamoto J, Uno T, Katayama H, Tatara R (2018) Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings. Support Care Cancer 26(8):2793–2799CrossRefPubMed

14.

Strasser F, Binswanger J, Cemy T et al (2007) Fighting a losing battle: eating related distress of men with advanced cancer and their female partners: a mixed methods study. Palliat Med 21(2):129–137CrossRefPubMed

15.

Hopkinson JB, Okamoto I, Addington-Hall JM (2011) What to eat when off treatment and living with involuntary weight loss and cancer: a systematic search and narrative review. Support Care Cancer 19(1):1–17CrossRefPubMed

16.

Reid J (2014) Psychosocial, educational and communicative interventions for patients with cachexia and their family carers. Curr Opin Support Palliat Care 8(4):334–338CrossRefPubMedPubMedCentral

17.

Cooper C, Burden ST, Cheng H, Molassiotis A (2015) Understanding and managing cancer-related weight loss and anorexia: insights from a systematic review of qualitative research. J Cachexia Sarcopenia Muscle 6(1):99–111CrossRefPubMedPubMedCentral

18.

Hopkinson JB (2016) Food connections: a qualitative exploratory study of weight- and eating-related distress in families affected by advanced cancer. Eur J Oncol Nurs 20:87–96CrossRefPubMed

19.

Wheelwright S, Darlington AS, Hopkinson JB, Fitzsimmons D, Johnson C (2016) A systematic review and thematic synthesis of quality of life in the informal carers of cancer patients with cachexia. Palliat Med 30(2):149–160CrossRefPubMed

20.

Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991) The Edmonton symptom assessment system (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 7:6–9CrossRefPubMed

21.

Bauer J, Capra S, Ferguson M (2002) Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785CrossRef

22.

Yokomichi N, Morita T, Nitto A, Takahashi N, Miyamoto S, Nishie H, Matsuoka J, Sakurai H, Ishihara T, Mori M, Tarumi Y, Ogawa A (2015) Validation of the Japanese version of the Edmonton symptom assessment system-revised. J Pain Symptom Manag 50(5):718–723CrossRef

23.

Del Fabbro E, Hui D, Dalal S et al (2011) Clinical outcomes and contributors to weight loss in a cancer cachexia clinic. J Palliat Med 14(9):1004–1008CrossRefPubMedPubMedCentral

24.

Omlin A, Blum D, Wierecky J, Haile SR, Ottery FD, Strasser F (2013) Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case-control study. J Cachexia Sarcopenia Muscle 4(1):55–61CrossRefPubMedPubMedCentral

25.

Blum D, Stene GB, Solheim TS, Fayers P, Hjermstad MJ, Baracos VE, Fearon K, Strasser F, Kaasa S, Block Lieve V, Koen M, Sarah B, Augusto C, Joachim C, Massimo C, Anneke F, Richard H, Higginson Irene J, Stein K, Karen L, Guido M, Bregje OP, Koen P, Roeline P, Sophie P, Sheila P, Luc D, on behalf of Euro-Impact (2014) Validation of the consensus-definition for Cancer Cachexia and evaluation of a classification model--a study based on data from an international multicentre project (EPCRC-CSA). Ann Oncol 25(8):1635–1642CrossRefPubMed

26.

Kubrak C, Olson K, Jha N, Jensen L, McCargar L, Seikaly H, Harris J, Scrimger R, Parliament M, Baracos VE (2010) Nutrition impact symptoms: key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment. Head Neck 32(3):290–300PubMed

27.

Amano K, Morita T, Baba M et al (2013) Effect of nutritional support on terminally ill patients with cancer in a palliative care unit. Am J Hosp Palliat Care 30(7):728–731CrossRef

28.

Amano K, Maeda I, Ishiki H et al (2016) A feasibility study to investigate the effect of nutritional support for advanced cancer patients in an inpatient hospice in Japan. Palliat Med Hosp Care Open J 2(2):37–45CrossRef

29.

Cohen MZ, Torres-Vigil I, Burbach BE, de la Rosa A, Bruera E (2012) The meaning of parenteral hydration to family caregivers and patients with advanced cancer receiving hospice care. J Pain Symptom Manag 43(5):855–865CrossRef

30.

Morita T, Miyashita M, Shibagaki M, Hirai K, Ashiya T, Ishihara T, Matsubara T, Miyoshi I, Nakaho T, Nakashima N, Onishi H, Ozawa T, Suenaga K, Tajima T, Akechi T, Uchitomi Y (2006) Knowledge and beliefs about end-of-life care and the effects of specialized palliative care: a population-based survey in Japan. J Pain Symptom Manag 31(4):306–316CrossRef

31.

Torres-Vigil I, Cohen MZ, de la Rosa A, Cárdenas-Turanzas M, Burbach BE, Tarleton KW, Shen WM, Bruera E (2012) Food or medicine: ethnic variations in perceptions of advanced cancer patients and their caregivers regarding artificial hydration during the last weeks of life. BMJ Support Palliat Care 2(3):276–279CrossRefPubMedPubMedCentral

32.

Bükki J, Unterpaul T, Nübling G, Jox RJ, Lorenzl S (2014) Decision making at the end of life--cancer patients’ and their caregivers’ views on artificial nutrition and hydration. Support Care Cancer 22(12):3287–3299CrossRefPubMed

33.

Druml C, Ballmer PE, Druml W, Oehmichen F, Shenkin A, Singer P, Soeters P, Weimann A, Bischoff SC (2016) ESPEN guideline on ethical aspects of artificial nutrition and hydration. Clin Nutr 35:545–556CrossRefPubMed

Title: Eating-related distress in advanced cancer patients with cachexia and family members: a survey in palliative and supportive care settings
Authors: Koji Amano
Tatsuya Morita
Saori Koshimoto
Teruaki Uno
Hirofumi Katayama
Ryohei Tatara
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 8/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4590-6

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