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Supportive Care in Cancer

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01-06-2013 | Original Article

Relationship between weakness and phase angle in advanced cancer patients with fatigue

Authors: A. Navigante, P. Cresta Morgado, O. Casbarien, N. López Delgado, R. Giglio, M. Perman

Published in: Supportive Care in Cancer | Issue 6/2013

Abstract

Objective

This study aims to determine the relationship between weakness and bioimpedance analysis (BIA)-derived phase angle in a population of untreated cancer patients with fatigue.

Methods

We prospectively evaluated 41 treatment-naive cancer patients of several origins that presented with performance status 1–2, weight loss >5 % in the last 6 months, and Fatigue Numeral Scale score >4. Weakness was considered a physical component of the multidimensional fatigue syndrome and was evaluated through several parameters utilizing hand grip strength technique by dinamometry. The same assessment was also performed on a healthy control population (n = 20). BIA-derived phase angle was also determined by BIA.

Results

Compared to healthy controls, cancer patients exhibited significant differences in all the parameters: median fatigue was 6 (range 5–9), evaluated maximal strength mean was 27 ± 10.71 vs. 42 ± 10.74 kg (p < 0.0001 for patients vs. control, respectively), and muscle strength difference (max–min muscle strength) was also statistically different (p < 0.0001). We also determined parameter associations within the patient population. We found statistical significant correlations between median phase angle score and endurance muscle with percentage of weight loss (r = 0.43, p = 0.03) for head and neck cancer patients, and in non-small cell lung cancer patients, grip work correlated significantly with normal or decreased phase angle (r = 0.85), p = 0.006 (Spearman Rank Correlation).

Conclusions

Weakness could be correlated with normal or decreased phase angle in a population with ambulatory advanced cancer with fatigue naive of treatment. We also found a significant relationship between median phase angle score and endurance muscle with percentage of weight loss in the subpopulation of patients with head and neck carcinoma.

National Comprehensive Cancer Network. Cancer-related fatigue. http://www.nccn.Org/professionals/physician-gls/PDF/fatigue_pdf. Accessed 11 Jan 2013

Berger AM, Bruera E, Cimprich B (2010) Recognition and treatment of the symptom of cancer-related fatigue. Educational Book. ISSN 1548–8748. American Society of Clinical Oncology. pp. 350–355

Luthy C, Cedraschi C, Pugliesi A, Di Silvestro K, Mugnier-Konrad B, Rapiti E, Allaz AF (2011) ‘Patients’ views about causes and preferences for the management of cancer-related fatigue—a case for non-congruence with the physicians? Support Care Cancer 19:363–370PubMedCrossRef

Marx J (2002) Ubiquitin lives up to its name. Science 297:1792–1794PubMedCrossRef

Strasser F (2008) Diagnostic criteria of cachexia and their assessment: decreased muscle strength and fatigue. Curr Opin Clin Nutr Metab Care 11:417–421PubMedCrossRef

Cerchietti L, Navigante A, Castro M (2007) Effects of eicosapentaenoic and docosahexaenoic n-3 fatty acid from fish oil and preferential Cox-2 inhibition on systemic syndromes in patients with advanced lung cancer. Nutr Cancer 54(1):14–20CrossRef

Whitehouse A, Smith H, Drake J, Tisdale M (2001) Mechanism of attenuation of skeletal muscle protein catabolism in cancer cachexia by eicosapentaenoic acid. Cancer Res 61:3604–3609PubMed

Wieland B, Stewart G, Skipworth R, Sangster K, Fearon K et al (2007) Is there a human homologue to the murine proteolysis-inducing factor? PIF is not a proper molecule. Clin Cancer Res 13:4984–4992PubMedCrossRef

Barbosie-Silva MG, Barrios A (2005) Bioelectrical impedance analysis-part1: review of principles and methods. Clin Nutr 23:1226–1243

10.

Wang A, See M, Ho Z, Lui S, Li P, Won J (2005) Evaluation of handgrip strength as nutritional marker and prognostic indicator in peritoneal dialysis patients. Am J Clin Nutr 81:79–86PubMed

11.

Kyle U, Bosacus I, De Lorenzo A, Bleurenberg P, Elia M, Gomez M et al (2004) Bioelectrical impedance analysis-part1: review of principles and methods. Clin Nutr 23:1226–1243PubMedCrossRef

12.

Okuzama T, Tanaka K, Kugarge A, Okanura H, Nushiwaki S, Hasaka T et al (2001) Fatigue in ambulatory patients with advanced lung cancer: prevalence-correlated factors and screening. J Pain Symptom Manag 22:554–561CrossRef

13.

Morrow G (2007) Cancer-related fatigue: causes, consequences, and management. Oncologist 12(1):1–3PubMedCrossRef

14.

Bower JE (2008) Behavioral symptoms in patients with breast cancer and survivors. J Clin Oncol 27:768–777CrossRef

15.

Richardson A (1995) Fatigue in cancer patients: a review of the literature. Eur J Cancer Care 4:20–32CrossRef

16.

Bautmans I, Gorus E, Njemini R, Mets T (2007) Handgrip performance in relation to self-perceived fatigue, physical functioning and circulating IL-6 elderly persons without inflammation. BMC Geriatrics 7(5):1–8

17.

Dy SM, Lorenz KA, Naeim A, Sanati H, Walling A, Asch SM (2008) Evidence-based recommendations for cancer fatigue, anorexia, depression and dyspnea. J Clin Oncol 26:3886–3895PubMedCrossRef

18.

Hauser K, Rybicki L, Walsh D (2010) What’s in a name? Word descriptors of cancer-related fatigue. Palliat Med 24(7):724–730PubMedCrossRef

19.

Martínez L, Ramírez E, Tejeda A, Lafuente E, Rosales L, Gonzalez V et al (2007) Bioelectrical impedance and strength measurements in patients with heart failure: comparison with functional class. Nutrition 23:412–418CrossRef

20.

Tugba Y, Mellar D, Walsh D, Lagman R, Le Grand S (2006) Bioelectrical impedance analysis (BIA) during hydration in advanced cancer. Support Care Cancer 14(6):594, 03–011

21.

Callahan DM, Kent-Braun JA (2011) Effect of old age on human skeletal muscle force–velocity and fatigue properties. J Appl Physiol 111:1345–1352PubMedCrossRef

22.

Miyatani M, Kanehisa H, Masuo Y, Ito M, Fukunaga T (2001) Validity of estimating limb muscle volume by bioelectrical impedance. J Appl Physiol 91:386–394PubMed

23.

Fukunaga T, Miyatani M, Tachi M, Kouzaki M, Kawakami Y, Kanehisa H (2001) Muscle volume is a major determinant of joint torque in humans. Acta Physiol Scand 172:249–255PubMedCrossRef

24.

Pepys MB, Hirschfield GM (2003) C-reactive protein: a critical update. J Clin Invest 111:1805–1812PubMed

25.

Jeejeebhoy K (1988) Rhoads lecture—1988. Bulk or bounce—the object of nutritional support. JPEN J Parenter Enter Nutr 12:539–549CrossRef

26.

Jensen GL, Hsiao YP, Wheeler D (2012) Adult nutrition assessment tutorial. JPEN J Parenter Enter Nutr 36:267–274CrossRef

27.

Baldwin C (2011) Nutritional support for malnourished patients with cancer. Curr Opin Support Palliat Care 5:29–36PubMedCrossRef

28.

Kubrak C, Olson K, Jha N, Jensen L, Mc Cagar L, Scikaly H et al (2010) Nutritional 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

29.

Scott H, Mc Millan D, Watson W, Milroy R, Mc Ardle C (2001) Longitudinal study of resting energy expenditure, body cell mass and the inflammatory response in male patients with non-small cell lung cancer. Lung Cancer 32:307–312PubMedCrossRef

30.

Jensen GL, Mirtallo J, Compher C, Dhaliwal R, Forbes A, Grijalba RF et al (2010) Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the practice setting from the International Consensus Guideline Committee. JPEN J Parenter Enter Nutr 34:156–159CrossRef

31.

Minton O, Strasser F, Rabruch L, Stone P (2012) Identification of factors associated with fatigue in advanced cancer: a subset analysis of the European Palliative Care Research Collaborative Computerized Symptom Assessment Date Set. J Pain Symptom Manag 43:226–235CrossRef

32.

Kisiel-Sajewicz K, Mellar PD, Siemionow V, Sediyova-Khoshknabi D, Wyant A, Walsh D et al (2012) Lack of muscle contractile property changes at the time of perceived physical exhaustion suggests central mechanisms contributing to early motor task failure in patients with cancer-related fatigue. J Pain Symptom Manag 44:351–361CrossRef

33.

Yavuzsen T, Mellar PD, Ranganathan VK, Walsh D, Siemionow V, Kirkova J et al (2009) Cancer-related fatigue: central or peripheral? J Pain Symptom Manag 38(4):587–596CrossRef

34.

Khoshknabi DS, Mellar PD, Ranganathan VK, Siemionow V, Walsh D, Kirkova J, Yue GH (2008) Combining objective and subjective outcomes in cancer-related fatigue: illustrations from a single case report. J Palliat Med 11(6):829–833PubMedCrossRef

35.

Mellar PD, Walsh D (2010) Mechanisms of fatigue. J Support Oncol 8(4):587–596

Title: Relationship between weakness and phase angle in advanced cancer patients with fatigue
Authors: A. Navigante
P. Cresta Morgado
O. Casbarien
N. López Delgado
R. Giglio
M. Perman
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 6/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-012-1714-2

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Abstract

Objective

Methods

Results

Conclusions

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