Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). This study evaluates the relationship between nutritional status using scored Patient Generated-Subjective Global Assessment (PG-SGA) with the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30) which consists of five functional scales, three symptoms scales and one item of global health/quality of life (QOL).
Methods: A total of 42 CRC patients at oncology outpatient clinics from two hospitals in Malaysia participated in the study from March 2011 to March 2012. The participants were classified as either well-nourished (PG-SGA A) or malnourished (PG-SGA B and C).
Results: The majority of patients were Chinese, male, with a mean age of 57.1 ± 9.8 years and had been diagnosed with stage 2 CRC. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fatigue (p<0.001), nausea and vomiting (p<0.05), and pain (p<0.001) compared to malnourished patients. PG-SGA was strongly correlated with the main domains of the QOL: global health status (r = -0.395, p<0.05), fatigue (r = 0.816, p<0.001), nausea and vomiting (r = 0.730, p<0.001) and pain (r= 0.629, p<0.001). The better the nutritional status (lower total mean score of PG-SGA), the higher the QOL (high mean score of global health status).
Conclusion: The scored PG-SGA is suitable for use as a nutrition assessment tool to identify malnutrition and it is associated
with QOL among this population.
Key words: Chemotherapy, colorectal cancer patient, malnutrition, nutritional status, PGSGA score, quality of life
Study site: Oncology clinics, Hospital Kuala Lumpur, Hospital Selayang, Kuala Lumpur, Malaysia
Malnutrition is common among patients with cancer and it is also associated with their negative health outcomes. Generally, cancer patients undergoing chemotherapy have a high risk of malnutrition, secondary to both the disease and the treatment. It is important that patients maintain a good nutritional status to improve the effects, and minimise the side effects of cancer treatment. A good nutritional status should be maintained for patients through nutritional intervention during cancer treatment. There appears to be no published studies on the effects of intense dietary counselling versus usual dietary care on the nutritional status of colorectal cancer (CRC) patients undergoing chemotherapy alone. Furthermore, there have been no randomised controlled trials (RC1) undertaken in Malaysia, where CRC is increasing. It is therefore important to undertake a RCT of a dietary and lifestyle counselling intervention of CRC outpatients undergoing chemotherapy.
Methods: The intervention study was an open (masking not used), prospective, and Rcr to examine the effects of intensive individualised dietary and lifestyle counselling on dietary intake and nutritional status in CRC patients undergoing chemotherapy. It was designed as an 8-week program of intensive, individualised dietary and lifestyle counselling followed up with another 8-week post-intervention period without dietary and lifestyle counselling, and compared to a control arm given the usual care. A total of forty-two participants took part in this study and were randomised into two groups, namely, the intervention group (IG) (n=22) and the control group(CG) (n=20) at Kuala Lumpur Hospital and SelayangHospital, Malaysia.
Results: In this study, 67% of CRC patients were malnourished at baseline. In the IQ the prevalence of malnutrition dropped from 72.7% at baseline to 27.3% eight weeks after the intervention. This repesents a large, and clinically meaningful shift. In the CG, the prevalence of malnutrition, or at risk of malnutrition, was still at 75% at the end of the sixteen weeks.
Conclusion: Intensive, individualised dietary and lifestyle counselling resulted in improved nutritional status in patients with CRC undergoing chemotherapy.
Introduction: Plate wastage in hospital contributes to malnutrition-related complications including longer hospital- ization among cancer patients. The objective of this study was to determine the relationship between patients’ ex- periences of access to food hospital and plate wastage among hospitalized cancer patients. Methods: Two hundred and thirty-one cancer patients in the National Cancer Institute, Malaysia were recruited for this study. All eligible patients were undergoing cancer treatments and provided with informed consent. Data obtained included socio-de- mographic characteristics and patients’ experiences of access to food hospital which will contribute to plate wastage. Plate wastage was determined by weighing the unwanted food left on the plate. Results: Prevalence of plate wastage among cancer patients was high at approximately 54%. The appearance of food served was associated with higher plate wastage (p
Malnutrition is common among pediatric oncology patients. Factors contributing to malnutrition include physiological abnormalities, response to the tumors and side effects of the treatment. A pilot study was carried out to determine the nutritional status of 17 pediatric oncology patients aged 4 to 12 years old in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur. The
nutritional status was assessed via anthropometric measurements and dietary intake through 3 days repeatitive 24 hours diet recall with subjects and their carers. Biochemical profiles (serum albumin and hemoglobin) were reviewed from the medical record. Through anthropometry measurements, weight and height were used to calculate Z-scores and further determine the percentile weight-for-age, height-for-age using NCHS percentile charts (WHO 1983). Frisancho’s standards (1981) were used to define malnutrition based on MUACfor- age. Underweight as determined using z scores below -2 for weight-for-age was observed in 70.6% of the subjects. Whilst, 76.5% of the subjects were classified as stunted (z score < –2) for height-for-age. Based on MUAC-for-age percentile, the sign of severe malnutrition category (<5 percentile) was observed in 35.3% of the subject and 23.6% of the subject were in the moderate malnutrition (>5 – <10 percentile). About 70.6% of the subject had low haemoglobin (< 11 g/dl) and 29.4% of the subject were hypoalbuminemia (< 35 g/dl) . Total macronutrient intake was assessed and compared with the individual requirement (Seashore 1984) for energy and protein intake were satisfactory, except for subjects in age group 10 – 12 years who achieved only 70% of the individuals requirements. As a conclusion, although food intake of the subjects was satisfactory but chronic malnutrition was prevalent. Early recognition of malnutrition is essential in order to plan for a nutritional intervention and further enhancing the quality of life.
Key words: Nutritional status, pediatric oncology, anthropometric, dietary intake, biochemical profile.
Introduction: This is open label randomised control trial, aimed to identify whether an early (commenced at the time of diagnosis) and intensive nutrition intervention (INI) (individualised dietary counselling, oral nutritional sup- plements [ONS], telephone, and home visit) can improve weight and dietary intake of gynaecological cancer (GC) patients preoperatively. Methods: Selected GC patients planned for surgery were randomly grouped into control group (CG) (n = 35) and intervention group (IG) (n = 34). Malnutrition screening tool (MST) was used as a screening tool, while Patient-Generated Subjective Global Assessment (PG-SGA) was used as a nutrition assessment tool. IG received an intensive individualised dietary counselling with the supply of ONS at baseline (Day 1). This continued with telephone and home visit follow-up by research dietitian (Day 3 and Day 6). Meanwhile, CG only received general nutritional counselling without supply of ONS. Final assessment was conducted on Day 14. The primary outcomes included weight changes measured using TANITA and dietary intake assessment using 24-hour diet recall. Results: Mean duration of INI was 14 days. At the end of the treatment period, there was a significant weight change between groups (p < 0.001), with 0.14% weight gain in IG and 1.3% weight reduction in CG. Mean energy and protein intake of IG were higher compared to CG by +329 kcal/day and +12.2 g/day, respectively. Conclusion: This study showed that INI that incorporated individualised dietary counselling, ONS, telephone counselling, and home visit can increase energy and protein intake of GC patients, resulting in weight gain.