Nutrition Intervention Study for Patients Undergoing Treatment for Gastrointestinal Cancer

Abstract

LEARNING OUTCOME: To determine the potential for improving quality of life and nutritional status for patients undergoing treatment for gastrointestinal (GI) cancer through the provision of a formalized nutrition intervention program. Many cancer patients have detectable malnutrition during the course of their disease due to the cancer or any of the commonly used treatment modalities. The adverse impact of malnutrition on prognosis, productivity, and quality of life has been documented in previous studies, but the benefits of nutrition interventions have been less well documented and so remain controversial. A nutrition intervention program does not exist at an NCI designated outpatient cancer center in the Southwest; therefore, the goals of this study were two-fold: 1) to conduct a retrospective chart review to determine the prevalence and degree of malnutrition and if delays in treatment related to the degree of malnutrition in patients who had completed therapy for GI cancer, and 2) to conduct a pilot study to determine if a formalized nutrition screening and intervention program brings about a positive change in quality of life, nutritional status, and timing of therapy for patients undergoing aggressive treatment for GI cancer. The results of the chart review (n=30) revealed: 1) weight loss correlated with delays in treatment (p=.03), and 2) the presence of malnutrition at the onset of therapy predicts further weight loss during therapy (p=.04). The results of the subsequent pilot study (n=25) showed that 52% of patients had malnutrition at the onset of therapy. With nutrition screening, counseling, and monitoring (without the use of specialized nutrition support), 72% of patients maintained or improved nutritional status while on therapy. Treatment delays were weakly associated with the presence of malnutrition but were not statistically significant. Quality of life scores (using the Functional Assessment of Anorexia/Cachexia Treatment questionnaire) showed maintenance or improvement in scores for 80% of the patients. Future research is planned to conduct a prospective randomized controlled clinical trial to determine the benefits of a formalized nutrition screening and intervention program with regard to quality of life and nutritional status for cancer patients.