Perceptions and consequences of cancer-related weight loss among patients with cancer and caregivers.

Abstract

224 Background: Cancer-related weight loss affects up to 50% of individuals with cancer, yet our understanding of psychosocial consequences of this weight loss is limited. This study examined patient and caregiver perceptions of symptoms and consequences of cancer-related weight loss. Methods: Patients with self-reported weight loss (n = 15; 26% non-mBC, 13% colorectal, 13% MM, 13% ovarian, 35% other; mean BMI = 22.9) and caregivers of people experiencing weight loss (n = 15) were recruited through the online Cancer Experience Registry. Participants completed a one-hour phone interview about views about weight loss; transcribed responses underwent content and thematic analysis by three coders (agreement = 89%). Results: Across participants, the most commonly reported weight loss-related symptoms included appetite changes (80% of participants), nausea (73%), and taste changes (60%). Most bothersome consequences of weight loss for patients included fear of disease progression (53%), loss of identity (47%), caregiver burden worries (40%), anxiety (27%), and body image concerns/embarrassment about physical appearance (27%). Most bothersome consequences for caregivers were burden of providing care (80%), distress about physical appearance of the patient (80%), changed sense of patient identity (60%), fear of illness progression (53%), and family impact (40%). Weight loss acceptance varied by BMI; obese/overweight patients reported greater acceptance, citing improvements in body image and better physical fitness as reasons for acceptance. Only 33% of patients and 22% of caregivers reported that their healthcare team addressed cancer-related weight loss during medical visits. Conclusions: With respect to cancer-related weight loss, patients and caregivers most often identified psychosocial concerns as bothersome; concerns about weight loss causing changes in physical appearance were more prevalent among caregivers. These results support development of a psychometric measure to evaluate cancer-related weight loss and suggest the need for better integration of cancer-related weight loss concerns into survivorship care plans.