The Impacts of Nutrition Education Programs on Cancer Survivors' Nutritional Status

Abstract

Background and context: Since 1982, cancer has been the leading cause of death in Taiwan, claiming more than 40,000 lives each year. This not only caused huge medical expenses, but also affected the quality of life of patients and their families. However, many cancer survivors and their caregivers do not fully understand lifestyle advice, including nutrition and dietary behaviors, to lower the progression of the disease. Due to cancer and painstaking treatment, cancer patients often suffer from inadequate calories intake and serious body weight (BW) loss, which is highly related to malnutrition or cancer cachexia. After they leave the hospital, they still need nutritional guidance; therefore, the importance of providing nutrition services in the community should be emphasized. Aim: To help cancer survivors achieve better nutritional status by teaching them how to have adequate calories intakes and maintain BW that they're supposed to have better quality of life. Strategy/Tactics: (1) Cancer survivors with nutritional needs were referred from 66 cooperative cancer resources centers of hospitals nationwide. (2) Dietitians assess their nutritional conditions and provide nutritional guidance. (3) Deliver free nutritional supplements to the cancer survivors who are financially disadvantaged or have dysphagia problems. Program/Policy process: The registered dietitians conducted nutritional education through nutrition counseling and guidance. For those who are financially disadvantaged or have dysphagia problems, the 24-hour dietary recall and PG-SGA scale were used to assess the survivors' nutritional status, including BW and calories intake, then free nutritional supplements according to their needs and a regular follow-up to collect their BW and nutritional information changes after our interventions were done. Outcomes: From 2016 to 2017, a total of 434 of cancer survivors who have financial difficulties or dysphagia problems accepted the free nutritional supplements and nutritional guidance services. 178 survivors completed follow-up and collected nutritional information. 40.4% of them are head and neck cancers, 38.2% are digestive system-related cancers that were in poor eating conditions. After our interventions, 70.2% of these survivors can maintain or increase their BW with average BW 57.9 ± 12.8 kg; and 77.0% can maintain or increase the calories intake, which average increased from 1798 ± 252.5 kcal/day to 1541.6 ± 347.9 kcal/day. What was learned: We can effectively help cancer survivors achieve adequate calories intakes and maintain BW to prevent the occurrence of malnutrition by providing the services of nutritional supplements and nutritional guidance.