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Chen Y, Fang Y, Liu M, Yao R, Wan J. Taste alterations in patients following hematopoietic stem cell transplantation: A qualitative study. Asia Pac J Oncol Nurs 2023; 10:100311. [PMID: 38033392 PMCID: PMC10685015 DOI: 10.1016/j.apjon.2023.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/24/2023] [Indexed: 12/02/2023] Open
Abstract
Objective This study aims to explore the experiences and consequences of taste alterations in patients undergoing HSCT, how they respond to these changes, and the factors that influence their responses. Methods In this descriptive qualitative study, face-to-face semi-structured individual interviews were conducted with 31 patients undergoing HSCT in a comprehensive hospital in Hubei, China. The interview data were transcribed and analyzed using Colaizzi's seven-step analysis. The Symptom Management Theory was applied to design the study and identify key themes. Results Three key themes were identified from the theory: (1) the complexity and diversity of taste experiences; (2) coping strategies; and (3) the multifaceted challenges of coping. Taste alterations in HSCT patients were characterized by diversity and dynamism. Patients employed three distinct coping styles in response to taste alterations: active coping, reluctant submission, and passive coping. These coping styles were influenced by various factors, including the specific treatment modalities of HSCT, individual patient characteristics, and the healthcare environment. Conclusions The experience of taste alterations among HSCT patients is intricate and varied, and the importance of addressing this symptom can easily be underestimated. Management of taste alterations is influenced by multiple factors. Nursing staff should give careful attention to taste alterations in HSCT survivors, enhance their expertise in managing taste alterations, provide robust health education, conduct regular screening and assessments, and formulate individualized intervention plans to assist patients in actively and effectively managing taste alterations.
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Affiliation(s)
- Yuanyuan Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Fang
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minjie Liu
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruishan Yao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Wan
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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López-Plaza B, Gil Á, Menéndez-Rey A, Bensadon-Naeder L, Hummel T, Feliú-Batlle J, Palma-Milla S. Effect of Regular Consumption of a Miraculin-Based Food Supplement on Taste Perception and Nutritional Status in Malnourished Cancer Patients: A Triple-Blind, Randomized, Placebo-Controlled Clinical Trial-CLINMIR Pilot Protocol. Nutrients 2023; 15:4639. [PMID: 37960292 PMCID: PMC10648678 DOI: 10.3390/nu15214639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Taste disorders are common among cancer patients undergoing chemotherapy, with a prevalence ranging from 20% to 86%, persisting throughout treatment. This condition leads to reduced food consumption, increasing the risk of malnutrition. Malnutrition is associated not only with worse treatment efficacy and poor disease prognosis but also with reduced functional status and quality of life. The fruit of Synsepalum dulcificum (Daniell), commonly known as miracle berry or miracle fruit, contains miraculin, a taste-modifying protein with profound effects on taste perception. The CLINMIR Protocol is a triple-blind, randomized, placebo-controlled clinical trial designed to evaluate the regular consumption of a food supplement containing a miraculin-based novel food, dried miracle berry (DMB), on the taste perception (measured through electrogustometry) and nutritional status (evaluated through the GLIM Criteria) of malnourished cancer patients under active antineoplastic treatment. To this end, a pilot study was designed with 30 randomized patients divided into three study arms (150 mg DMB + 150 mg freeze-dried strawberries, 300 mg DMB, or placebo) for three months. Throughout the five main visits, an exhaustive assessment of different parameters susceptible to improvement through regular consumption of the miraculin-based food supplement will be conducted, including electrical and chemical taste perception, smell perception, nutritional and morphofunctional assessment, diet, quality of life, the fatty acid profile of erythrocytes, levels of inflammatory and cancer-associated cytokines, oxidative stress, antioxidant defense system, plasma metabolomics, and saliva and stool microbiota. The primary anticipated result is that malnourished cancer patients with taste distortion who consume the miraculin-based food supplement will report an improvement in food taste perception. This improvement translates into increased food intake, thereby ameliorating their nutritional status and mitigating associated risks. Additionally, the study aims to pinpoint the optimal dosage that provides maximal benefits. The protocol adheres to the SPIRIT 2013 Statement, which provides evidence-based recommendations and is widely endorsed as an international standard for trial protocols. The clinical trial protocol has been registered at the platform for Clinical Trials (NCT05486260).
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Affiliation(s)
- Bricia López-Plaza
- Nutrition Research Group, La Paz University Hospital Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
- Medicine Department, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | | | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany;
| | - Jaime Feliú-Batlle
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain;
- CIBERONC (CIBER Cancer), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain;
| | - Samara Palma-Milla
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain;
- Nutrition Department, Hospital University La Paz, 28046 Madrid, Spain
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Galaniha LT, Nolden AA. Taste loss in cancer patients: clinicians' perceptions of educational materials and diagnostic tools. Support Care Cancer 2023; 31:349. [PMID: 37222954 DOI: 10.1007/s00520-023-07794-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 05/02/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE Cancer therapy is essential and lifesaving; however, it can have short- and long-term consequences on patients' health. Up to 87% of cancer patients report changes in taste function, yet patients report a lack of support from clinicians regarding their experience with taste loss during and following treatment. Thus, the objective of this study was to assess clinicians' knowledge and experience with managing patients with taste loss and identify potential gaps in the availability of educational materials and diagnostic tools. METHOD In an online survey, sixty-seven participants who identify as clinicians and practice in the United States and work with cancer patients that complain of taste problems answered questions on their knowledge and experience supporting cancer patients experiencing changes in taste function and provided their opinion on access to educational materials. RESULTS The current study reports gaps in participants' knowledge of taste and taste disorder terminology, with 15.4% correctly defining both taste and flavor and roughly half were familiar with specific taste disorder classifications. Over half of the participants reported not having access to adequate information to help their patients manage taste alterations. Only two-thirds of participants reported routinely asking patients if they are experiencing changes in taste function. CONCLUSION Clinicians' responses emphasized the need to improve access to educational materials regarding taste changes and increase the availability of information regarding management strategies. Addressing these inequities in education and improving the standard of care is the first step in improving the care for cancer patients suffering from altered taste function.
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Affiliation(s)
| | - Alissa A Nolden
- Department of Food Science, University of Massachusetts, Amherst, MA, 01003, USA.
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Drivers of Dietary Choice After a Diagnosis of Colorectal Cancer: A Qualitative Study. J Acad Nutr Diet 2023; 123:407-416. [PMID: 36002111 DOI: 10.1016/j.jand.2022.08.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dietary changes often accompany management of a cancer diagnosis, but how and why patients with colorectal cancer (CRC) make dietary decisions requires further investigation. OBJECTIVE To learn about patients' food-related beliefs and understand whether and why dietary changes were made by patients starting chemotherapy after a CRC diagnosis. DESIGN A qualitative semi-structured interview study was conducted as a secondary analysis among a subset of patients with stages II-IV CRC enrolled at baseline in a randomized controlled trial. PARTICIPANTS/SETTING Twenty-nine patients participated in the interview. Data were collected at the University of Alberta (Edmonton, Alberta, Canada) from 2016-2019 before any trial intervention. QUALITATIVE DATA ANALYSIS Audio-recorded interviews were transcribed verbatim then coded inductively by two research team members. Qualitative content analysis was applied to capture emergent themes. RESULTS Patients reported varied degrees of dietary change that stemmed from internal and external influences. Four main themes emerged to describe patients' dietary decisions after a CRC diagnosis: 1) Medical Influences: eating to live; 2) Health Beliefs: connecting lived experiences with new realities; 3) Static Diets: no changes postdiagnosis; and 4) Navigating External Influences: confluence of personal agency and social constraints. CONCLUSION The extent to which patients altered their dietary choices depended on perspectives and beliefs. These included the degree to which dietary decisions provided some agency (ie, feeling of control) for dealing with physical ramifications of cancer treatment, individuals' personal understandings of healthy foods, and the role of diet in managing their new physical reality postdiagnosis. This information provides registered dietitian nutritionists and health care providers with insight into dietary intentions of select patients being treated for CRC. These findings can guide future research focused on effective strategies for streamlined nutritional support that aligns with patient needs.
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Holdoway A. Nutrition in palliative care: issues, perceptions and opportunities to improve care for patients. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S20-S27. [PMID: 36416622 DOI: 10.12968/bjon.2022.31.21.s20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Dietary advice, the provision of timely nutritional support and the alleviation of diet-related issues, should be an essential component of a holistic approach to palliative and end-of-life care, adjusted to account for the stage in the patient's journey, including prognosis. With an ageing population and increasing numbers of people living with not just one life-limiting disease but several, the dietary management of these patients is becoming more complex. This article considers the issues patients and families experience, how nurses can play a key role in identifying and alleviating nutrition- and diet-related issues in palliative care, including the use of tools to screen, assess and guide nutrition conversations and interventions. The content of the article is mostly drawn from the literature relating to palliative cancer care, knowledge derived from stakeholder engagement, clinical observations in a dietetic role in a hospice setting and qualitative research on the role of diet in palliative care as perceived by patients, carers, and health professionals.
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Affiliation(s)
- Anne Holdoway
- Consultant Dietitian, The Bath Clinic, Bath; Chair, Managing Adult Malnutrition in the Community Panel; Education Officer, British Association for Parenteral and Enteral Nutrition
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6
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Enriquez-Fernandez BE, Chen L, Klassen P, Ghosh S, Mazurak V, Wismer WV. Fortified Snack Preferences among Patients with Cancer. Nutr Cancer 2021; 74:1712-1723. [PMID: 34346233 DOI: 10.1080/01635581.2021.1957948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Fortified snacks can increase nutrient intake among patients with cancer. The aim of this study was to identify snack foods preferred as potential vehicles for fortification and how experienced symptoms influence preferences. A study-specific survey among 150 patients identified snack foods for fortification, influence of symptom presence, desired nutrients and characteristics of a fortified snack, and perception of oral nutritional supplements. Patients had mainly breast, gastrointestinal, lung, and colorectal tumors. Soup, yogurt, cheese, fruit juice, egg products, and protein bars were identified as suitable fortified snacks by >60% of subjects. Desired characteristics for snacks included nutritious, flavorful, convenient, ready to eat, easy to chew, and easy to swallow. Vitamins, minerals, and protein were the nutrients of interest. Three clusters of symptoms were identified that predicted patients' desired characteristics of fortified snacks and satisfaction with food-related life. Patients in High and Moderate symptom clusters were more likely to have reduced food intake and higher consumption of oral nutritional supplements. Preferences for fortified snacks and their characteristics are influenced by symptom presence. The results of this study provide insight to guide the development of fortified snacks for patients with cancer.
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Affiliation(s)
| | - Lingyun Chen
- Department of Agricultural Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Pamela Klassen
- Department of Agricultural Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Sunita Ghosh
- Division of Medical Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Vera Mazurak
- Department of Agricultural Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Wendy Victoria Wismer
- Department of Agricultural Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
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Ellender G, Coveney J. Flavor alterations in cancer treatment: Extrinsic factors as a means of augmentation. Clin Nutr ESPEN 2021; 43:76-89. [PMID: 34024568 DOI: 10.1016/j.clnesp.2021.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/01/2021] [Accepted: 02/24/2021] [Indexed: 01/13/2023]
Abstract
Flavor, comprising taste, smell and somatosensory inputs, is commonly altered in patients undergoing chemotherapy resulting in malnutrition leading to cachexia. A narrative review considered taste and smell alterations associated with malignancies treated using chemotherapy and the various interventions proffered to lessen alterations. Many of the currently used interventions directed towards enhancing intrinsic factors of food appeared ineffective in encouraging intake of adequate nutrition to ward off complications of malnutrition. Counselling is used in some cases with positive results. The use of extrinsic influences commensurate with the principles of food behavior and gastronomy are considered as a means of providing purpose to patients to accommodate flavor loss which when integrated with counseling and appropriate intrinsic factors are potentially a means of curtailing malnutrition and enhancing the psychological status of the patient. The close association between the cephalic phase responses (CPRs) and the control of eating and digestive behaviors is multifaceted, and when the influences of taste and smell are diminished, other contributing factors guiding CPRs may compensate a deficit. The need for the application of a consistent lexicon is essential when describing taste and smell alterations.
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Affiliation(s)
- Graham Ellender
- Adelaide Dental School, The University of Adelaide, South Australia 5000, Australia.
| | - John Coveney
- Global Food, Culture and Health, Flinders University, Bedford Park, South Australia 5042, Australia.
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de Kruif AJT, Westerman MJ, Winkels RM, Koster MS, van der Staaij IM, van den Berg MMGA, de Vries JHM, de Boer MR, Kampman E, Visser M. Exploring changes in dietary intake, physical activity and body weight during chemotherapy in women with breast cancer: A Mixed-Methods Study. J Hum Nutr Diet 2021; 34:550-561. [PMID: 33411940 PMCID: PMC8248384 DOI: 10.1111/jhn.12843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/03/2020] [Accepted: 10/27/2020] [Indexed: 01/21/2023]
Abstract
Background The present study aimed (i) to assess changes in dietary intake (DI), physical activity (PA) and body weight (BW) in breast cancer patients during chemotherapy; (ii) to describe how women explained, experienced and dealt with these potential changes; and (iii) to eventually develop lifestyle intervention strategies tailored to the women's personal needs during chemotherapy. Methods A longitudinal parallel mixed‐method design was used with quantitative assessment of changes in dietary intake (24‐h recall, Appetite, Hunger, Sensory Perception questionnaire), physical activity (Short Questionnaire to Assess Health‐enhancing physical activity, Multidimensional Fatigue Inventory) and BW (dual‐energy X‐ray absorptiometry), in addition to qualitative interviews with 25 women about these potential changes during chemotherapy. Results Most women who perceived eating less healthily with low energy intake (EI) and being less active before diagnosis continued to do so during chemotherapy, according to quantitative measurements. They struggled to maintain sufficient energy intake. Despite a lower than average reported EI, they unexpectedly gained weight and explained that fatigue made them even more inactive during chemotherapy. Active women usually managed to stay active because exercise was very important to them and made them feel good, although they also suffered from the side‐effects of chemotherapy. They found more ways to deal with taste, smell and appetite problems than women with a lower energy intake. Conclusions The combination of the quantitative and qualitative data provided more insight into the changes in dietary intake, physical activity and BW during chemotherapy. The women's explanations showed why some women remain active and others need support to deal with changes in lifestyle factors such as healthy nutrition and fatigue.
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Affiliation(s)
- Anja JThCM de Kruif
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Marjan J Westerman
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Marije S Koster
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irene M van der Staaij
- Department of Quality Assurance and Process Management, Student & Educational Affairs, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Michiel R de Boer
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Postma EM, Kok DE, de Graaf C, Kampman E, Boesveldt S. Chemosensory perception and food preferences in colorectal cancer patients undergoing adjuvant chemotherapy. Clin Nutr ESPEN 2020; 40:242-251. [PMID: 33183544 DOI: 10.1016/j.clnesp.2020.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM Cancer is one of the major public health problems, with colorectal cancer being one of the most occurring types of cancer. During treatment, patients may experience changes in their dietary intake due to side-effects of treatment, like changes in chemosensory perception, i.e. smell and taste function. This study investigated alterations in chemosensory perception and food preferences in colorectal cancer patients during and after adjuvant chemotherapy. METHODS Objective olfactory and gustatory function were measured by the Sniffin' Sticks and the Taste Strips test. Subjective smell and taste perception were determined with a questionnaire, while food preferences were assessed with a computer-based ranking task. To investigate changes during chemotherapy, patients undergoing adjuvant chemotherapy were measured before the start, halfway through (approximately 3 months after the start of adjuvant chemotherapy), and within one month after finishing chemotherapy (longitudinal measurements, n = 15 patients). As a comparison group, colorectal cancer patients not undergoing chemotherapy (n = 20), underwent the same measurements at similar time points. To measure changes after treatment, chemosensory perception and food preferences of patients who had undergone chemotherapy treatment were measured once, either at 6, 12 or 24 months after diagnosis (cross-sectional measurements; n = 20 for all time points). Changes during treatment were assessed using linear mixed model analyses, and changes after treatment were assessed with a one-way ANOVA or a Kruskal Wallis test. RESULTS Objective olfactory and gustatory function did not differ statistically significantly between any of the groups and at any time point during or after treatment (all p > 0.05). In contrast, subjective smell (F(1,84) = 8.17, p = 0.005) and taste (F(1,99) = 4.08, p = 0.046) perception were rated statistically significantly lower by patients undergoing chemotherapy than the comparison group during treatment. At 6 months after diagnosis, patients who underwent chemotherapy rated their subjective taste perception significantly lower than patients at 12 and 24 months after treatment (F(2,57) = 12.05, p = 0.002). Food preferences did not change during treatment, or thereafter (all p > 0.05). Preference for protein-rich foods was positively correlated with objective gustatory function (r = 0.36, p < 0.001), while the preference for low-energy foods showed a negative correlation with objective gustatory function (r = -0.28, p = 0.004). CONCLUSIONS Similar to other cancer patient populations, mainly subjective smell and taste perception are affected in colorectal cancer patients undergoing adjuvant chemotherapy. Changes in objective olfactory and gustatory function in relation to chemotherapy were not detected by the tests used in our study nor did food preferences change. However, it should be noted that subjective changes in smell and taste perception can affect subsequent flavor perception and food enjoyment, which might negatively impact eating behavior and nutritional intake.
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Affiliation(s)
- E M Postma
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands; Smell and Taste Centre, ENT Department, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6716 RP, Ede, the Netherlands
| | - D E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - C de Graaf
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - E Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - S Boesveldt
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands.
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Drareni K, Bensafi M, Giboreau A, Dougkas A. Chemotherapy-induced taste and smell changes influence food perception in cancer patients. Support Care Cancer 2020; 29:2125-2132. [PMID: 32870414 DOI: 10.1007/s00520-020-05717-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Chemotherapy-induced taste and smell alterations may have a negative impact on the quality of life and nutritional status. A prominent issue when dealing with taste and smell alterations and their consequences on food behavior and well-being lies in the variation arising from individual differences in chemosensory perceptions. The main aim of this study was to examine the effect of individuals' variation in the severity of taste and smell alterations relative to the stage of chemotherapy on self-reported food behavior and food perception. METHODS Eighty-nine cancer patients completed a questionnaire subdivided into two parts: a chemosensory part that allowed classification of patients in three groups ("no alterations," "moderate alterations," and "severe alterations") and a food behavior part. RESULTS The results highlighted a negative impact of chemosensory alterations on food perception. Compared with patients without taste and smell alterations, patients with severe chemosensory alterations reported significantly more frequent food perception problems, including modification of the perceived taste of food, finding bad taste in all food, and being unable to perceive food taste. Whereas 72% of patients with severe alterations were in late stage, only 37% of patients were in late stage in the no alterations group, indicating an effect of the treatment stage on taste and smell alterations. CONCLUSION Our results underlie the importance of providing specific attention to the severity of chemotherapy-induced taste and smell alterations and considering the individual differences among patients for a better nutritional management.
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Affiliation(s)
- K Drareni
- Institut Paul Bocuse Research Centre, 1, Chemin de Calabert, 69130, Ecully Cedex, France. .,CNRS, UMR5292, INSERM U1028, Lyon Neuroscience Research Center, University of Lyon, Lyon, France.
| | - M Bensafi
- CNRS, UMR5292, INSERM U1028, Lyon Neuroscience Research Center, University of Lyon, Lyon, France
| | - A Giboreau
- Institut Paul Bocuse Research Centre, 1, Chemin de Calabert, 69130, Ecully Cedex, France
| | - A Dougkas
- Institut Paul Bocuse Research Centre, 1, Chemin de Calabert, 69130, Ecully Cedex, France
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Hopkinson JB, Kazmi C, Elias J, Wheelwright S, Williams R, Russell A, Shaw C. Diet and weight management by people with nonmetastatic colorectal cancer during chemotherapy: mixed methods research. COLORECTAL CANCER 2020. [DOI: 10.2217/crc-2019-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Aim: To investigate self-management of dietary intake by colorectal cancer patients receiving chemotherapy. Methods: A questionnaire was administered to 92 patients with nonmetastatic colorectal cancer receiving chemotherapy treatment at a UK cancer center in 2018–19. A maximum variation sample of 20 patients who completed the questionnaire were interviewed. Results: More than three in five patients were at nutritional risk but fewer than one in five were concerned about dietary intake or weight. Self-management of diet and weight was inconsistent with achieving the nutritional intake recommended by clinical guidelines on nutrition in cancer. Conclusion: There is potential for psychoeducation to support change in self-management of nutritional risk, with implications for better treatment tolerance and outcomes including quality of life.
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Affiliation(s)
- Jane B Hopkinson
- Cardiff University, School of Healthcare Sciences, Cardiff, Wales CF24 OAB, UK
| | - Catherine Kazmi
- Cardiff University, School of Healthcare Sciences, Cardiff, Wales CF24 OAB, UK
| | - Jayne Elias
- Velindre University NHS Trust, Cardiff, Wales CF15 7QZ, UK
| | - Sally Wheelwright
- Macmillan Survivorship Research Group, University of Southampton, England SO17 1BJ, UK
| | | | - Ann Russell
- National Institute for Health Research (NIHR), Cancer & Nutrition Collaborative, Level E, Lab & Path Block (MP113), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Clare Shaw
- National Institute for Health Research (NIHR), Biomedical Research center, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UK
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12
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Enriquez-Fernandez BE, Martinez-Michel L, Thorlakson J, Wismer WV. Patient-reported taste change assessment questionnaires used in the oncology setting: A narrative review. Eur J Oncol Nurs 2020; 47:101775. [PMID: 32559713 DOI: 10.1016/j.ejon.2020.101775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Patient-reported questionnaires to assess taste changes (TC) among patients with cancer and the common domains or aspects assessed by those questionnaires are identified in this narrative review. Taste changes are a prevalent symptom experienced by patients with cancer that impact food choice and enjoyment, reduce food intake, and diminish quality of life. Appropriate assessment is essential to detect and manage this symptom. METHOD A systematic search of relevant databases between 1999 and 2018 yielded 1959 articles; 38 articles were included in the review. RESULTS Seventeen questionnaires designed specifically to assess patient-reported taste changes among patients with cancer are described in the review. Seven domains were identified among the questionnaires; the most frequently assessed domain was the description of the taste change in 14 questionnaires). Timeframe, scoring, number of items and domains, and item phrasing varied greatly among questionnaires and the approach to domain and item evaluation was inconsistent. Comprehensive questionnaires (n = 7) assessed five or more domains to characterize the taste change experience. The majority of questionnaires have been cited only once or twice. CONCLUSION Patient-reported taste change assessment in oncology has been achieved by a large number of diverse questionnaires; no standard tool or approach is used. Development of a question bank of validated or standardized taste change modules or items may strengthen the consistency and applicability of research in this area.
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13
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Cohen J, Collins L, Gregerson L, Chandra J, Cohn RJ. Nutritional concerns of survivors of childhood cancer: A "First World" perspective. Pediatr Blood Cancer 2020; 67 Suppl 3:e28193. [PMID: 31994836 DOI: 10.1002/pbc.28193] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/12/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Childhood cancer survivor (CCS) numbers are increasing as a result of advances in both treatment and supportive care. This positive outcome is tempered by the recognition of a high burden of chronic health conditions. Here, we review the nutritional concerns of CCS, including dietary habits after treatment and the factors during treatment that may contribute to chronic health conditions. Dietary interventions that have been conducted in CCS will be summarized along with focused goals of these interventions. We will also address the need to leverage these interventions to reduce the risk of chronic disease in CCS.
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Affiliation(s)
- Jennifer Cohen
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Randwick, New South Wales, Australia
| | - Laura Collins
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Laura Gregerson
- Department of Nutrition, Exercises and Sport, University of Copenhagen, Copenhagen, Denmark
| | - Joya Chandra
- Departments of Pediatrics Research, Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard J Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Randwick, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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14
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Drareni K, Dougkas A, Giboreau A, Laville M, Souquet PJ, Bensafi M. Relationship between food behavior and taste and smell alterations in cancer patients undergoing chemotherapy: A structured review. Semin Oncol 2019; 46:160-172. [DOI: 10.1053/j.seminoncol.2019.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022]
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15
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McGettigan N, Dhuibhir PU, Barrett M, Sui J, Balding L, Higgins S, O’Leary N, Kennedy A, Walsh D. Subjective and Objective Assessment of Taste and Smell Sensation in Advanced Cancer. Am J Hosp Palliat Care 2019; 36:688-696. [DOI: 10.1177/1049909119832836] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Context: Taste and smell abnormalities (TSA) occur throughout the cancer trajectory regardless of cancer primary site and contribute to cancer-associated malnutrition. TSA etiology is poorly understood. Tumor-related inflammation is a possible cause. Objective: This study examined the prevalence, characteristics, and severity of TSA in advanced cancer and explored the relationship between TSA and nutritional status. No previous study combined subjective and objective measures for both taste and smell assessment in this population. Method: Consecutive advanced cancer hospice patients were recruited. A modified version of the “Taste and Smell Survey” assessed subjective TSA. Validated taste strips and “Sniffin’ Sticks” were the objective measures. The abridged patient-generated subjective global assessment evaluated nutritional status. Results: A 93% prevalence of TSA in 30 patients with advanced cancer was identified. When subjective and objective evaluations were combined, 28 had taste abnormalities, 24 smell abnormalities, and 24 both. Taste changes included “persistent bad taste” (n = 18) and changes in how basic tastes were perceived. Half reported smell was not “as strong” as prediagnosis, while more than half (n = 16) had an objective smell abnormality. Most (97%) were at risk of malnutrition. Fatigue, dry mouth, early satiety, and anorexia were common nutrition-impact symptoms. No statistically significant relationship was found between TSA and malnutrition scores. Conclusions: TSA were highly prevalent. Subjective taste and smell changes did not always accord with objective TSA, suggesting both assessments are valuable. TSA characteristics varied, and particular foods tasted and smelled different and were not enjoyed as before. TSA are common, high-impact problems in advanced cancer.
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Affiliation(s)
- Niamh McGettigan
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- School of Biological Sciences, Dublin Institute of Technology, Kevin St., Dublin, Ireland
| | | | - Michelle Barrett
- Academic Department of Palliative Medicine, Our Lady’s Hospice & Care Services, Dublin, Ireland
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Jessica Sui
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Academic Department of Palliative Medicine, Our Lady’s Hospice & Care Services, Dublin, Ireland
| | - Lucy Balding
- Academic Department of Palliative Medicine, Our Lady’s Hospice & Care Services, Dublin, Ireland
- St James’ Hospital, Dublin, Ireland
| | - Stephen Higgins
- Academic Department of Palliative Medicine, Our Lady’s Hospice & Care Services, Dublin, Ireland
- Tallaght University Hospital, Dublin, Ireland
| | - Norma O’Leary
- Academic Department of Palliative Medicine, Our Lady’s Hospice & Care Services, Dublin, Ireland
- St James’ Hospital, Dublin, Ireland
| | - Aileen Kennedy
- School of Biological Sciences, Dublin Institute of Technology, Kevin St., Dublin, Ireland
| | - Declan Walsh
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Academic Department of Palliative Medicine, Our Lady’s Hospice & Care Services, Dublin, Ireland
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
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16
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Meirelles CDS, Diez-Garcia RW. Taste changes as a metaphor for biographical disruption: A qualitative study in patients undergoing haematopoietic stem cell transplantation. Clin Nutr ESPEN 2018; 27:127-133. [PMID: 30144885 DOI: 10.1016/j.clnesp.2018.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE and objective: The treatment side effects of patients undergoing haematopoietic stem cell transplantation can cause various eating difficulties. The objective of this study was to explore the significance of eating experiences and taste changes from the perspective of patients undergoing haematopoietic stem cell transplantation. METHOD This was a qualitative, exploratory study based on semi-structured interviews applied during hospitalisation for haematopoietic stem cell transplantation. Thematic content analysis and the biographical disruption concept were used as theoretical references to explore the results. RESULTS Twenty patients were studied. The overarching theme identified from the results was deconstruction of the taste reference resulting from sensory taste change, loss of eating references and changes to the hedonic relationship with food caused by the treatment. In addition to this deconstruction, participants described the reformulation of eating habits as a way of coping with the disease, which affected the eating experience and motivated the dietary strategies adopted. CONCLUSIONS Taste changes during haematopoietic stem cell transplantation are related to both biological issues and metaphysical aspects. This study raises the meaning of loss of sensory references and their symbolic aspects. These results were important to expand our view to include other aspects that can contribute to improving the care given to these individuals.
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Affiliation(s)
- Camila de Souza Meirelles
- Laboratory of Food Practices and Behaviour, University of Sao Paulo, Brazil; Department of Internal Medicine, Nutrition and Metabolism Program, Ribeirão Preto Medical School, University of Sao Paulo (FMRP/USP), Brazil
| | - Rosa Wanda Diez-Garcia
- Laboratory of Food Practices and Behaviour, University of Sao Paulo, Brazil; Department of Internal Medicine, Nutrition and Metabolism Program, Ribeirão Preto Medical School, University of Sao Paulo (FMRP/USP), Brazil.
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17
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Wismer WV. Rapid descriptive product profile techniques for food product development for cancer survivors. Curr Opin Food Sci 2018. [DOI: 10.1016/j.cofs.2018.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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18
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Amézaga J, Alfaro B, Ríos Y, Larraioz A, Ugartemendia G, Urruticoechea A, Tueros I. Assessing taste and smell alterations in cancer patients undergoing chemotherapy according to treatment. Support Care Cancer 2018; 26:4077-4086. [PMID: 29855774 DOI: 10.1007/s00520-018-4277-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 05/17/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Taste and smell changes are common side effects in cancer patients undergoing chemotherapy treatments (CT). This can lead to a reduced food enjoyment and an inadequate nutrient intake with a high impact on nutritional status and quality of life. The aim of this study was to evaluate the self-reported chemosensory alterations of patients undergoing chemotherapy according to CT type. METHODS An observational study was conducted with 151 patients undergoing CT at Oncology Outpatient Unit from Onkologikoa Foundation. An interviewer-assisted questionnaire was designed to investigate chemosensory changes in patients undergoing CT. RESULTS Seventy-six percent patients reported taste disorders and 45% smell changes. Xerostomia is the most frequent symptom reported by patients receiving chemotherapy in our study (63.6%), and it is strongly associated to bad taste in mouth (OR = 5.96; CI = 2.37-14.94; p value = 0.000) and taste loss (OR = 5.96; CI = 2.37-14.94; p value = 0.000). Anthracyclines, paclitaxel, carboplatin, and docetaxel were the CT agents producing the highest taste disturbance rates. Cisplatin and 5-Fluorouracil are the CT resulting in the lowest complaints. Logistic regression revealed statistically significant associations between taste loss and carboplatin and docetaxel (OR = 3.50; CI = 1.12-10.90; p value = 0.031) and cold hypersensitivity and oxaliplatin (OR = 12.14; CI = 4.18-35.25; p value = 0.000). Not only platin-based CT such as carboplatin produced dysgeusia, but also anthracyclines and paclitaxel treatments. CONCLUSIONS The better knowledge of taste and smell alterations according to CT type may provide valuable information for the design of new strategies to tackle CT side effects. It is important to take into account taste and smell dysfunctions and other alterations such as xerostomia together.
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Affiliation(s)
- Javier Amézaga
- AZTI, Food and Health, Parque Tecnológico de Bizkaia, Astondo Bidea 609, 48160, Derio, Bizkaia, Spain
| | - Begoña Alfaro
- AZTI, Food and Health, Parque Tecnológico de Bizkaia, Astondo Bidea 609, 48160, Derio, Bizkaia, Spain
| | - Yolanda Ríos
- AZTI, Food and Health, Parque Tecnológico de Bizkaia, Astondo Bidea 609, 48160, Derio, Bizkaia, Spain
| | - Aitziber Larraioz
- Onkologikoa Foundation, Paseo Doctor Begiristain 121, 20014, San Sebastián, Gipuzkoa, Spain
| | - Gurutze Ugartemendia
- Onkologikoa Foundation, Paseo Doctor Begiristain 121, 20014, San Sebastián, Gipuzkoa, Spain
| | - Ander Urruticoechea
- Onkologikoa Foundation, Paseo Doctor Begiristain 121, 20014, San Sebastián, Gipuzkoa, Spain
| | - Itziar Tueros
- AZTI, Food and Health, Parque Tecnológico de Bizkaia, Astondo Bidea 609, 48160, Derio, Bizkaia, Spain.
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19
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Tueros I, Uriarte M. Innovative food products for cancer patients: future directions. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2018; 98:1647-1652. [PMID: 29168190 DOI: 10.1002/jsfa.8789] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/19/2017] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
One of the main challenges for cancer patients under treatment is to prevent and tackle malnutrition. The current clinical nutrition market offers different food supplements or oral nutritional support products (mainly milkshakes or modified texture products) for cancer patients under risk of malnutrition. However, it is worth mentioning that these products do not address the pleasure of eating, since they do not meet sensory requirements, such as taste and smell alterations, nor patients' food preferences, leading to a big impact on their quality of life (QOL). Still, controversy remains regarding the specific nutritional requirements for cancer patients during the disease. Several randomized controlled clinical trials yield opposite results when using different bioactive compounds such as omega-3 fatty acids or antioxidants in order to prevent malnutrition or improve QOL. The use of 'omics' technologies in oncology, such as membrane lipidomics, as a powerful tool to provide new insights for the understanding of diet and cancer and their interacting metabolic pathways, will be discussed. The better knowledge of specific requirements (nutrients, sensory parameters and food preferences) for cancer patients provides valuable information for the food industry in the design of customized food products capable of preventing malnutrition, alleviating symptoms and improving QOL. © 2017 Society of Chemical Industry.
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Affiliation(s)
- Itziar Tueros
- AZTI, Food and Health, Parque Tecnológico de Bizkaia, Derio, Bizkaia, Spain
| | - Matxalen Uriarte
- AZTI, Food and Health, Parque Tecnológico de Bizkaia, Derio, Bizkaia, Spain
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20
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Hopkinson J. Psychosocial Support in Cancer Cachexia Syndrome: The Evidence for Supported Self-Management of Eating Problems during Radiotherapy or Chemotherapy Treatment. Asia Pac J Oncol Nurs 2018; 5:358-368. [PMID: 30271817 PMCID: PMC6103201 DOI: 10.4103/apjon.apjon_12_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
People receiving cancer treatment are at nutritional risk. Their eating problems can lead to malnutrition and weight loss. Involuntary weight loss is also a defining characteristic of tumor-induced cachexia. Weight loss is associated with poor tolerance of treatment, poor treatment outcomes, morbidity, and mortality. Support for self-management of nutritional risk may protect against malnutrition and be important in multimodal therapies to arrest the progression of cachexia. Nurses can help patients by supporting self-management of eating problems. This scoping review is about eating problems during cancer treatment. It considers patient experience and self-management of eating problems during cancer treatment for the proactive management of malnutrition and cachexia. It draws on a systematic search of Medline, CINAHL, PsycINFO, and the Cochrane Library for publications about people with cancer who have eating problems during treatment. Limits were English language; January 2000 to December 2017; adults. The search found studies about eating problems in patients treated with chemotherapy or radiotherapy for head-and-neck cancer, lung cancer, gastrointestinal cancer, breast cancer, testicular cancer, and ovarian cancer. Nutritional counseling can improve nutritional intake, quality of life, and weight. However, the patient perspective on self-management and how to motivate engagement in nutritional care is unexplored. There is a potential for reducing nutritional risk during cancer treatment using psychoeducation to support behavioral change, thus empower self-management of eating problems. Benefits are likely in subgroups of people receiving cancer treatment, such as those with head and neck, gastrointestinal, and lung cancers.
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Affiliation(s)
- Jane Hopkinson
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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21
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Cherwin CH, Perkhounkova Y. Distress-Based Gastrointestinal Symptom Clusters and Impact on Symptom Interference and Quality of Life in Patients with a Hematologic Malignancy Receiving Chemotherapy. J Pain Symptom Manage 2017; 53:751-758. [PMID: 28042061 DOI: 10.1016/j.jpainsymman.2016.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/28/2016] [Accepted: 11/14/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND/SIGNIFICANCE People with cancer can experience co-occurring related symptoms, labeled symptom clusters. Gastrointestinal (GI) symptoms are common side effects of chemotherapy, but little research has investigated GI symptom clusters. A further gap in symptom cluster research is the lack of studies reporting symptom clusters based on symptom distress ratings. PURPOSE To identify distress-based GI symptom clusters and to investigate their relationship to symptom interference with daily life and quality of life (QoL). SUBJECTS About 105 adults with hematologic malignancy receiving chemotherapy. METHODS On Day 1 of a cycle of chemotherapy, participants completed a modified version of the Memorial Symptom Assessment Scale assessing 30 clinically relevant symptoms, the M.D. Anderson Symptom Inventory Symptom Interference with Daily Life subscale, and the Fox Simple Quality of Life Scale. Exploratory factor analysis was used to identify distress-based symptom clusters. Symptom clusters with ≥50% GI symptoms were labeled GI symptom clusters. Linear mixed modeling explored relationships between GI symptom clusters and symptom interference with daily life and QoL. RESULTS Of the six distress-based symptom clusters found, the bloating cluster and appetite cluster were identified as GI symptom clusters. Both the bloating cluster and the appetite cluster were significantly related to symptom interference with daily life, but only the appetite cluster was significantly related to QoL. CONCLUSIONS This research demonstrates the existence of distress-based GI symptom clusters and their relationship to symptom interference and QoL. Future work should explore predictors of distress-based symptom clusters and interventions to manage them.
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22
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Álvarez-Camacho M, Martínez-Michel L, Gonella S, Scrimger R, Chu K, Wismer W. Physical symptom burden of post-treatment head and neck cancer patients influences their characterization of food: Findings of a repertory grid study. Eur J Oncol Nurs 2016; 22:54-62. [DOI: 10.1016/j.ejon.2016.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 01/22/2016] [Accepted: 03/22/2016] [Indexed: 11/15/2022]
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23
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Okkels S, Bredie W, Klausen T, Beck A. An investigation into between-meal food desires among hospitalised haematological cancer patients. Clin Nutr 2016; 35:440-445. [DOI: 10.1016/j.clnu.2015.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/13/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
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24
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25
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de Vries YC, Helmich E, Karsten MDA, Boesveldt S, Winkels RM, van Laarhoven HWM. The impact of chemosensory and food-related changes in patients with advanced oesophagogastric cancer treated with capecitabine and oxaliplatin: a qualitative study. Support Care Cancer 2016; 24:3119-26. [PMID: 26919988 PMCID: PMC4877431 DOI: 10.1007/s00520-016-3128-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/09/2016] [Indexed: 01/19/2023]
Abstract
Purpose Chemosensory changes are frequently observed side effects of cytotoxic treatment and have an impact on daily life by altering food-related behaviour and daily practices. For oesophagogastric cancer patients, these changes can be particularly important as they may have specific needs with regard to eating, due to obstruction of the upper intestinal tract. The purpose of this study was to gain insight into the impact of chemosensory and food-related changes in oesophagogastric cancer patients undergoing chemotherapy and how this may influence the practical and social aspects of food-related behaviour of patients and their relatives. Methods We used a qualitative interview approach with a cross-sectional design using semi-structured interviews. Template analysis was used to analyse patients’ experiences with and the impact of chemosensory changes on daily life. Thirteen advanced oesophagogastric cancer patients treated with capecitabine and oxaliplatin were included by convenience sampling, recruited from one academic hospital, and interviewed at home or in the hospital. Results There was a large variation in the impact of chemosensory changes in oesophagogastric cancer (OGC) patients, though daily life was impacted substantially when chemosensory and/or food-related changes were experienced. Three main themes emerged from the interviews: altered food preferences, practical constraints in daily life, and impact on social functioning. Conclusion Chemosensory and food-related changes significantly influenced food preferences and had practical and social consequences in daily life of patients and their relatives. Specific nutritional care for these patients should be directed towards enhancing food enjoyment and should take the specific needs, related to the location of the tumour, into account.
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Affiliation(s)
- Yfke C de Vries
- Top Institute Food and Nutrition, P.O. Box 557, Wageningen, 6700 AN, The Netherlands. .,Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands.
| | - Esther Helmich
- Center for Evidence-Based Education, Academic Medical Center, Amsterdam, The Netherlands.,Rehabilitation and Care Center Vreugdehof, Amsterdam, The Netherlands
| | - Matty D A Karsten
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
| | - Sanne Boesveldt
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands
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26
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Belqaid K, Tishelman C, McGreevy J, Månsson-Brahme E, Orrevall Y, Wismer W, Bernhardson BM. A longitudinal study of changing characteristics of self-reported taste and smell alterations in patients treated for lung cancer. Eur J Oncol Nurs 2015; 21:232-41. [PMID: 26706824 DOI: 10.1016/j.ejon.2015.10.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/23/2015] [Accepted: 10/27/2015] [Indexed: 01/04/2023]
Abstract
PURPOSE Taste and smell alterations (TSAs) are common symptoms in patients with cancer that may interfere with nutritional intake and quality of life. In this study, we explore and describe how characteristics of self-reported TSAs change in individuals with lung cancer over time using a multiple case study approach to present longitudinal data from individuals. METHODS Patients under investigation for lung cancer were recruited from one university hospital in Sweden. The 52 patients providing data eligible for the analyses presented here were those treated for primary lung cancer with three measurement time-points, of which one was prior to treatment and two after treatment start. Four self-report instruments were used for data collection. These included the Taste and Smell Survey, used to characterize TSAs for each individual at the three time-points and instruments measuring nutritional status, symptom burden and well-being. Three patient cases are described in detail to illustrate variation in individual experiences of TSAs. RESULTS The characteristics of the TSAs experienced changed over time for many of the individuals in this study, including those undergoing surgery or stereotactic radiotherapy. The case descriptions show how the individual experiences of TSAs and the impact on daily life of these symptoms not only depend on TSA characteristics, but may be influenced by contextual factors, e.g. other symptoms and life situation. CONCLUSIONS Our results suggest that healthcare professionals need to consider the variation in characteristics of TSAs among and within patients over time, and be attentive to individual experiences of TSAs.
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Affiliation(s)
- Kerstin Belqaid
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, S-171 77 Stockholm, Sweden.
| | - Carol Tishelman
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, S-171 77 Stockholm, Sweden.
| | - Jenny McGreevy
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, S-171 77 Stockholm, Sweden.
| | - Eva Månsson-Brahme
- Department of Oncology, Karolinska University Hospital, S-171 76 Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
| | - Ylva Orrevall
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, S-171 77 Stockholm, Sweden.
| | - Wendy Wismer
- Department of Agricultural, Food and Nutritional Science, University of Alberta, 410 Agriculture/Forestry Centre, Edmonton AB T6G 2P5, Canada.
| | - Britt-Marie Bernhardson
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, S-171 77 Stockholm, Sweden.
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27
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Alvarez-Camacho M, Gonella S, Ghosh S, Kubrak C, Scrimger RA, Chu KP, Wismer WV. The impact of taste and smell alterations on quality of life in head and neck cancer patients. Qual Life Res 2015. [PMID: 26589527 DOI: 10.1007/s11136‐015‐1185‐2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
PURPOSE Taste and smell alterations (TSAs) are among the most frequent and troublesome symptoms reported by head and neck cancer (HNC) patients after treatment. Little is known about the relationship between TSAs and quality of life (QoL) among HNC patients. The aim of this study was to determine the effect of TSAs on overall QoL among tube-fed and orally fed HNC patients before treatment, at end of treatment and at 2.5-month follow-up. METHODS Data were collected in a longitudinal study prior to treatment (n = 126), at end of treatment (n = 100) and at 2.5-month follow-up (n = 85). Chemosensory Complaint Score (CCS) and the University of Washington Quality of Life Questionnaire version 3 were used to assess TSAs and QoL, respectively. Generalized estimated equation modeling was used to estimate the effect of CCS on QoL. RESULTS At end of treatment, QoL and CCS had declined for both tube-fed and orally fed patients and thereafter improved, but not to pre-treatment levels. Neither QoL nor CCS mean scores were different between the two groups at any time point. CCS was a significant predictor of overall QoL (β = -1.82, p < 0.0001), social-emotional (β = -1.76, p < 0.0001), physical (β = -1.12, p < 0.0001) and overall functions (β = -1.15, p < 0.0001) at a multivariate level. Taste was reported as an important symptom for both tube-fed and orally fed groups at end of treatment and follow-up. CONCLUSIONS TSAs are an important symptom and an independent predictor of QoL for both tube-fed and orally fed HNC patients. HNC patients need support to manage TSAs, regardless of the method of nutritional intake.
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Affiliation(s)
- M Alvarez-Camacho
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - S Gonella
- Dipartimento di Sanità Pubblica e Medicina di Comunità, Università degli Studi di Verona, Verona, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - S Ghosh
- Division of Medical Oncology, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - C Kubrak
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada.,Outpatient Department, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - R A Scrimger
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - K P Chu
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - W V Wismer
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
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28
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The impact of taste and smell alterations on quality of life in head and neck cancer patients. Qual Life Res 2015; 25:1495-504. [PMID: 26589527 DOI: 10.1007/s11136-015-1185-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Taste and smell alterations (TSAs) are among the most frequent and troublesome symptoms reported by head and neck cancer (HNC) patients after treatment. Little is known about the relationship between TSAs and quality of life (QoL) among HNC patients. The aim of this study was to determine the effect of TSAs on overall QoL among tube-fed and orally fed HNC patients before treatment, at end of treatment and at 2.5-month follow-up. METHODS Data were collected in a longitudinal study prior to treatment (n = 126), at end of treatment (n = 100) and at 2.5-month follow-up (n = 85). Chemosensory Complaint Score (CCS) and the University of Washington Quality of Life Questionnaire version 3 were used to assess TSAs and QoL, respectively. Generalized estimated equation modeling was used to estimate the effect of CCS on QoL. RESULTS At end of treatment, QoL and CCS had declined for both tube-fed and orally fed patients and thereafter improved, but not to pre-treatment levels. Neither QoL nor CCS mean scores were different between the two groups at any time point. CCS was a significant predictor of overall QoL (β = -1.82, p < 0.0001), social-emotional (β = -1.76, p < 0.0001), physical (β = -1.12, p < 0.0001) and overall functions (β = -1.15, p < 0.0001) at a multivariate level. Taste was reported as an important symptom for both tube-fed and orally fed groups at end of treatment and follow-up. CONCLUSIONS TSAs are an important symptom and an independent predictor of QoL for both tube-fed and orally fed HNC patients. HNC patients need support to manage TSAs, regardless of the method of nutritional intake.
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Boltong A, Keast R. Chemosensory Science in the Context of Cancer Treatment: Implications for Patient Care. CHEMOSENS PERCEPT 2015. [DOI: 10.1007/s12078-015-9180-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Belqaid K, Orrevall Y, McGreevy J, Månsson-Brahme E, Wismer W, Tishelman C, Bernhardson BM. Self-reported taste and smell alterations in patients under investigation for lung cancer. Acta Oncol 2014; 53:1405-12. [PMID: 24702121 PMCID: PMC4220986 DOI: 10.3109/0284186x.2014.895035] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study of patients under investigation for lung cancer (LC) aims to: 1) examine the prevalence of self-reported taste and smell alterations (TSAs) and their relationships with demographic and clinical characteristics; and 2) explore nutritional importance of TSAs by examining their associations with patient-reported weight loss, symptoms interfering with food intake, and changes in food intake. Methods Patients were recruited consecutively during investigation for LC from one university hospital in Sweden. Patient-reported information on TSAs, demographics, six-month weight history, symptoms interfering with food intake, and changes in food intake was obtained. Relationships between TSAs and other variables were examined using two-tailed significance tests. In addition, putative explanatory factors for weight loss were explored in those patients diagnosed with LC, since a relationship between TSAs and weight loss was found in this group. Results The final sample consisted of 215 patients, of which 117 were diagnosed with primary LC within four months of study inclusion and 98 did not receive a cancer diagnosis. The 38% prevalence of TSAs was identical in both groups, and were generally reported as mild and not interfering with food intake. However, a statistically significant relationship between TSAs and weight loss was found among patients with LC, with a median weight change of − 5.5% and a higher frequency of weight loss ≥ 10%. Patients with LC and weight loss ≥ 10%, had higher frequency of reporting TSAs, of decreased food intake and of ≥ 1 symptom interfering with food intake compared with those with less weight loss. Conclusion TSAs, although relatively mild, were present in 38% of patients with and without LC. Relationships between TSAs and weight loss were found among patients with LC, but not fully explained by decreased food intake. This highlights the complexity of cancer-related weight loss.
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Affiliation(s)
- Kerstin Belqaid
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet , Stockholm , Sweden
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McGreevy J, Orrevall Y, Belqaid K, Wismer W, Tishelman C, Bernhardson BM. Characteristics of taste and smell alterations reported by patients after starting treatment for lung cancer. Support Care Cancer 2014; 22:2635-44. [PMID: 24752563 DOI: 10.1007/s00520-014-2215-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 03/09/2014] [Indexed: 12/13/2022]
Abstract
PURPOSE Taste and smell alterations (TSAs) in patients with lung cancer are poorly understood. This study investigates characteristics of TSAs when most severe, reported by patients after starting treatment for lung cancer. METHODS Data was collected regarding TSAs, symptoms, food intake and nutritional status through structured interviews using the Taste and Smell Survey, the Patient-Generated Subjective Global Assessment and 3-day food diaries. This data derives from a longitudinal project and the interview with each patient when TSAs were most severe was purposefully selected for analysis. RESULTS Sixty-one of the 89 patients reported TSAs, and the TSAs group were on average younger and more frequently smokers. Thirty-one patients reported symptoms impacting negatively on food intake, with 87 % in the TSAs group and 13 % in the no-TSAs group. Most commonly reported were loss of appetite, nausea and early satiety. Gender differences were seen with more women reporting stronger sensation(s) and more men reporting weaker sensation(s) and other changes. TSAs were described as affecting enjoyment of food and eating. A trend was seen where energy intakes declined with increasing TSAs. Energy intakes in the total study population were below recommended. CONCLUSION TSAs varied in characteristics and interacted with other symptoms. Gender differences may highlight a need to investigate approaches for identification and management of TSAs in men and women. Patients reported TSAs impacting on food enjoyment, and the hypothesis that patients with higher TSS scores have lower nutritional intakes should be followed up with a larger study in the lung cancer population.
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Affiliation(s)
- Jenny McGreevy
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden,
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Witham G. Nutrition and cancer: issues related to treatment and survivorship. Br J Community Nurs 2013; Suppl Nutrition:S20-4. [PMID: 24177239 DOI: 10.12968/bjcn.2013.18.sup10.s20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This paper reviews nutritional issues related to cancer treatment and further explores nutritional needs pertinent to cancer survivorship. It examines the major problems with nutrition when patients undergo the main cancer treatment modalities of chemotherapy, radiotherapy and surgery. Particular attention is paid to long-term dietary advice in acknowledgement of the improved effectiveness of cancer treatment and the chronic nature of the condition.
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Affiliation(s)
- Gary Witham
- Senior Lecturer in Adult Nursing, Manchester Metropolitan University
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Dotson CD, Colbert CL, Garcea M, Smith JC, Spector AC. The consequences of gustatory deafferentation on body mass and feeding patterns in the rat. Am J Physiol Regul Integr Comp Physiol 2012; 303:R611-23. [PMID: 22785426 DOI: 10.1152/ajpregu.00633.2011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The contribution of orosensory signals, especially taste, on body mass, and feeding and drinking patterns in the rat was examined. Gustatory deafferentation was produced by bilateral transection of the chorda tympani, glossopharyngeal, and greater superficial petrosal nerves. Total calories consumed from sweetened-milk diet and oil-chow mash by the nerve-transected rats significantly decreased relative to sham-operated controls, mostly attributable to decreases in bout number, but not size. Nevertheless, caloric intake steadily increased over the postsurgical observation period, but body mass remained below both presurgical baseline and control levels and did not significantly increase over this time. After the sweetened-milk diet/oil-chow mash phase, rats received a series of sucrose preference tests. Interestingly, the nerve-transected rats preferred sucrose, and intake did not differ from controls, likely due to the stimulus sharing some nontaste chemosensory properties with the sweetened-milk diet. The neurotomized rats initiated a greater number of sucrose-licking bouts that were smaller in size and slower in licking rate, compared with control rats, and, unlike in control rats, the latter two bout parameters did not vary across concentration. Thus, in the absence of gustatory neural input, body mass is more stable compared with the progressive trajectory of weight gain seen in intact rats, and caloric intake initially decreases but recovers. The consequences of gustatory neurotomy on processes that determine meal initiation (bout number) and meal termination (bout size) are not fixed and appear to be influenced by presurgical experience with food stimuli coupled with its nongustatory chemosensory properties.
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Affiliation(s)
- Cedrick D Dotson
- Department of Neuroscience, University of Florida College of Medicine, Gainesville, USA.
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