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Keaver L, O'Callaghan N, LaVertu AE, Semple CJ, Hughes CM, Hanna JR, Ryan L. Experiences of cancer patients in receiving dietary advice from healthcare professionals and of healthcare professionals in providing this advice-a systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01359-4. [PMID: 36964295 DOI: 10.1007/s11764-023-01359-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/06/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE This systematic review investigated qualitative and quantitative studies exploring patients and healthcare professionals' (HCP) experience of nutrition care throughout the cancer journey. METHODS Five databases were systematically searched for studies reporting on patient and healthcare professionals' experience of nutrition advice. RESULTS Fifteen studies including 374 patients and 471 healthcare professionals were included. Findings indicate that patients desire more specific nutrition advice supported by members of the multidisciplinary team and delivered in appropriate and understandable language. Healthcare professionals have highlighted a lack of time, funding, dietetic roles, and knowledge as barriers to integrating nutrition as a standard part of cancer care. Five themes were identified (current provision of nutrition advice, optimal provision of nutrition advice, tension between patient values and nutritional or HCP priorities, providing evidence-based nutrition care, and practical barriers to nutrition advice provision). CONCLUSIONS Further work is essential to better understand and address identified barriers and improve the provision of nutrition advice to this population. IMPLICATIONS FOR CANCER SURVIVORS Findings from this review will guide the delivery of nutrition advice for cancer survivors.
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Affiliation(s)
- Laura Keaver
- Atlantic Technological University, Sligo, Ireland.
| | | | - Amy E LaVertu
- Hirsh Health Sciences Library, Tufts University, Boston, MA, USA
| | | | | | | | - Lisa Ryan
- Atlantic Technological University, Sligo, Ireland
- Atlantic Technological University, Galway, Ireland
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The Second Nutrition and Cancer Networking Meeting Nutrition and Breast Cancer: Translating Evidence into Practice. Proc Nutr Soc 2023; 82:58-62. [PMID: 36503526 DOI: 10.1017/s002966512200283x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The 2nd Nutrition and Cancer Networking Meeting 'Nutrition and Breast Cancer: Translating Evidence into Practice' was held at Newcastle University in May 2022, with support from the Nutrition Society and British Association for Cancer Research. The first meeting in this series was held in Sheffield in 2019. The aim of this joint meeting was to bring together researchers with an interest in nutrition and breast cancer, with the programme spanning topics from risk and prevention to nutrition during treatment and beyond. Several key themes emerged, including the importance of engaging patients in the development of interventions and trials, making trials more accessible to diverse communities; training of clinical staff in nutrition and latest evidence; wider range of compounds should be considered in food composition tables; and alternative trial designs can be considered for prevention research to reduce financial burden and increase power.
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Anderson PM, Thomas SM, Sartoski S, Scott JG, Sobilo K, Bewley S, Salvador LK, Salazar-Abshire M. Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating. Nutrients 2021; 13:nu13124397. [PMID: 34959948 PMCID: PMC8706251 DOI: 10.3390/nu13124397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Cancer and its therapy is commonly associated with a variety of side effects that impact eating behaviors that reduce nutritional intake. This review will outline potential causes of chemotherapy and radiation damage as well as approaches for the amelioration of the side effects of cancer during therapy. Methods: Information for clinicians, patients, and their caregivers about toxicity mitigation including nausea reduction, damage to epithelial structures such as skin and mucosa, organ toxicity, and education is reviewed. Results: How to anticipate, reduce, and prevent some toxicities encountered during chemotherapy and radiation is detailed with the goal to improve eating behaviors. Strategies for health care professionals, caregivers, and patients to consider include (a) the reduction in nausea and vomiting, (b) decreasing damage to the mucosa, (c) avoiding a catabolic state and muscle wasting (sarcopenia), and (d) developing therapeutic alliances with patients, caregivers, and oncologists. Conclusions: Although the reduction of side effects involves anticipatory guidance and proactive team effort (e.g., forward observation, electronic interactions, patient reported outcomes), toxicity reduction can be satisfying for not only the patient, but everyone involved in cancer care.
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Affiliation(s)
- Peter M. Anderson
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA;
- Correspondence: or ; Tel.: +216-445-7140 or +216-308-2706
| | - Stefanie M. Thomas
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA;
| | - Shauna Sartoski
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Department of Nursing, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Jacob G. Scott
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA;
- Department of Radiation Oncology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Kaitlin Sobilo
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Department of Nursing, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sara Bewley
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Peds Nutritional Services, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Laura K. Salvador
- Department of Pediatrics, MD Anderson Cancer Center, Houston, TX 77030, USA; (L.K.S.); (M.S.-A.)
| | - Maritza Salazar-Abshire
- Department of Pediatrics, MD Anderson Cancer Center, Houston, TX 77030, USA; (L.K.S.); (M.S.-A.)
- Department of Nursing Education, MD Anderson Cancer Center, Houston, TX 77030, USA
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Hutchinson SA, Websdale A, Cioccoloni G, Røberg-Larsen H, Lianto P, Kim B, Rose A, Soteriou C, Pramanik A, Wastall LM, Williams BJ, Henn MA, Chen JJ, Ma L, Moore JB, Nelson E, Hughes TA, Thorne JL. Liver x receptor alpha drives chemoresistance in response to side-chain hydroxycholesterols in triple negative breast cancer. Oncogene 2021; 40:2872-2883. [PMID: 33742124 PMCID: PMC8062267 DOI: 10.1038/s41388-021-01720-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 12/18/2022]
Abstract
Triple negative breast cancer (TNBC) is challenging to treat successfully because targeted therapies do not exist. Instead, systemic therapy is typically restricted to cytotoxic chemotherapy, which fails more often in patients with elevated circulating cholesterol. Liver x receptors are ligand-dependent transcription factors that are homeostatic regulators of cholesterol, and are linked to regulation of broad-affinity xenobiotic transporter activity in non-tumor tissues. We show that LXR ligands confer chemotherapy resistance in TNBC cell lines and xenografts, and that LXRalpha is necessary and sufficient to mediate this resistance. Furthermore, in TNBC patients who had cancer recurrences, LXRalpha and ligands were independent markers of poor prognosis and correlated with P-glycoprotein expression. However, in patients who survived their disease, LXRalpha signaling and P-glycoprotein were decoupled. These data reveal a novel chemotherapy resistance mechanism in this poor prognosis subtype of breast cancer. We conclude that systemic chemotherapy failure in some TNBC patients is caused by co-opting the LXRalpha:P-glycoprotein axis, a pathway highly targetable by therapies that are already used for prevention and treatment of other diseases.
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Affiliation(s)
- Samantha A Hutchinson
- School of Food Science and Nutrition, University of Leeds, Leeds, UK.,Institute for Cancer Research, London, UK
| | - Alex Websdale
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | | | | | - Priscilia Lianto
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Baek Kim
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ailsa Rose
- School of Medicine, University of Leeds, Leeds, UK
| | - Chrysa Soteriou
- School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | | | | | | | - Madeline A Henn
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana Champaign, Urbana, Illinois, USA
| | - Joy J Chen
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana Champaign, Urbana, Illinois, USA
| | - Liqian Ma
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana Champaign, Urbana, Illinois, USA
| | | | - Erik Nelson
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana Champaign, Urbana, Illinois, USA.,Cancer Center at Illinois, University of Illinois at Urbana Champaign, Urbana, Illinois, USA.,Division of Nutritional Sciences, University of Illinois at Urbana Champaign, Urbana, Illinois, USA.,University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, Illinois, USA.,Carl R. Woese Institute for Genomic Biology, Anticancer Discovery from Pets to People Theme, University of Illinois at Urbana Champaign, Urbana, Illinois, USA
| | - Thomas A Hughes
- School of Medicine, University of Leeds, Leeds, UK. .,Leeds Breast Cancer Research Group, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
| | - James L Thorne
- School of Food Science and Nutrition, University of Leeds, Leeds, UK. .,Leeds Breast Cancer Research Group, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
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Matsell SL, Sánchez-García MA, Halliday V, Williams EA, Corfe BM. Investigating the nutritional advice and support given to colorectal cancer survivors in the UK: is it fit for purpose and does it address their needs? J Hum Nutr Diet 2020; 33:822-832. [PMID: 32951269 DOI: 10.1111/jhn.12815] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The present study assessed the quantity and quality of nutritional advice and support given to colorectal cancer survivors in the UK. METHODS A descriptive cross-sectional survey was completed by 75 colorectal cancer survivors recruited through social media and bowel cancer support groups in the UK. The survey consisted of open-ended and closed questions that aimed to explore the nutritional needs, nutritional advice given and other sources of information accessed by colorectal cancer survivors. RESULTS Sixty-nine percent of respondents reported that they did not receive any nutritional advice or support from their healthcare team throughout diagnosis, treatment and post-treatment. Colorectal cancer survivors accessed nutritional advice from a variety of sources, mainly cancer charity websites. Respondents expressed their desire for individualised advice relating to their nutritional problems. CONCLUSIONS The results obtained in the present study indicate that a high proportion of colorectal cancer patients are not receiving the nutritional support that they need to overcome nutritional difficulties. There is an urgent need to improve clinical practice to ensure colorectal patients receive nutritional advice that is both consistent between healthcare professionals and personalised throughout each stage of diagnosis, treatment and post-treatment.
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Affiliation(s)
- S L Matsell
- The Molecular Gastroenterology Research Group, Department of Oncology & Metabolism, The Medical School, The University of Sheffield, Sheffield, UK
| | - M A Sánchez-García
- The Molecular Gastroenterology Research Group, Department of Oncology & Metabolism, The Medical School, The University of Sheffield, Sheffield, UK
| | - V Halliday
- Section of Public Health, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - E A Williams
- Department of Oncology & Metabolism, The Medical School, The University of Sheffield, Sheffield, UK.,Healthy Lifespan Institute, The University of Sheffield, Sheffield, UK
| | - B M Corfe
- The Molecular Gastroenterology Research Group, Department of Oncology & Metabolism, The Medical School, The University of Sheffield, Sheffield, UK.,Healthy Lifespan Institute, The University of Sheffield, Sheffield, UK.,Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, UK
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