Impact of an early education multimedia intervention in managing nutrition-related chemotherapy side effects: a pilot study

Effectiveness of Web Applications on Improving Nutritional Status of Patients with Colorectal Cancer

The most common cancer in Thailand is colorectal cancer (CRC). A lack of knowledge and misleading information from social media have contributed to cancer deaths from malnutrition. A web application is a tool that provides easy access to scientific nutritional information via an online platform. In this study, our goal was to compare the nutritional status of CRC patients using different nutrition-based educational tools with nutrition counseling, namely the Nutrition Educational Prototype based on Smartphone Web Applications (NEPSA) and standard hospital leaflets. Anthropometric and biochemical analyses and a dietary assessment, especially calories and protein, were measured during three visits. This study finally included 28 CRC patients who were undergoing chemotherapy and malnutrition with a body mass index (BMI) of <20 kg/m2. Thirteen participants received NEPSA while the remaining fifteen participants received a standard hospital leaflet. The results showed that NEPSAs improved nutritional outcomes by encouraging weight gain, increasing BMI, hemoglobin, hematocrit, and albumin levels, and consuming more calories and protein. NEPSA should be implemented to enhance the nutrition outcomes from anthropometric, biochemical, and dietary perspectives from nutrition advice among CRC patients. There could be positive impacts at the national level regarding equal accessibility to Thailand's nutrition information.

Clinically significant symptoms prevalence in breast and colon cancers and leukemia patients: a comparison analysis of patient-reported outcomes

PURPOSE

To assess the prevalence and severity of clinically significant symptoms (CSSs) for breast cancer, colon cancer, and leukemia patients undergoing chemotherapy.

METHODS

A retrospective review of the Edmonton Symptom Assessment System scores reported by patients from the database of our previous large-scale study, which was collected between May 2018 and January 2019. We described the prevalence of CSSs in proportion and severity in mean ± SD.

RESULTS

Of 546 cancer patients, 209 were breast cancer, 159 were colon cancer, and 178 were leukemia. The majority of participants were females 345 (63.2%), and the mean age of the entire study sample was 49.4 ± 13.93. Diminished feeling of well-being was the most prevalent CSS across the three cancers, with a statistically significant difference (p < 0.001). Fatigue (6.59 ± 2.07), pain (6.55 ± 2.01), and loss of appetite were the most distressing CSSs (6.49 ± 1.99) across the whole sample. Loss of appetite (6.34 ± 2.05) was the most distressing CSS in breast cancer, fatigue (6.97 ± 2.07) in leukemia, and pain (7.00 ± 2.11) in colon cancer. Statistically significant differences were found in the severity between the three cancer in pain (p < 0.001), fatigue (p = 0.010), nausea (p = 0.001), and diminished feeling of well-being (p = 0.033). Cancer type, sleeping hours, dependence on caregiver, female gender, level of education, and employment were significantly associated with higher odds of CSS severity.

CONCLUSION

Breast and colon cancer and leukemia patients undergoing chemotherapy experience multiple distressing CSSs. Our study validates CSSs as a discrete set of distressing symptoms that may serve and guide quality of care assessment and cancer clinical research, particularly among patients undergoing chemotherapy.

The Effect of Dietary Intervention Along with Nutritional Education on Reducing the Gastrointestinal Side Effects Caused by Chemotherapy Among Women with Breast Cancer

Gastrointestinal (GI) side effects caused by chemotherapy in women with breast cancer are common but poorly understood which might be controlled by nutritional intervention. Thus, the major aim of this study was to assess the effect of dietary intervention along with nutritional education on reducing these side effects. The present study is a single-center, single-controlled, and randomized trial. A total of 150 patients with breast cancer undergoing chemotherapy were randomly assigned into intervention group to receive dietary intervention and nutritional education (n = 73) or control group (n = 67) for 10 weeks, after their three sessions of chemotherapy. The primary endpoint was the GI symptoms after each session of chemotherapy that were measured by a designed questionnaire based on ROMIII questionnaire. The severity of GI side effects in the dietary intervention along with nutritional education was decreased significantly in the third session of chemotherapy compared to the first session, which include reflux disorder (P = 0.05), anorexia (P < 0.001), nausea (P = 0.002), constipation (P < 0.001), and diarrhea (P < 0.001). Moreover, significant reductions were observed in the severity of GI side effects in the intervention group compared to control group after the third session (P < 0.001). After adjusting the analysis for baseline values including age, job, education level, weight, and body mass index, significant changes were observed for GI side effects in the intervention group compared to the control group (P < 0.001). This study showed beneficial effects of individualized dietary intervention along with nutritional education on reducing diarrhea, constipation, vomiting, and nausea in women with breast cancer during the chemotherapy.

Randomized Study of the Effect of Dietary Counseling During Adjuvant Chemotherapy on Chemotherapy Induced Nausea and Vomiting, and Quality of Life in Patients With Breast Cancer

Patients with breast cancer (PsBC) usually face with chemotherapy induced nausea and vomiting (CINV). The aim of this study was to assess the impact of nutritional counseling on CINV and quality of life (QoL) of PsBC. 150 PsBC were randomly assigned for receiving a personalized diet, which contained 1.2-1.5 g/kg of protein, 30% of energy from fat and 55-60% of energy from carbohydrate, a face to face nutrition education, and a pamphlet which contained beneficial nutrition information to reduce the severity of CINV before each chemotherapy session for three times (n = 75) or regular care (n = 75). CINV, QoL, and dietary intake were evaluated after each chemotherapy session. Nausea rating index, overall nausea index, and visual analog scale (P < 0.001) were dramatically lower in the intervention group. Global health status/QoL as well as physical functioning, role functioning, emotional functioning, and cognitive functioning (P < 0.001) were significantly better in the intervention group. Patients in the control group experienced more fatigue, nausea and vomiting, pain, dyspnea, loss of appetite, constipation, and diarrhea (P < 0.001). Nutrition counseling during adjuvant chemotherapy among PsBC reduced the occurrence of CINV and led to significant improvements in the QoL.