Nutritional assessment and intervention in lung cancer patients undergoing treatment

Sathiyamoorthy, P N (2013) Nutritional assessment and intervention in lung cancer patients undergoing treatment. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Nutrition has an important role in prevention and management of cancer. It also prolongs the life. It gives the essential elements needed for the cell survival. Providing better nutrition to cancer patient while on treatment helps to reduce the treatment related adverse effects and treatment delays. Malignancy had an impact on food intake symptoms like; dry mouth, alteration in taste and smell of food, pain, dyspnoea and fatigue also affect food intake. Lung cancer is usually managed by chemotherapy and radiotherapy rarely by surgical resection. These treatments also affect food intake. These leads further deterioration of patient’s nutritional condition. ARMS OF THE STUDY: ARM 1: USUAL CARE which consists of one-to-one dietary counselling in person once prior to starting and every cycle of chemotherapy for between 15 to 30 minutes each. This patients takes usual diet only. ARM 2: MEDICAL NUTRITION THERAPY. This will involve indivualised one-to-one dietary counselling in person once prior to starting, and every cycle of chemotherapy. Each session will be between 15 to 30 minutes duration depending on the degree of nutritional issues identified. Patients in this group advised to take FDA approved nutrient dense high protein oral supplement that provides 450Kcal and 34 g protein per day for minimum of 8 weeks. MATERIALS AND METHODS: Study Period: From October 2012 to February 2013. Study Design : Randomized control trial. ELIGIBILITY CRITERIA: Forty nine patients with lung cancer who satisfied the following eligibility criteria were included in this study. 1. Age >18 years, 2. Gender : Both male and Females, 3. Histologically diagnosed of lung cancer on chemotherapy with or without Radiotherapy, 4. Performance status 3 or less according to ECOG score, 5. Life expectancy > 2 months. EXCLUSION CRITERIA: 1. Lung cancer patients on supportive care only. 2. Performance status -4 according to ECOG score. 3. Patients with a cognitive impairment or psychiatric illness. RESULTS: Out of the 782 cancer patients treated between October 2012 and February 2013 in our Medical Oncology Department, 76 (9.7%) patients are presented with Lung cancer. PGSGA score 8 or more at time of enrolment was used to select the patients both in the usual care (control arm) and medical nutritional therapy (study or interventional arm) groups. Total of 49 Lung cancer patients who met the eligibility criteria entered into this study. Among them 6 patients were removed from the study due to early death, poor follow up and poor compliance to intervention. CONCLUSION: In our study, about 65% of the enrolled patients had more than 10% weight loss at presentation which is a worst scenario. Dietary counselling alone or dietary counselling with oral supplements definitely gives a benefit in improving appetite, weight gain, energy intake, and QOL separately. Both group of patients tolerated the chemotherapy and its toxicity well and completed the course without any delay. In conclusion, all patients with lung cancer definitely need dietary counselling at least to improve the weight gain and treatment tolerability.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Nutritional assessment, Intervention, lung cancer patients, undergoing treatment.
Subjects: MEDICAL > Medical Oncology
Depositing User: Kambaraman B
Date Deposited: 13 Jan 2020 03:06
Last Modified: 13 Jan 2020 03:06

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