Diet-Induced Thermogenesis in Patients with Gastrointestinal Cancer Cachexia

1989 ◽  
Vol 77 (2) ◽  
pp. 133-138 ◽  
Author(s):  
P. M. T. Weston ◽  
R. F. G. J. King ◽  
A. W. Goode ◽  
N. S. Williams
Keyword(s):  
Weight Loss ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Gastrointestinal Disease ◽  
Dietary Assessment ◽  
Resting Energy Expenditure ◽  
Control Group ◽  
Significant Difference ◽  
Diet Induced Thermogenesis ◽  
Daily Intakes

1. Indirect calorimetry has been used to measure resting energy expenditure (REE) and the thermogenic response to a test meal (diet-induced thermogenesis) in groups of weight-stable and weight-losing patients with gastrointestinal adenocarcinoma. Average daily intakes of energy and protein were computed from dietary assessment for the week before hospitalization. Results were compared with a control group of patients with benign gastrointestinal disease. 2. Weight-losing cancer patients had a significantly reduced mean total energy and protein intake. 3. There was no significant difference in REE between the groups when results were normalized in terms of metabolic body size (kJ/kg 0.75) and lean body mass (kJ/kg). 4. Diet-induced thermogenesis was reduced in weight-losing cancer patients. 5. It is suggested that the reduction of diet-induced thermogenesis in weight-losing cancer patients is another element of starvation adaptation, subsequent to their weight loss, and that altered thermogenesis does not contribute to the weight loss seen in cancer cachexia.

scholarly journals Influence of dexamethasone on appetite and body weight in lung cancer patients

2008 ◽  
Vol 61 (11-12) ◽  
pp. 571-575 ◽  
Author(s):  
Tatjana Sarcev ◽  
Nevena Secen ◽  
Ana Sabo ◽  
Djordje Povazan
Keyword(s):  
Lung Cancer ◽  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Appetite Loss ◽  
Lung Cancer Patients ◽  
Randomized Controlled Studies ◽  
Significant Difference ◽  
Group A

Introduction Anorexia and cachexia are the most common symptoms in cancer patients. They increase morbidity and mortality among cancer patients as well as complications of surgery, radiotherapy and chemotherapy. The most common drugs for treatment of cancer cachexia are corticosteroids and megestrol acetate. Material and Methods The purpose of this study was to determine the influence of dexamethasone on appetite loss and weight loss in lung cancer patients treated with chemotherapy. Group A (30 patients) was treated with cisplatin, etoposide and standard supportive therapy, while group B (30 patients) received, in addition to this treatment, dexamethasone in the dose of 8 mg intravenously per day (1-3 day of chemotherapy). Results There was a statistically significant difference in appetite loss between two groups after the second chemotherapy cycle favoring group A. The analysis of weight loss showed a statistically significant difference between two groups after both chemotherapy cycles, once again in favor of group A. Concerning the improvement of appetite and weight gain, there was no statistically significant difference between two groups after both chemotherapy cycles. Discussion Many double-blind randomized controlled studies showed beneficial symptomatic effect of corticosteroids in cancer cachexia, especially on the improvement of appetite, food intake and performance status. In most of the studies the weight gain was not recorded. The most effective type of corticosteroids, dose and route of administration have not been established. Conclusion Dexamethasone significantly decreases appetite loss and weight loss in lung cancer patients treated with chemotherapy, while it has no influence on appetite improvement and weight gain.

The effect of foot reflexology on chemotherapy-induced nausea and vomiting in digestive or lung cancer patients: a randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Audrey Murat-Ringot ◽  
Pierre Jean Souquet ◽  
Fabien Subtil ◽  
Florent Boutitie ◽  
Marie Preau ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Controlled Trial ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Digestive Cancer ◽  
Complementary Medicines ◽  
Antiemetic Drugs ◽  
Platinum Based Chemotherapy ◽  
Significant Difference ◽  
Delayed Nausea

BACKGROUND Cancer is a chronic disease with an incident worldwide had been 24.5 million and 9.6 million deaths in 2017. Lung and colorectal cancer are the most common cancer for both sexes and according to national and international recommendations platinum-based chemotherapy is the reference adjuvant treatment. This chemotherapy can be moderately to highly emetogenic. Despite antiemetic therapy, chemotherapy-induced nausea and vomiting may persist. Moreover, cancer patient are increasingly interested in alternative and complementary medicines and express the desire that non-pharmacological treatments be used in hospitals. Among alternative and complementary medicines, foot reflexology decreases significantly the severity of chemotherapy-induced nausea and vomiting in breast cancer patients. OBJECTIVE The primary objective of the present study was to assess the benefits of foot reflexology as a complement to conventional treatments on severity of acute chemotherapy-induced nausea and vomiting in digestive or lung cancer patients. The secondary objectives assessed were the frequency and severity of delayed chemotherapy-induced nausea and vomiting, quality of life, anxiety, and self-esteem. METHODS The present study was conducted between April 2018 and April 2020 in French University Hospital. This is an open-label randomized controlled trial. Participants are randomized into two groups: 40 to interventional group (conventional care with foot reflexology) and 40 to control group (conventional care without foot reflexology). Foot reflexology sessions (30 minutes) are performed on an outpatient or inpatient. Eligible participants are patients with a lung or digestive cancer with indication for platinum-based chemotherapy. RESULTS The severity of acute nausea and vomiting was assessed with a visual analogue scale during the second cycle of chemotherapy. A significant increase of at least 2 points was observed for control group (20.6%, P = 0.01). Across all cycle, the foot reflexology group showed a trend towards less frequent delayed nausea (P=0.28), a significantly less frequent consumption of antiemetic drugs (P=0.04), and no significant difference for vomiting (P=0.99); there was a trend towards a perception of stronger severity for delayed nausea in the control group (P=0.39). According to quality of life and anxiety, there was no significant difference between the interventional group and the control group (P=0.32 and P=0.53 respectively). CONCLUSIONS In conclusion, the present study results indicated that foot reflexology decreased significantly the severity of acute nausea and consumption of antiemetic drugs in lung and digestive cancer patients. No side effects from foot reflexology have been noted. In order to better respond to a desire of patients for non-pharmacological treatments and CAMs to be used in hospitals to improve their care, the results of this study showed that foot reflexology seems to be a promising complement to conventional antiemetic drugs. To assess the performance of this intervention in routine practice, a larger study with several health care centers would be relevant with a cluster RCT. CLINICALTRIAL The present study registered with clinicaltrials.gov: NCT03508180 (28/06/2018) INTERNATIONAL REGISTERED REPORT RR2-10.2196/17232

scholarly journals Malnutrition and cancer, diagnosis and treatment

2021 ◽  
Author(s):  
Angelika Beirer
Keyword(s):  
Weight Loss ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Screening Tool ◽  
Psychological Treatment ◽  
Early Stage ◽  
Nutritional Therapy ◽  
German Society ◽  
Fat Free Mass ◽  
Nutritional Risk

Summary Background The prevalence of malnutrition in cancer patients ranges from about 20% to more than 70%. However, 10–20% of cancer patients’ deaths are related to malnutrition, not the malignancy itself. To reverse the pattern of weight loss, improve the patients’ quality of life, reduce the treatment toxicity, the psychological stress and the risk of mortality, the diagnosis of malnutrition should be made as early as possible to facilitate the best possible treatment. Methods A systematic literature search was conducted following guidelines of ESPEN (European Society for Clinical Nutrition), DGEM (German Society for Nutritional Medicine) and ASPEN (American Society for Parenteral and Enteral Nutrition). Results and conclusion To assess the risk of malnutrition, all cancer patients should be screened regularly with a valid screening tool (e.g., MUST [Malnutrition Universal Screening Tool], NRS [Nutritional Risk Screening] or PG-SGA [Scored Patient-Generated Subjective Global Assessment]). If risk of malnutrition is present, adequate nutritional therapy is recommended to stop involuntary weight loss. Patients should engage in exercise to maintain and improve muscle mass, strength and function. They should be offered regular dietetic counselling, and their muscle depletion should be monitored by determining fat-free mass. As cachectic patients in particular are at risk, the presence of cachexia should also be recognized at an early stage. Three consensus-based definitions are widely accepted: Fearon et al. and the EPCRC (European Palliative Care Research Collaborative) propose definitions specifically for cancer cachexia, while Evans et al. put forward a definition for cachexia associated with all types of underlying chronic diseases. However, if there is a cancer cachexia diagnosis, additional pharmacological and psychological treatment should be considered.

Exploring The Clinical Significance of Serum Angiopoietin-2 In Breast Cancer Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Abeer I Abd Elmagid ◽  
Hala Abdel Al ◽  
Wessam El Sayed Saad ◽  
Seham Kamal Mohamed
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Serum Levels ◽  
Tnm Staging ◽  
Control Group ◽  
Healthy Controls ◽  
Breast Cancer Patients ◽  
Female Patients ◽  
Significant Difference ◽  
Angiopoietin 2

Abstract Background Breast cancer is the most common cancer among women and one of the most important causes of death among them.Angiogenesis is an important step for primary tumor growth, invasiveness, and metastases. Angiopoietins are well-recognized endothelial growth factors that are involved in angiogenesis associated with tumors. Aim To explore the diagnostic significance of serum angiopoietin-2 (Ang-2) in breast cancer and to evaluate its prognostic efficacy through studying the degree of its association with the TNM staging of the disease. Patients and Methods This study was conducted on (35) Egyptian female patients who were diagnosed as breast cancer according to histopathological examination of breast biopsy (Group 1, Breast Cancer Patients) and (25) female patients with benign breast diseases (Group II, Pathological Control Patients), in addition to (20) age - matched apparently healthy, free mammogram, females serving as healthy controls (Group III, Healthy Controls). For all participants, measurement of serum Ang-2 was done using enzyme linked immunosorbent assay (ELISA) technique. Results A highly significant increased levels of Ang-2 was observed in breast cancer patients when compared to healthy control group (Z = 4.95, p < 0.01). However, no significant difference was observed in Ang-2 levels between breast cancer patients group and pathological control group (Z = 3.37, p > 0.05). No significant difference was detected in Ang-2 levels in relation to TNM stage and histological grade. No significant correlation was found between Ang-2 levels and serum levels of CA15-3, hormone receptors, HER2/new receptor status (p > 0.05, respectively). Conclusion This study revealed that Ang-2 serum levels were significantly increased in patient with breast cancer compared with healthy controls, indicating that high Ang-2 level is a promising non invasive biomarker for breast cancer diagnosis. However, no significant difference of Ang-2 levels was detected in relation of breast TNM staging in the population studied.

scholarly journals EFFECT OF MINDFULNESS INTERVENTION ON THE INTENSITY OF PAIN IN NASOPHARINGEAL CANCER PATIENTS UNDERGOING RADIATION TREATMENT

2018 ◽  
Vol 4 (2) ◽  
pp. 195-201
Author(s):  
Anna Jumatul Laely ◽  
Awal Prasetyo ◽  
Chandra Bagus Ropyanto
Keyword(s):  
Cancer Patients ◽  
Radiation Treatment ◽  
Nasopharyngeal Cancer ◽  
Psychological Trauma ◽  
Control Group ◽  
Intensity Level ◽  
Control Group Design ◽  
Mindfulness Intervention ◽  
Significant Difference ◽  
Before And After

Background: Physical responses that occur in patients with nasopharyngeal cancer are the emergence of pain due to the effects of treatment. The problem of pain in these patients at the stage of treatment remains critical to solve because it can cause comorbidity, psychological trauma and mortality. Mindfulness intervention is considered useful in transforming consciousness into the stage of acceptance.Objective: This study aims to determine the effect of mindfulness intervention on the intensity of pain in nasopharyngeal cancer patients undergoing radiation treatment.Methods: This was a quasy-experimental study with pretest posttest control group design. Thirty patients were selected using consecutive sampling, which divided into experiment and control group. Visual Analogue Scale (VAS) was used to measure pain. Each respondent received mindfulness intervention for 6 sessions, divided into 3 meetings. Paired t-test was used for data analysis.Results: The results showed a significant reduction of pain from 4.12 (moderate pain) to 3.06 (mild pain) in the experiment group. There was a significant difference in pain level before and after mindfulness intervention (p= 0.001).Conclusion: Mindfulness is effective in reducing pain intensity level in nasopharyngeal cancer patients undergoing radiation therapy.

scholarly journals Effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals, Bhubaneswar, Odisha

2020 ◽  
Vol 11 (1) ◽  
pp. 1165-1171
Author(s):  
Sasmita Das ◽  
Mary Preety Banra ◽  
Neethu Maria Joseph
Keyword(s):  
Cancer Patients ◽  
Research Design ◽  
Demographic Data ◽  
Large Population ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Food Component ◽  
Significant Difference ◽  
Chi Square Analysis ◽  
And Control

A quasi-experimental research study (posttest only research design) was conducted to evaluate the effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals of Bhubaneswar and to find out the association of level of chemotherapy-induced nausea and vomiting with selected socio-demographic variables. For this study, a quantitative experimental approach and post-test only research design was adopted. 100 patients were selected by convenience sampling technique and categorized into experimental (n=50) and control group (n=50) for this study. Self- structured socio-demographic proforma and self- structured record analysis proforma was used to collect socio-demographic data and modified nausea and vomiting scale was used to measure the level of chemotherapy-induced nausea and vomiting among cancer patients. The data was analyzed by using SPSS version 20.0 (Statistical Package for the Social Science). The post-testt level of chemotherapy-induced nausea and vomiting among experimental and control groups was compared by unpaired‘t’ test and the result showed (p=<0.0001) significant difference between both groups. The chi-square analysis shows a statistically significance association between chemotherapy-induced nausea and vomiting and the emetogenic potential of the drug in both groups and in control group age was also significance associated. The ANOVA test revealed the statistically significance of the posttest level of chemotherapy-induced nausea and vomiting within groups of the emetogenic potential of a drug. The present study concluded that the food component, like ginger tea, is an effective home remedy for the reduction of chemotherapy-induced nausea and vomiting among cancer patients. Further study can be conducted with a large population, different dose and compositions of ginger and with different adjuvant therapy to manage nausea and vomiting among cancer patients.

Radiation Proctitis: The Potential Role of Hyaluronic Acid in the Prevention and Restoration of Any Damage to the Rectal Mucosa among Prostate Cancer Patients Submitted to Curative External Beam Radiotherapy

2021 ◽  
Vol 12 (4) ◽  
pp. 446-455
Author(s):  
Gianluca Ferini ◽  
Antonella Tripoli ◽  
Vincenza Umina ◽  
Giuseppina Rita Borzì ◽  
Valentina Anna Marchese ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Hyaluronic Acid ◽  
Cancer Patients ◽  
Radiation Proctitis ◽  
Dose Fractionation ◽  
Control Group ◽  
Consecutive Series ◽  
Median Dose ◽  
Significant Difference ◽  
Experimental Group

Aim: To evaluate if hyaluronic acid reduces proctitis episodes with respect to corticosteroids in prostate cancer patients submitted to radical or adjuvant radiotherapy. Methods: A consecutive series of eligible patients received hyaluronic acid enemas as supportive care (experimental group, from January 2013 to June 2015). A historical group (control group), treated from October 2011 to December 2012, received beclomethasone dipropionate suppositories. We registered each patient’s data regarding acute and chronic proctitis. All patients were treated with static-intensity-modulated radiotherapy coupled to a daily set-up verification with orthogonal anterior–posterior/lateral X-ray pairs. Results: A total of 269 patients, 175 in the experimental group and 94 in the control group, was evaluated; 2 Gy/day (up to a total median dose of 80 Gy) and 2.7 Gy/day (up to a total median dose of 67.5 Gy) fractionation schemes were used for 216 and 53 patients, respectively. All patients had a good tolerance to radiotherapy, reporting no G3 or greater proctitis. No significant difference was reported concerning the total rate of proctitis between the two groups but only with respect to its grade: a higher G2 rate within the control group. There was no correlation between daily dose fractionation and toxicity grade. Conclusions: Hyaluronic acid enemas might be effective in reducing the severity of radiation proctitis.

Weight and Appetite Loss in Cancer

2021 ◽  
pp. 298-302
Author(s):  
Yesne Alici ◽  
Victoria Saltz
Keyword(s):  
Cancer Patients ◽  
Cancer Cachexia ◽  
Sense Of Self ◽  
Resting Energy Expenditure ◽  
Appetite Loss ◽  
Chronic Inflammatory Response ◽  
Variable Combination ◽  
Cancer Anorexia ◽  
Cachexia Syndrome

Weight and appetite loss in cancer patients, referred to as the cancer anorexia-cachexia syndrome, is a complex, multifactorial syndrome, defined by an ongoing loss of skeletal muscle mass, with or without loss of fat mass, which cannot be fully reversed by conventional nutritional support, and may lead to progressive functional impairment. It is a hypercatabolic state in the context of chronic inflammatory response best described in the setting of cancer but can also be seen in other advanced chronic illness. Cancer cachexia occurs in approximately 50% of cancer patients, and in 80% of those with advanced cancer. It impacts adversely on function, treatment tolerability and treatment response, and health service utilization, but most importantly, dignity, sense of self, quality of life, and survival. The pathophysiology of cancer cachexia is complex and multifactorial. It is characterized by a negative protein and energy balance, driven by a variable combination of reduced food intake, increased resting energy expenditure, and net loss of lean tissue. The best approach to weight and appetite loss among cancer patients is a multimodal therapy, in which a personalized combination of pharmacologic and nonpharmacologic treatments is implemented. This chapter will provide an overview of the cancer anorexia cachexia syndrome as relevant to the practice of clinicians of all disciplines managing cancer patients.

scholarly journals Effect of Flavor Enhancement on the Appreciation of Food in Breast Cancer Patients Undergoing Chemotherapy

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 320-320
Author(s):  
Kenza Drareni ◽  
Moustafa Bensafi ◽  
Helene Lusson ◽  
Damien Vansteene ◽  
Agnès Giboreau ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hierarchical Cluster ◽  
Cross Sectional Study ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Funding Sources ◽  
Significant Difference ◽  
The Impact

Abstract Objectives Given the influence of sensory signals on food intake regulation and the subsequent nutritional status, it is important to reduce the impact of commonly observed smell and taste alterations on the pleasure of eating during chemotherapy. This study aimed to examine the effect of various types of flavor enhancement on the appreciation of an appetizer by a group of patients undergoing chemotherapy. Methods Five eggplant appetizers with no seasoning (REF) or enhanced with either salt, lemon, garlic or cumin were developed. In this cross-sectional study, 36 healthy female subjects (age 58 ± 7 y) (control group) and 84 breast cancer patients (age 56 ± 11 y) treated with chemotherapy were recruited. A hierarchical cluster analysis based on patients' self-reported smell and taste abilities classified the patients in two groups: the ‘unaltered, (high sensory abilities) n = 49’ and the ‘altered, (poor sensory abilities), n = 35’ group. Participants tasted and assessed the appreciation of the reference appetizer on a visual analog scale and performed a randomized comparative liking task, by rating the appreciation for each flavor-enhanced appetizer relative to the REF (one-sample t-test). Results There was no significant difference in the appreciation of the REF appetizer between the three groups (P &gt; 0.05). In the comparative liking task, the control group rated similarly the appreciation between the flavor-enhanced and the REF appetizers except for the cumin-enhanced appetizer, which was appreciated significantly more than the REF (P &lt; 0.001). Patients in both ‘altered’ and ‘unaltered’ groups appreciated similarly the cumin appetizer (P &gt; 0.05), more the salt and garlic-enhanced appetizers (P ≤ 0.001, P = 0.005, respectively) and significantly less the lemon-enhanced appetizer relative to the REF (P = 0.029), confirming a tendency for patients to reject acid-flavored foods. Conclusions The salt and garlic enhancements were appreciated by the patients independent of the stage of chemotherapy or the severity of smell and taste alterations. Flavor enhancement seems a good strategy to maintain the pleasure of eating in patients undergoing chemotherapy. Further research is still needed on the appreciation and intake of a complete meal (starter, main course, dessert). Funding Sources APICIL and ELIOR groups.

scholarly journals Changes in Resting Energy Expenditure following Gastric Bypass Surgery: Impact on Total Body Weight.

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Fathimath Naseer ◽  
Ruth Price ◽  
Adele McElroy ◽  
Carel Le Roux ◽  
Tamsyn Redpath ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Total Body Weight ◽  
Post Surgery ◽  
Significant Difference ◽  
Total Body ◽  
Ree Group

AbstractBariatric surgery, including Gastric Bypass (GBP) Surgery, is the most efficient modality to manage severe obesity. Resting Energy Expenditure (REE) is an area of interest in the context of weight loss (WL) as it has been postulated to be an independent predictor of WL success following GBP. As such, the aim of this study is to investigate the impact of REE on WL following GBP. 31 GBP patients (77.4% females BMI 45.5 ± 7.0kg/m2 ; 47.3 ± 11.6y) and 32 weight-stable controls (46.9% females; BMI 27.0 ± 4.6kg/m2 ; 41.1 ± 13.5y) were assessed at one-month pre-surgery and at 3 and 12-months post-surgery. Fat mass (FM) and fat-free mass (FFM) were measured using dual energy X-ray absorptiometry (Lunar iDXA, GE Healthcare). REE was measured under standardised conditions using indirect calorimetry (ECAL, Metabolic Health Solutions). Statistical analyses were performed with SPSS v24.0, Armonk, NY. Multiple regression analysis showed that FM (P = 0.001), FFM (P < 0.0001) and gender (P = 0.012) significantly predicted the interindividual variability in REE. Total body weight (TBW) was removed from the model due to collinearity. Adjusted-REE values were then generated using the above predictor variables. Low-REE and high-REE groups were created using within-group adjusted-REE split. At both follow-ups (3- and 12-months post-surgery), patients had a greater reduction in TBW, FM, FFM, measured-REE and adjusted-REE values compared with controls (P < 0.0001). There was also no significant difference between measured and adjusted-REE values at all time-points (P > 0.05). Patients with high REEs at baseline lost more TBW than those in the low-REE group at 3-months post-surgery (-24.9 ± 6.5 kg vs. -16.6 ± 7.0 kg; P = 0.005) and 12-months post-surgery (-41.3 ± 12.5 kg vs. -25.8 ± 10.4.0 kg; P = 0.003). There was no significant difference in mean TBW changes for controls in the low-and high-REE groups at both follow-ups. Patients with high REEs at 3-months post-surgery did not lose more TBW than those in the low-REE group at 12-months post-surgery (-30.1 ± 12.8 kg vs. -38.6 ± 14.4 kg; P = 0.155). Similarly, there was no difference in mean TBW reduction between controls in the low- and high-REE groups (P = 0.115). Thus while patients with a high adjusted-REE value at baseline (> 9746.6kJ/day) lost more weight at 3- and 12-months post-GBP, it is plausible that from the third to the 12th month post-surgery, other key drivers of weight loss, particularly the reduction in energy intake are more important in predicting WL. Further research with a larger sample size is required to increase the chances of detecting a true effect.

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