Cancer patients who are malnourished experience significantly greater levels of psychological distress than those who are more adequately nourished, according to new results reported at the European Society for Medical Oncology's Symposium on Cancer and Nutrition (Zurich, 20-21 March 2009).
Malnutrition is a common problem in cancer. It is estimated that between 31% and 87% of cancer patients will experience weight loss and malnutrition during the course of their disease. Such patients are left with a poorer response to treatment, worse quality of life and reduced survival. Yet the problem often remains undiagnosed and untreated.
Dr Shafia Amdouni, from the Cancer Nutrition Rehabilitation Program at Canada's McGill University Health Center, and colleagues set out to study the relationship between malnutrition and psychological distress in patients who were taking part in a cancer nutrition rehabilitation program.
They studied 213 patients with advanced cancer, asking them to assess their own nutrition status and their distress.
Nutrition was measured using a patient-generated subjective global assessment, which calculates a grouping of nutritional scores after combining information from food intake, weight change, nutrition-related symptoms, and performance status and categorizes patients into three distinctive classes of nutritional status. Distress was measured using a 'distress thermometer', a self-reported measure using an 11-point scale from 0 (no distress) to 10 (extreme distress).
The researchers found that the score on the distress thermometer was positively correlated with the total score of the patient-generated subjective global assessment. The higher the distress, the worse the patient's nutrition status.
"Our data suggest that nutrition status may contribute to the level of distress in patients with cancer," Dr Amdouni says. "Evaluation of the nutrition status should be included in the evaluation of distress experienced by these patients."
Ideally, patients should be seen by a clinical nutritionist or a clinical dietician, the researchers say.