Cancer Anorexia and Cachexia: Screening in an Ambulatory Infusion Service and Nutrition Consultation

Berry, Donna L.; Blonquist, Traci M.; Nayak, Manan M.; Röper, Kristin; Hilton, Nancy; Lombard, Heidi; Hester, Allison; Chiavacci, Anne; Meyers, Stephanie; McManus, Katherine

doi:10.1188/18.cjon.63-68

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…For example, while the MSAS includes the items ‘weight loss’ and ‘lack of appetite,’ for our studies, weight gain and increased appetite were added. This cluster is an example of how the specific symptoms on an inventory may allow for the identification of different symptom clusters based on the type of cancer (eg, weight gain in women with breast cancer24 and/or stage of disease (eg, cachexia in patients with lung cancer) 28…”

Section: Discussionmentioning

confidence: 99%

Symptom clusters in oncology outpatients: stability and consistency across a cycle of chemotherapy

Harris

Kober

Cooper

et al. 2022

BMJ Support Palliat Care

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ObjectivesImproved understanding of the stability and consistency of symptom clusters across time, symptom dimensions and cancer diagnoses will lead to refinements in symptom assessments and management, and provide direction for mechanistic studies. Study purposes were to describe the occurrence, severity and distress of 38 symptoms; evaluate the stability and consistency of symptom clusters across a cycle of chemotherapy, three symptom dimensions and four distinct cancer types; and identify common and distinct symptom clusters.MethodsOncology outpatients (n=1329) completed the Memorial Symptom Assessment Scale prior to their next cycle of chemotherapy (T1), 1 week after chemotherapy (T2) and 2 weeks after chemotherapy (T3). Symptom clusters were identified using exploratory factor analysis using unweighted least squares. GEOMIN rotated factor loadings with absolute values ≥0.40 were considered meaningful. Clusters were stable if they were identified across each time point and/or dimension. Clusters were consistent if the same two or three symptoms with the highest factor loadings were identified across each time point and/or dimension.ResultsPatients reported 13.9 (±7.2) symptoms at T1, 14.0 (±7.0) at T2 and 12.2 (±6.8) at T3. Psychological, weight gain, gastrointestinal and respiratory clusters were stable across time and dimensions. Only the psychological, weight gain and respiratory clusters were consistent across time and dimensions.ConclusionGiven the stability of the psychological, weight gain and gastrointestinal clusters across cancer diagnoses, symptoms within these clusters need to be routinely assessed. However, respiratory and hormonal clusters are unique to specific cancer types and the symptoms within these clusters are variable.

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Section: Discussionmentioning

confidence: 99%

Symptom clusters in oncology outpatients: stability and consistency across a cycle of chemotherapy

Harris

Kober

Cooper

et al. 2022

BMJ Support Palliat Care

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“…However, only some single items or subscales of these tools can be used for cancer cachexia assessment. [ 10 ] Recently, a cancer cachexia-specific questionnaire, the QLQ-CAX24, was developed to assess the symptoms and biometrics of patients with cancer cachexia more comprehensively. This measurement tool contains five multi-item scales (food aversion, eating and weight loss worry, eating difficulties, loss of control, and physical decline) and four single items;[ 29 ] it has been widely used by nurses and other medical staff where it is combined with objective measures (24-h recall collection of diaries of food consumption, 6-min walk test (6MWT), muscle strength, etc.)…”

Section: Clinical Approaches For Cancer Cachexia Treatment In Multidisciplinary Settingsmentioning

confidence: 99%

“…implemented a screening intervention for cancer anorexia and cachexia in the thoracic infusion services of the Cancer Institute. [ 10 ] The nurses at this institute demonstrated that they have the ability to classify nutritional status so long as appropriate tools are provided to them; in this intervention, more than 50% of patients who were detected to be in a moderate-to-severe risk category for cancer cachexia were referred to for nutrition services. Furthermore, the multimodal therapy of cancer cachexia can be completed in collaboration with different departments and experts; therefore, it is difficult to determine who will be the next specialist to meet with the patient.…”

Section: The Role Of Nurses In a Multidisciplinary Cancer Cachexia Care Teammentioning

confidence: 99%

“…Certain types of cancer are more likely to develop cachexia, such as head-and-neck cancer, upper gastrointestinal track cancer, and lung cancer. [ 7 8 ] The prevalence of cachexia is high in patients with gastric and pancreatic cancer (80%),[ 9 ] thoracic cancer (50%),[ 10 ] and newly diagnosed head-and-neck cancer (42%);[ 8 ] whereas patients with breast cancer and leukemia have a lower prevalence of cachexia. Furthermore, men are more susceptible to this condition than women.…”

Section: Introductionmentioning

confidence: 99%

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The Role of Nurse in the Multidisciplinary Management of Cancer Cachexia

Zhao

Pang

2021

Asia-Pacific Journal of Oncology Nursing

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“…[ 2 ] There is not a specific cancer cachexia assessment tool, but a few have been suggested including the Edmonton Symptom Assessment Scale, the abridged patient-generated subjective assessment, the malnutrition-screening tool, the mini-nutritional assessment, and the 12-item Anorexia/Cachexia Scale (A/CS-12) among others. [ 11 20 34 35 ] Diagnosis of precachexia is made based on the criteria described in the international consensus described in Table 1 .…”

Section: Clinical Framework For Quality Care In Cancer Cachexia: An Imentioning

confidence: 99%

Clinical Framework for Quality Improvement of Cancer Cachexia

Granda-Cameron

Lynch

2018

Asia-Pacific Journal of Oncology Nursing

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The objective of this article is to introduce the Clinical Framework for Quality Improvement of Cancer Cachexia (Cachexia Care Framework) as a tool to demonstrate the relevance of integrating the clinical components of cancer cachexia and the organizational strategies of a cancer institution on the quality of patient care and delivery of services throughout the cancer cachexia continuum. The data sources included peer-reviewed literature relevant to cancer cachexia and quality cancer care, and the authors’ expertise. The Cachexia Care Framework results from a combination of the international consensus definition of cancer cachexia, the Institute of Medicine report Ensuring Quality Cancer Care, and the authors’ experience with a cancer cachexia clinic. This framework is proposed as a guidance for oncology nurses and other healthcare providers to improve the quality of care of cancer cachexia patients. Specifically, the framework can be used by oncology nurses involved in the care of patients diagnosed with cancer cachexia either in direct patient care, administration, research, or education. Nurses can use the framework in clinical practice to identify specific assessments and interventions based on the cachexia stage of the patient; in nursing administration, the framework offers a wide view of potential errors that can happen and the opportunity to prevent them; in nursing research, the framework illustrates the several factors and processes that can impact patient outcomes; and in nursing education, the framework outlines the elements necessary to develop and implement a continuum education curriculum to educate the workforce of oncology nurses, and in the academic setting, an interprofessional curriculum to educate nurses and many other healthcare disciplines.

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Cancer Anorexia and Cachexia: Screening in an Ambulatory Infusion Service and Nutrition Consultation

Abstract: 90 participants enrolled, and 46 scored in a moderate-to-severe-risk category; of those, 42 were referred to nutrition services.

Cited by 7 publications

References 27 publications

Symptom clusters in oncology outpatients: stability and consistency across a cycle of chemotherapy

Symptom clusters in oncology outpatients: stability and consistency across a cycle of chemotherapy

The Role of Nurse in the Multidisciplinary Management of Cancer Cachexia

Clinical Framework for Quality Improvement of Cancer Cachexia

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