Dietitian encounters after treatment for ovarian cancer

Abstract

Background: After ovarian cancer treatment, women report health issues that may be amenable to change with dietary support. The present study investigated how many women encounter a dietitian post-treatment and the factors associated with dietitian service use. Methods:We used data from a cohort of women with invasive epithelial ovarian cancer to identify socio-economic, clinical and personal factors associated with dietitian encounter after treatment completion. Data were collected at regular intervals using validated questionnaires up to 4 years post-treatment completion. Logistic regression (LR) and generalised linear mixed models (GLMM) were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess factors associated with dietitian encounter at any time-point post-treatment (LR), as well as in the 3 months prior to a follow-up questionnaire (GLMM) to assess time-varying factors.Results: Of 819 women, 97 (12%) reported seeing a dietitian post-treatment. Factors associated with dietitian encounter were being overweight (OR LR = 1.7, CI = 1.1-2.8), having poorer self-rated health (OR LR = 2.5, CI = 1.2-5.2; OR GLMM = 2.3, CI = 1.2-4.4) or poorer diet quality (OR LR = 0.5, CI = 0.2-1.0) pre-diagnosis, treatment within the public health system (OR GLMM = 1.8, CI = 1.2-2.7), previous support from dietetic (OR LR = 3.1, CI = 1.8-5.4; OR GLMM = 2.8, CI = 1.8-4.2) or other allied health services (OR LR = 2.0, CI = 1.2-3.2; OR GLMM = 3.7, CI = 2.4-5.5), and having progressive disease at follow-up (OR GLMM = 2.2, CI = 1.4-3.3). Most women (86%) with ≥ 3 moderate-to-severe nutrition impact symptoms did not report a dietitian encounter post-treatment.Conclusions: Few women encounter a dietitian post-treatment for ovarian cancer, including those with multiple nutrition impact symptoms. Further work is needed to engage those likely to benefit from dietitian support but less likely to seek or receive it.

Dietary Practices After Primary Treatment for Ovarian Cancer: A Qualitative Analysis From the OPAL Study

“…Those who reported advice from a dietitian were mostly women with disease recurrence who received information to manage poor appetite and unintentional weight loss. This is supported by a previous analysis of this cohort, 23 which identified that women with progressive disease at follow-up were significantly more likely to report seeing a dietitian in the previous 3 months, after adjusting for socioeconomic, clinical, and personal factors. The use of naturopaths for dietary information was most commonly reported by women undergoing further treatment; in a qualitative study of endometrial cancer survivors, CAM practitioners were sought for assistance with symptom management and were perceived to provide a more personalized approach than conventional health professionals.…”

“…Participant recruitment for the OPAL (Ovarian Cancer Prognosis and Lifestyle) Study has been described elsewhere. 23 Briefly, the OPAL Study is a national prospective cohort of 958 women in Australia (aged 18 to 79 years) diagnosed with invasive epithelial ovarian cancer (henceforth ovarian cancer) between January 2012 and May 2015. The study was approved by the Human Research Ethics Committees of QIMR Berghofer Medical Research Institute and all participating centers (n ¼ 18).…”

Mental health and diet quality after primary treatment for ovarian cancer

“…Recruitment methods and eligibility have been described elsewhere. 10 A total of 958 women consented to participate. Health, lifestyle, and quality of life data were collected via self-administered questionnaires at first recruitment (as soon as possible after diagnosis), then again at 3-month intervals during the first year postdiagnosis, and then annually up to 4 years.…”

“…7,8 Previous research suggests many women with ovarian cancer may experience a decline in nutritional status, with malnutrition rates as high as 67% during active treatment, 9 and one in three women reporting ongoing nutrition impact symptoms in the acute post-treatment period. 10 Following treatment completion, international cancer agencies recommend people adhere to dietary recommendations for cancer prevention. 11 These include eating a diet rich in wholegrains, vegetables, fruit, and beans, with limited consumption of red and processed meats, ultra-processed foods, sweetened beverages, and alcohol.…”

Igniting your passion for research impact and success: A guide for early career nutrition researchers!

“…Many of the original research papers published in this issue of Nutrition & Dietetics have been contributed by early-career researchers, often supported by more senior researchers. [17][18][19][20][21][22][23][24][25] Network. The definition of networking is 'to try to meet and talk to people who may be useful to you in your work'.…”