scholarly journals Effect of Chocolate on Older Cancer Patients in Palliative Care: A Randomised Controlled Study

Author(s):  
Josiane C. Vettori ◽  
Luanda G. da-Silva ◽  
Karina Pfrimer ◽  
Jordão-Junior Alceu A ◽  
Paulo Louzada-Junior ◽  
...  

Abstract Background Older advanced stage cancer patients, with changes in metabolic and nutritional status, represent an important demand for palliative care. The objective of the present study was to determine the effects of 4 weeks of chocolate consumption on the nutritional status, quality of life, body composition, oxidative stress and inflammaory activity of older cancer patients in palliative care. Methods Older cancer patients in palliative care with ambulatory monitoring were randomized to the following groups: control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks of treatment for nutritional status, food consumption, anthropometry, body composition, and laboratory parameters, and quality of life using the instrument of the European Organization for the Research and Treatment of Cancer. Results IG1 progressed with increased screening (p < 0.01) and nutritional (p = 0.04) scores on the Mini Nutritional Assessment tool. Anthropometry and body composition did not change. Regarding antioxidant capacity, reduced glutathione levels increased in IG2 (p = 0.04) and were higher than in IG1 (p < 0.01). Malondealdehyde levels were reduced in IG2 (p = 0.02) at the end of the study. Regarding quality of life, functionality improved in IG1, with a higher score in the functional domain (p = 0.03), and in the role functioning (p < 0.01) and in the social (p < 0.01) subdomains. Conclusions The consumption of chocolate with a greater cocoa content may contribute to the improvement of nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. Trial registration: ClinicalTrials.gov NCT04367493 - April 29, 2020. Retrospectively registered.

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Josiane C. Vettori ◽  
Luanda G. da-Silva ◽  
Karina Pfrimer ◽  
Alceu A. Jordão ◽  
Paulo Louzada-Junior ◽  
...  

Abstract Background Older advanced stage cancer patients, with changes in nutritional status, represent an important demand for palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutritional status of older cancer patients in palliative care. Methods Older cancer patients in palliative care with ambulatory (n = 46) monitoring were randomized to control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks for nutritional status (primary outcome), evaluated by the Mini Nutritional Assessment tool (MNA). Food consumption, anthropometry, body composition, laboratory parameters and quality of life (QL) with the European Organization for the Research and Treatment of Cancer instrument were also evaluated. Results IG1 progressed with increased screening (estimated difference [95% CI]: − 1.3 [− 2.2;-0.4], p < 0.01), and nutritional (estimated difference [95% CI]: − 1.3 [− 2.5;-0.1], p = 0.04) scores on the MNA, with no change in anthropometry and body composition. Regarding antioxidant capacity, reduced glutathione levels increased (estimated difference [95% CI]: − 0.8 [− 1.6;-0.02], p = 0.04) and malondealdehyde levels decreased in IG2 (estimated difference [95% CI]:+ 4.9 [+ 0.7;+ 9.1], p = 0.02). Regarding QL, functionality improved in IG1, with higher score in the functional domain (estimated difference [95% CI]:-7.0 [− 13.3;-0.7], p = 0.03). Conclusions The consumption of chocolate with a greater cocoa content may contribute to the improvement of the nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. Trial registration A randomized clinical trial (ClinicalTrials.gov NCT04367493).


Open Medicine ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 348-357 ◽  
Author(s):  
Hubert Jocham ◽  
Theo Dassen ◽  
Guy Widdershoven ◽  
Ruud Halfens

AbstractPalliative care aims at improving the patient’s quality of life. The assessment of this quality of life (QoL) is crucial for the evaluation of palliative care outcome. Many patients require hospital admissions for symptom control during their cancer journey and most of them die in hospitals, although they would like to stay at home until the end of their lives. In 1986, the European Organization for Research and Treatment (EORTC) initiated a research programme to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. This questionnaire measures cancer patients’ physical, psychological and social functions and was used in a wide range of clinical cancer trials with large numbers of research groups and also in various other non-trial studies. The aim of this study was to evaluate the psychometric properties, especially the reliability, validity and applicability of the EORTC QLQ-C30 in a German sample of terminally ill cancer patients receiving palliative care in different settings. The questionnaire was well accepted in the present patient population. Scale reliability was good (pre-treatment 0.80) especially for the functional scale. The results support the reliability and validity of the QLQ-C30 (version 3.0) as a measure of the health-related quality of life in German cancer patients receiving palliative care treatment.


2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 184-184
Author(s):  
Marie Anne Flannery ◽  
Chintan Pandya ◽  
Mohamedtaki Abdulaziz Tejani ◽  
Charles Stewart Kamen ◽  
Allison Magnuson ◽  
...  

184 Background: Although extensive descriptive work has been conducted on the symptom experience in cancer, relatively little is known about the specific palliative care needs for geriatric oncology populations. When all age groups are studied older individuals report less symptoms and the symptom experience of older cancer patients is minimized. Utilizing data collected from two geriatric oncology referral clinics the primary aim of this study was to identify geriatric oncology patients’ symptom reports, the number of symptoms experienced, and interference reported from symptoms. Methods: Patients referred to a geriatric oncology consult clinic were asked to complete the MD Anderson Symptom Inventory (MDASI) total of 13 items. In addition all patients underwent comprehensive geriatric assessment with a battery of tests. Results: 192 patients completed the symptom inventory with a median age of 81 years (range 65-95). 94% of patients reported at least one symptom, >45% reported experiencing 10 of the 13 symptoms (mean number of symptoms =5.7, SD= 3.7). Most frequently reported symptoms were in order: drowsiness, trouble remembering, dry mouth, disturbed sleep, pain, distress, decreased appetitive, dyspnea, and sadness. Severity ratings for individual symptoms M’s= 0.3-2.5, although the complete range of 0-10 was reported. 67% of patients reported that symptoms were interfering with their quality of life, general activity level and walking ability. Conclusions: In contrast to the myth that older cancer patients have minimal symptoms, at time of referral to a geriatric oncology consultation patients report on average experiencing six symptoms which interfere with their quality of life. There is an intersection between geriatric oncology and palliative care and these descriptive findings highlight the importance of systematic symptom assessment for older individuals with cancer to identify needed symptom relief strategies.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15508-e15508
Author(s):  
Hongli Li ◽  
Shaohua Ge ◽  
Yi Ba

e15508 Background: The incidence of gastric cancer is much higher in China than in any other country. Although the overall survival rate of patients with gastric cancer has increased due to the advancements in multimodality management. However, significant morbidity, including loss of appetite, dysphagia, nausea, and vomiting is still associated with gastric cancer patients. These symptoms have a profound impact on nutritional status and quality of life in these patients. The primary objective of the present study was to assess the nutritional status and quality of life in gastric cancer patients. Methods: A preliminary assessment of patients’ nutritional status, quality of life, and medical characteristics was conducted using the Patient Generated Subjective Global Assessment (PG-SGA) and the European Organization for Research and Treatment of Cancer quality of life (QOL-C30, version 3) questionnaires. The PG-SGA is a clinical nutrition assessment tool used to evaluate oncology patients. The nutritional status of the patients fell into three groups by a score of PG-SGA-A, -B, and C. Results: A preliminary assessment of patients’ nutritional status, quality of life, and medical characteristics was conducted using the Patient Generated Subjective Global Assessment (PG-SGA) and the European Organization for Research and Treatment of Cancer quality of life (QOL-C30, version 3) questionnaires. The PG-SGA is a clinical nutrition assessment tool used to evaluate oncology patients. The nutritional status of the patients fell into three groups by a score of PG-SGA-A, -B, and C. Conclusions: These results suggest that the nutritional status of the patients with stomach cancer may impact on their QoL. It is necessary to develop nutritional intervention to improve QoL in gastric cancer patients.


2021 ◽  
Vol 27 (5) ◽  
pp. 459-466
Author(s):  
Manal Badrasawi ◽  
Aseel Al-Adhame ◽  
Aseel Doufish

Background: Malnutrition is significantly associated with poor clinical outcomes and reduced quality of life among cancer patients. Although the number of cancer patients receiving chemotherapy has increased in Palestine, there has been limited research on the relationship between malnutrition and quality of life. Aims: To determine the relationship between nutritional status and quality of life of cancer patients receiving chemotherapy at Al-Hussein Governmental Hospital in Biet-Jala, Palestine. Methods: This cross-sectional study included all the patients receiving chemotherapy between 2018 and 2019. Nutritional status was assessed using anthropometric measurements and biochemical data retrieved from the participating patients’ files. The clinical assessment of malnutrition was done using the Subjective Global Assessment, and quality of life was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire version 3. Results: One hundred patients (79 female, 21 male) were included in the final analysis. The results revealed that 25% of the patients were severely malnourished, and 42% were mildly to moderately malnourished. There was a significant relationship between malnutrition and quality of life in the following domains: physical functioning, cognitive functioning and fatigue. Conclusions: Malnutrition is prevalent among Palestinian cancer patients receiving chemotherapy, and it is associated with poor quality of life. The results of the study highlight the need for nutritional support programmes for cancer patients to enhance their nutritional status and improve their quality of life.


2020 ◽  
Author(s):  
Kaźmierczak-Siedlecka Karolina ◽  
Marcin Folwarski ◽  
Jakub Ruszkowski ◽  
Karolina Skonieczna-Żydecka ◽  
Waldemar Szafrański ◽  
...  

Abstract BackgroundSeveral human trials have confirmed that Lactobacillus plantarum 299v (Lp299v) relief the gastrointestinal symptoms observed in patients with irritable bowel syndrome, such as nausea, vomiting, and diarrhoea. These symptoms are similar to those associated with home enteral nutrition and they affect nutritional status as well as patients’ quality of life.MethodsThe current double-blind, randomized, and placebo-controlled study included 35 cancer patients receiving home enteral nutrition. There were 2 groups of participants consuming either 2 × 1010 CFU of Lp299v (n = 21) or placebo (n = 14) for 4 weeks. The aims of this study were to determine the effect of Lp299v on nutritional status, enteral formula tolerance, and quality of life in cancer patients.ResultsAn increase in serum albumin concentration was significantly higher in the Lp299v group than in the placebo group at the endpoint (p = 0.032). Moreover, the changes in the frequency of vomiting and flatulence were significantly reduced at week 4 compared to baseline in the Lp299v group (p = 0.0117). The improvement of quality of life was observed in both groups; however, with no statistically significant differences between the analysed groups (p > 0.05).ConclusionsWe have demonstrated that administration of Lp299v in cancer patients receiving home enteral nutrition may improve laboratory parameters, predominantly the concentration of albumin, however, overall it does not have an impact on nutritional status. Lp299v may reduce the gastrointestinal symptoms related to enteral nutrition; notwithstanding, the improvement of quality of life may be the result of enteral nutrition rather than the effect of administration of Lp299v.Trial registration ClinicalTrials.gov (identifier: NCT03940768)


Author(s):  
Lorenzo Anelli ◽  
Alessia Di Nardo ◽  
Massimo Bonucci

Abstract Introduction A retrospective clinical study was performed to identify the characteristics of patients with lung cancer treated with integrative cancer treatment in addition to conventional medicine. Materials and Methods We reviewed medical records for lung cancer patients who visited a single integrative setting in Rome, Italy. A total of 57 patients were included, and the majority had advanced-stage cancer. All of them underwent integrative therapy with nutrition and phytotherapy indications. The diet was designed to reduce most of possible factors promoting cancer proliferation, inflammation, and obesity. Foods with anti-inflammatory, prebiotic, antioxidant, and anticancer properties had been chosen. Herbal supplements with known effects on lung cancer were prescribed. In particular, astragal, apigenine, fucosterol, polydatin, epigallocatechin gallate, cannabis, curcumin, and inositol were used. Furthermore, medical mushrooms and other substances were used to improve the immune system and to reduce chemotherapy side effects. Five key parameters have been evaluated for 2 years starting at the first surgery: nutritional status, immune status, discontinuation of therapy, quality of life, and prognosis of the disease. Results A relevant improvement in parameters relative to nutritional status, immune status, and quality of life has been observed after integrative therapy compared with the same parameters at the first medical visit before starting such approach. Conclusion The results suggest that integrative therapy may have benefits in patients with lung cancer. Even though there are limitations, the study suggests that integrative therapy could improve nutritional status and quality of life, with possible positive effect on overall survival.


2004 ◽  
Vol 2 (2) ◽  
pp. 115-124 ◽  
Author(s):  
JÖRG DIRMAIER ◽  
SILKE ZAUN ◽  
UWE KOCH ◽  
TIMO HARFST ◽  
HOLGER SCHULZ

Objective: Recent years have shown an increase in the use of questionnaires measuring health-related quality of life to verify the quality of treatment in the field of oncology. An often used cancer-specific questionnaire is the “Quality of Life Core Questionnaire of the European Organization for the Research and Treatment of Cancer” (EORTC QLQ-C30). The purpose of this study is to analyze the psychometric properties of the EORTC QLQ-C30 (version 1) in order to determine the feasibility and appropriateness for its use in inpatient cancer rehabilitation in Germany with heterogeneous diagnoses.Methods: The questionnaire was administrated to a sample of 972 cancer patients at the beginning of treatment and to 892 patients after treatment. Besides descriptive analysis, the statistical analyses include confirmatory analysis and the multitrait/multimethod approach to test the questionnaire's postulated scale structure (factorial validity) and its reliability (internal consistencies). The analysis also includes a comparison of responsiveness indices (effect size, reliable change index) to test the sensitivity of the instrument.Results: The EORTC QLQ-C30 showed satisfactory levels of reliability and sensitivity, but the postulated scale structure could not be confirmed. The results illustrate that the varimax-rotated solution of a principal component analysis does not confirm the scale structure postulated by the authors. Correspondingly, the selected fit indices within the scope of the confirmatory factor analysis do not show satisfactory results either.Significance of results: We therefore consider version 1 of the EORTC QLQ-C30 to be only limitedly useful for the routine assessment of changes in the quality of life of cancer patients in inpatient rehabilitation in Germany, especially because of the instrument's length and possible redundancies. For this reason, a scoring procedure limited to a subset of items is suggested, revealing satisfactory to good psychometric indices. However, further psychometric tests are necessary, especially with regard to validity and sensitivity.


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