Weight Gain and Loss In Cancer Patients Undergoing Chemotherapy: Importance of Dose Adjustment

2021 ◽  
Vol 08 ◽  
Author(s):  
Maria Ayanny de Lima Fernandes ◽  
Andreza Tallyne de Aguiar Silva ◽  
Iago Dillion Lima Cavalcanti ◽  
Adrya Lúcia Peres Bezerra de Medeiros ◽  
Lígia Maria de Oliveira Lima ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Antineoplastic Agent ◽  
Skinfold Thickness ◽  
Significant Loss ◽  
Arm Circumference ◽  
Gain And Loss ◽  
Triceps Skinfold Thickness ◽  
Anthropometric Assessment

Introduction: The established dose of chemotherapy is based on the values of the patient's body weight, where variations during treatment can increase the toxicity of chemotherapy, with the development of nephrotoxicity, among other toxicity profiles, as well as in cases of weight gain, patients may receive low doses and compromise the therapeutic response to the tumor. Objective: to evaluate weight gain and loss in cancer patients undergoing chemotherapy. Methods: Longitudinal analytical study with patients at the end of chemotherapy treatment of both genders. The type, location of the tumor and the antineoplastic agent used were collected from the medical records, as well as height and weight at the beginning of treatment. At the time of collection, anthropometric assessment was performed using body mass index, arm circumference, arm muscle circumference, triceps skinfold thickness and percentage of weight loss. Results: Among the patients included in the study, 47.5% had a weight gain of around 2.5 kg, while the remaining patients (52.5%) had a weight loss of around 2.8 kg. Of the patients who had GFR, 55.5% had severe PP, 33.4% had no significant loss and 11.1 had significant loss. In the current study, only 22% had a GFR <60ml/min/1.73m², but they would already need to readjust the medication calculation. Conclusion: It is important to evaluate body surface variations and also the GFR to adjust the dose of the antineoplastic agent and to prevent or minimize nephrotoxicity, as well as to reduce the risk of underdosing and inefficiency of the therapy.

scholarly journals Adductor pollicis muscle as predictor of malnutrition in surgical patients

2014 ◽  
Vol 27 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Camila Yandara Sousa Vieira de MELO ◽  
Silvia Alves da SILVA
Keyword(s):  
Weight Loss ◽  
Nutritional Assessment ◽  
Skinfold Thickness ◽  
Adductor Pollicis ◽  
Surgical Patients ◽  
Muscle Area ◽  
Cross Sectional ◽  
Adductor Pollicis Muscle ◽  
Arm Circumference ◽  
Triceps Skinfold Thickness

Background - In the compromised nutritional status, there is excessive skeletal muscle loss and decreased inflammatory response, contributing to increased morbidity and mortality and length of stay. Aim: To estimate the prevalence of malnutrition by measuring adductor pollicis muscle using cutoffs for surgical patients suggested in the literature. Methods: Cross-sectional study with 151 patients scheduled for elective surgical procedure. Nutritional assessment was performed by classical anthropometric measurements: arm circumference, triceps skinfold thickness, arm muscle circumference, corrected arm muscle area, BMI and percentage of weight loss and the extent of the adductor pollicis muscle in both hands. Results: The prevalence of malnutrition in patients was high. A significant association between nutritional diagnosis according to the measures of adductor pollicis muscle and arm circumference, BMI and triceps skinfold thickness but there was no association with arm muscular circumference, arm muscular area or percentage of weight loss. Conclusion: The adductor pollicis muscle has proved to be a good method to diagnose muscle depletion and malnutrition in surgical patients.

scholarly journals INFLUÊNCIA DA COMPOSIÇÃO DA SALMOURA SOBRE OS PARÂMETROS FÍSICO-SENSORIAIS E MICROBIOLÓGICOS DE FILÉS DE PEITO DE FRANGO MARINADOS POR IMERSÃO

2000 ◽  
Vol 18 (2) ◽  
Author(s):  
ANNA CLAUDIA SIMAS PORTO ◽  
REGINA COELI DE OLIVEIRA TÔRRES ◽  
EUNICE CASSANEGO ILHA ◽  
MARILDE TEREZINHA BORDIGNON LUIZ ◽  
ERNANI SEBASTIÃO SANT’ANNA
Keyword(s):  
Staphylococcus Aureus ◽  
Weight Loss ◽  
Weight Gain ◽  
Isoelectric Point ◽  
Rosmarinus Officinalis ◽  
Raw Material ◽  
Highest Weight ◽  
Microbiological Parameters ◽  
Gain And Loss ◽  
And Staphylococcus Aureus

Avaliou-se a influência da composição da salmoura sobre os parâmetros físicosensoriais e microbiológicos de filés de peito de frango marinados por imersão. O experimento foi constituído por cinco formulações de salmoura. A proporção salmoura:frango foi de 2:1 (v/p). O processo de marinação ocorreu a temperatura de 5 C/12 horas, seguido de drenagem por 30 minutos. As amostras destinadas ao acompanhamento da vida de prateleira, 6 e 11 dias, foram armazenadas a 5 C. Foram avaliados ganho de peso durante a marinação e perda de peso no cozimento, sendo efetuadas determinação de pH, contagem de microrganismos aeróbios psicrotróficos, contagem de Staphylococcus aureus e pesquisa de Salmonella sp. Os menores ganhos de peso foram verificados para os tratamentos com adição de vinagre na salmoura, fato atribuído à redução do pH próximo ao ponto isoelétrico da carne. Estes tratamentos evidenciaram as maiores perdas de peso durante o cozimento. A matériaprima apresentou ausência de Salmonella sp. e contagens de Staphylococcus aureus e microrganismos psicrotróficos dentro dos limites estabelecidos pelo ICMSF. Após 11 dias de armazenamento, apenas os tratamentos com vinagre na composição da salmoura apresentaram contagem de microrganismos aeróbios psicrotróficos dentro do limite estabelecido pelo ICMSF (107 UFC/g). As melhores texturas foram verificadas nos tratamentos com adição de alecrim na composição da salmoura. Abstract It was evaluated the influence of brine composition on physicosensory and microbiological parameters in breast fillet of marinated chicken by immersion. The experiment was constituted by five brine formulations. The proportion of brine:fillet was 2:1 (v/w) for all treatments. The marination process occurred at 5 C/12 hours, following of drainage for 30 minutes. The samples were stored at 5 C at 6 and 11 days to monitor shelflife. It was then evaluated weight gain and loss, pH determination, count of psicrotrophics microorganisms and Staphylococcus aureus and absence of Salmonella sp. The lowest values of weight gain were observed in treatments with addition of vinegar in brine, probably due to the decrease of pH close to the meat isoelectric point. This treatments also evidenced the highest weight loss during the cooking. The raw material presented absence of Salmonella sp. and a count of Staphylococcus aureus and psicrotrophics microorganisms within quality limits established by ICMSF. After 11 days of storage, the treatments with vinegar in the brine composition presented count of psicrotrophics microorganisms within limits established by ICMSF (107 CFU/g). The best textures were presented in treatments with addition of rosemary (Rosmarinus officinalis) in brine composition.

scholarly journals Weight Changes According to Treatment in a Diverse Cohort of Breast Cancer Patients

2021 ◽  
Author(s):  
Jami Fukui ◽  
Kami White ◽  
Timothy Frankland ◽  
Caryn Oshiro ◽  
Lynne Wilkens
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Therapeutic Window ◽  
Breast Cancer Patients ◽  
Weight Changes ◽  
Time Points

Abstract BackgroundWeight changes are common among breast cancer patients. The majority of studies to date have focused on weight gain after a breast cancer diagnosis and its implications on health in survivors. Fewer studies have examined weight loss and its related characteristics. Weight changes have been reported to be influenced by several factors such as age, treatment, stage and pre-diagnostic weight. We evaluated weight changes during key treatment time points in early stage breast cancer patients.MethodsWe characterized 389 female patients diagnosed in Hawaii with early stage breast cancer from 2003-2017 in the Multiethnic Cohort (MEC) linked with Kaiser Permanente Hawaii electronic medical record data. We evaluated weight changes from surgery to 4 years post-diagnosis with six time points along a patient’s treatment trajectory (chemotherapy, radiation, endocrine, or surgery alone) and annually thereafter, adjusting for age, race/ethnicity and initial body mass index (BMI).ResultsWe found key time points of significant weight change for breast cancer patients according to their adjuvant treatment. In patients who had surgery alone (S), surgery-radiation (SR), or surgery-endocrine therapy (SE), the majority of patients had stable weight, although this consistently decreased over time. However, the percentages of patients with weight loss and weight gain during this time steadily increased up to 4 years after initial surgery. Weight loss was more common than weight gain by about 2 fold in these treatment groups. For patients with surgery-chemotherapy (SC), there was significant weight loss seen within the first 3 months after surgery, during the time when patients receive chemotherapy. And this weight loss persisted until year 4. Weight gain was less commonly seen in this treatment group.ConclusionsWe identified key time points during breast cancer treatment that may provide a therapeutic window to positively influence outcomes. Tailored weight management interventions should be utilized to promote overall health and long term survivorship.

scholarly journals Weight changes according to treatment in a diverse cohort of breast cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12513-e12513
Author(s):  
Jami Aya Fukui ◽  
Kami White ◽  
Timothy Frankland ◽  
Caryn Oshiro ◽  
Lynne Wilkens
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Therapeutic Window ◽  
Breast Cancer Patients ◽  
Weight Changes ◽  
Time Points

e12513 Background: Weight changes are common among breast cancer patients. The majority of studies to date have focused on weight gain after a breast cancer diagnosis and its implications on health in survivors. Fewer studies have examined weight loss and its related characteristics. Weight changes have been reported to be influenced by several factors such as age, treatment, stage and pre-diagnostic weight. We evaluated weight changes during key treatment time points in early stage breast cancer patients. Methods: We characterized 389 female patients diagnosed in Hawaii with early stage breast cancer from 2003-2017 in the Multiethnic Cohort (MEC) linked with Kaiser Permanente Hawaii electronic medical record data. We evaluated weight changes from surgery to 4 years post-diagnosis with six time points along a patient’s treatment trajectory (chemotherapy, radiation, endocrine, or surgery alone) and annually thereafter, adjusting for age, race/ethnicity and initial body mass index (BMI). Results: We found key time points of significant weight change for breast cancer patients according to their adjuvant treatment. In patients who had surgery alone (S), surgery-radiation (SR), or surgery-endocrine therapy (SE), the percentage of patients with stable weight, while generally comprising the majority, consistently decreased over time. However, the percentages of patients with weight loss and weight gain during this time steadily increased up to 4 years after initial surgery. Weight loss was more common than weight gain by about 2 fold in these treatment groups (weight loss 33.2%-42% vs weight gain 11.6%-21.4%). For patients with surgery-chemotherapy (SC), there was significant increase in patients with weight loss seen within the first 3 months after surgery (16.2% to 43.7%), during the time when patients receive chemotherapy. And this weight loss trend persisted until year 4. Weight gain was less commonly seen in this treatment group. Conclusions: We identified key time points during breast cancer treatment that may provide a therapeutic window to positively influence outcomes. Tailored weight management interventions should be utilized to promote overall health and long term survivorship.

scholarly journals Is total lymphocyte count related to nutritional markers in hospitalized older adults?

2017 ◽  
Vol 54 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Vânia Aparecida LEANDRO-MERHI ◽  
Vitória Negri BRÁZ ◽  
José Luis Braga de AQUINO
Keyword(s):  
Older Adults ◽  
Lymphocyte Count ◽  
Skinfold Thickness ◽  
Total Lymphocyte Count ◽  
Nutritional Risk ◽  
Total Lymphocyte ◽  
Arm Circumference ◽  
Hospitalized Older Adults ◽  
Mid Upper Arm Circumference ◽  
Triceps Skinfold Thickness

ABSTRACT BACKGROUND Older patients are commonly malnourished during hospital stay, and a high prevalence of malnutrition is found in hospitalized patients aged more than 65 years. OBJECTIVE To investigate whether total lymphocyte count is related to other nutritional markers in hospitalized older adults. METHODS Hospitalized older adults (N=131) were recruited for a cross-sectional study. Their nutritional status was assessed by the Nutritional Risk Screening (NRS), anthropometry, and total lymphocyte count. The statistical analyses included the chi-square test, Fisher's exact test, and Mann-Whitney test. Spearman's linear correlation coefficient determined whether total lymphocyte count was correlated with the nutritional markers. Multiple linear regression determined the parameters associated with lymphocyte count. The significance level was set at 5%. RESULTS According to the NRS, 41.2% of the patients were at nutritional risk, and 36% had mild or moderate depletion according to total lymphocyte count. Total lymphocyte count was weakly correlated with mid-upper arm circumference (r=0.20507); triceps skinfold thickness (r=0.29036), and length of hospital stay (r= -0.21518). Total lymphocyte count in different NRS categories differed significantly: older adults who were not at nutritional risk had higher mean and median total lymphocyte count ( P =0.0245). Multiple regression analysis showed that higher lymphocyte counts were associated with higher triceps skinfold thicknesses and no nutritional risk according to the NRS. CONCLUSION Total lymphocyte count was correlated with mid-upper arm circumference, triceps skinfold thickness, and nutritional risk according to the NRS. In multiple regression the combined factors that remained associated with lymphocyte count were NRS and triceps skinfold thickness. Therefore, total lymphocyte count may be considered a nutritional marker. Other studies should confirm these findings.

scholarly journals Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy

2020 ◽  
Author(s):  
ELENA ÁLVARO SANZ ◽  
JIMENA ABILÉS ◽  
MARGARITA GARRIDO SILES ◽  
FRANCISCO RIVAS RUÍZ ◽  
BEGOÑA TORTAJADA GOITIA ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Nutritional Intervention ◽  
Normal Weight ◽  
Nutritional Risk ◽  
Nutritional Interventions ◽  
Patients With Cancer ◽  
The Mean

Abstract Background Patients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Therefore, the implementation of strategies for its early detection and for intervention should improve the evolution of these patients. Our study aim is to design and implement a protocol for outpatients starting chemotherapy, by means of which any malnutrition can be identified and treated at an early stage. Methods Before starting chemotherapy for patients with cancer, a complete assessment was made of their nutritional status, using the Nutriscore screening tool. When nutritional risk was detected, an interventional protocol was applied. Results Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy. Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ±8.2. By the end of the chemotherapy, the mean weight gain was 0% ±7.3 (p < 0.001) and 71.0% of the patients had experienced weight gain or maintenance, with respect to the initial weight. Conclusion More than a third of cancer patients who start chemotherapy are candidates for early nutritional intervention. This finding highlights the importance of early identification of patients at risk in order to improve the efficacy of nutritional interventions, regardless of the stage of the disease.

scholarly journals Reversal of Integrase Inhibitor- and Tenofovir Alafenamide-Related Weight Gain after Switching Back to Tenofovir DF/Emtricitabine/Efavirenz

2021 ◽  
Author(s):  
F Will Pohlman ◽  
Kara S McGee ◽  
Mehri McKellar
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Antiretroviral Therapy ◽  
Integrase Inhibitor ◽  
Rapid Weight Loss ◽  
Tenofovir Df ◽  
Specific Factors ◽  
Gain And Loss ◽  
Tenofovir Alafenamide

Abstract We report a case of substantial weight gain in a virologically suppressed patient with HIV after changing his antiretroviral therapy from efavirenz/emtricitabine/tenofovir DF to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide with subsequent rapid weight loss upon switching back. The role of antiretrovirals in weight gain and loss and patient- and HIV-specific factors are discussed.

scholarly journals Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Elena Álvaro Sanz ◽  
Jimena Abilés ◽  
Marga Garrido Siles ◽  
Francisco Rivas Ruíz ◽  
Begoña Tortajada Goitia ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Nutritional Intervention ◽  
Normal Weight ◽  
Nutritional Risk ◽  
Nutritional Interventions ◽  
Patients With Cancer ◽  
The Mean

AbstractPatients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Therefore, the implementation of strategies for its early detection and for intervention should improve the evolution of these patients. Our study aim is to design and implement a protocol for outpatients starting chemotherapy, by means of which any malnutrition can be identified and treated at an early stage. Before starting chemotherapy for patients with cancer, a complete assessment was made of their nutritional status, using the Nutriscore screening tool. When nutritional risk was detected, an interventional protocol was applied. Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy. Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ± 8.2. By the end of the chemotherapy, the mean weight gain was 0% ± 7.3 (p < 0.001) and 71.0% of the patients had experienced weight gain or maintenance, with respect to the initial weight. More than a third of cancer patients who start chemotherapy are candidates for early nutritional intervention. This finding highlights the importance of early identification of patients at risk in order to improve the efficacy of nutritional interventions, regardless of the stage of the disease.

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