Cancer is a leading cause of morbidity and mortality in the world. Although developments in early cancer detection and treatments led to improved survival, malnutrition remains to be a significant ...problem that may affect the response to treatments. Cancer patients remain to be at high risk for malnutrition secondary to local and systemic/metabolic effects of tumors and cancer treatments. The mechanism of cancer cachexia is multifactorial and includes inadequate nutritional intake and systemic inflammation that leads to a metabolic imbalance. Weight loss and cachexia are of prognostic significance and are closely linked to the quality of life. Since early detection and intervention lead to improved outcomes, screening and monitoring nutritional status are critical components of cancer care leading to adequate nutritional therapies. This review article aims to provide an overview of the mechanisms of malnutrition and cancer related cachexia and recent guidelines with the current evidence on the importance of nutrition therapy for cancer patients.
This study investigates the outcomes of virtual nutritional counseling (VNC) for oncology patients during the Covid-19 pandemic. Our study evaluated the nutritional status data of cancer patients at ...the baseline and after VNC. An oncology dietitian evaluated the patients by video calling each patient via WhatsApp and sent an individual nutrition diet plan and recommendations via e-mail. Patient-Generated Subjective Global Assessment (PG-SGA) was used as a screening and evaluation tool to assess nutritional status. A total of 157 patients with a mean age of 55.8 ± 14.7 (
= 19-89) were included in the study. Researchers detected at least one nutrition-related sign in 77.7% of patients. After the VNC and based on the final PG-SGA assessments, 62.2% of the patients whose baseline PG-SGA Score-B improved to Score-A, 12.5% with a baseline PG-SGA Score-C improved to Score-A and 54.2% with a baseline Score-C improved to a Score
B (
= 55,000,
< 0.001). Based on the number of VNCs, the improvement in malnutrition status following two sessions and three or more sessions was found to be 17.6% and 35.7%, respectively (
< 0.001). Our results confirm that VNC can improve the nutritional status of cancer patients. Hence, nutritional counseling should be an integral part of oncological treatment.
The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival ...(OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC.
In this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed.
Three hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p = < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49-14.49) and 8.08 months (95% CI, 6.88-9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment.
Our study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy.
Introduction
Increased stress levels caused by the pandemic might cause delays in cancer treatment. We conducted a survey among cancer patients undergoing treatment to evaluate their psychological ...wellbeing and treatment adherence during Coronavirus disease 19 (COVID‐19) pandemic.
Material and Methods
Patients receiving active chemotherapy at a private oncology center between January and May 2021 were included. Healthy volunteers were employees of a district health directorate with no history of cancer or chronic disease. Treatment adherence was described as compliant if the prescribed treatment was received within a week and the information was gained from patient charts. Hospital anxiety and depression scale (HADS) and COVID‐19 phobia scale (CP19‐S) were administered to participants.
Results
402 participants were included; 193 (48%) were cancer patients. The mean age of the participants was 44 years old and 68% of the participants were female. All participants' CP19‐S mean score was 47.9. Patient group had significantly lower CP19‐S (p = 0.006). Chronic disease and history of a shocking event were the factors associated with CP19‐S. All participants reporting hospital anxiety were found to have significantly higher COVID‐19 phobia levels (p < 0.05). Patients' mean HADS‐anxiety score was significantly higher (7.3 vs. 6.5, p = 0.027). COVID‐19 phobia was an independent factor increasing the level of anxiety and depression in both groups. Adherence to treatment was 100%.
Conclusion
The pandemic increased levels of anxiety, however, cancer treatment continued to be a priority in patients' lives. Strategies should be developed to support oncology patients cope with the pandemic and increase their courage to avoid treatment delays.
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