Clinical Nutrition Research

The Korean Society of Clinical Nutrition (한국임상영양학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Continuous Nutrition Care on Nutritional Status and Dietary Habits of Patients With Colorectal Cancer Receiving Adjuvant Chemotherapy After Surgery

  • Jina Son (Department of Dietetics, Chungnam National University Hospital) ;
  • Ha I Kang (Department of Dietetics, Chungnam National University Hospital) ;
  • Eun young Jung (Department of Dietetics, Chungnam National University Hospital) ;
  • Hae won Ryu (Department of Hemato-oncology, Chungnam National University Hospital) ;
  • Kyung-Ha Lee (Department of Surgery, Chungnam National University Hospital)
  • Received : 2023.03.13
  • Accepted : 2023.04.14
  • Published : 2023.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Patients with colorectal cancer may experience symptoms such as diarrhea, nausea, and anorexia, during surgery and chemotherapy, which can increase the risk of malnutrition. In addition, dietary habits play a key role in the onset of colorectal cancer; therefore, it is necessary to improve dietary habits to prevent recurrence during treatment after diagnosis. In this study, a clinical nutritionist conducted 4 interviews for patients diagnosed with colorectal cancer and scheduled for colectomy: before surgery, after surgery, 1st chemotherapy, and 2nd chemotherapy, and provided nutrition care for each treatment course to determine its effects on nutrition status and disease prognosis. Significant weight loss but no decrease in muscle mass was observed during treatment. Body fat mass, although not statistically significant, showed a decreasing tendency. The percentage of people who responded 'yes' to the below items increased after compared to before receiving nutrition education: 'I eat meat or eggs more than 5 times a week,' 'I eat seafood at least three times a week,' 'I eat vegetables at every meal,' 'I eat fruits every day,' and 'I eat milk or dairy products every day.' These results indicate that the patients changed their dietary habit from a monotonous eating pattern to a pattern of consuming various food groups after receiving nutrition education. These results suggest that continuous nutrition care by clinical dietitians, according to the patient's treatment process, can help improve the patient's nutritional status and establish healthy eating habits.

Keywords

Acknowledgement

This research was supported by the Chungnam National University Hospital Research Fund, 2022.

References

  1. Korea Center Cancer Registry. Cancer occurrence status. Goyang: Korea Center Cancer Registry; 2021.
  2. Patel SG, Karlitz JJ, Yen T, Lieu CH, Boland CR. The rising tide of early-onset colorectal cancer: a comprehensive review of epidemiology, clinical features, biology, risk factors, prevention, and early detection. Lancet Gastroenterol Hepatol 2022;7:262-74.
  3. Hall W. NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA 1990;264:1444-50.
  4. Kelly K. An overview of how to nourish the cancer patient by mouth. Cancer 1986;58:1897-901.
  5. Jeong G, Kim K, Kwak Y. Quality of life in colorectal cancer patients according to the severity of symptom clusters classification. Asian Oncol Nurs 2014;14:74-83.
  6. Park HJ, Kil HS, Cho WY. Qualitative study of compliance with nutritional management in colorectal cancer patient undergoing chemotherapy. Korean J Community Nutr 2020;25:303-16.
  7. Kim EK, Yang YH, Choi-Kwon S. Nutritional status of cancer patients upon admission. J Korean Acad Nurs 1999;29:271-80.
  8. World Cancer Research Fund, American Institute for Cancer Research. Diet, nutrition, physical activity and colorectal cancer [Internet]. Available from https://www.wcrf.org/wp-content/uploads/2021/02/ Colorectal-cancer-report.pdf [cited 2021 February]. 2018.
  9. Park KO, Choi-Kwon S. Effects of individualized nutritional education programs on the level of nutrient intake and nutritional status of colorectal cancer patients undergoing palliative chemotherapy. J Korean Acad Nurs 2012;42:799-809.
  10. Nho JH, Kim SR, Kang GS, Kwon YS. Relationships among malnutrition, depression and quality of life in patients with gynecologic cancer receiving chemotherapy. Korean J Women Health Nurs 2014;20:117-25.
  11. Lee H, Choi-Kwon S. The relationships among chemotherapy-induced nausea and vomiting (CINV), nonpharmacological coping methods, and nutritional status in patients with gynecologic cancer. J Korean Acad Nurs 2017;47:731-43.
  12. Cho JW, Youn JY, Choi MG, Rha MY, Lee JE. Assessing nutritional status in outpatients after gastric cancer surgery: a comparative study of five nutritional screening tools. Korean J Community Nutr 2021;26:280-95.
  13. Lee SH, Lee HJ, Hyun S, Lee MS, Kim DH, Kim YD. Nutritional intake and postoperative pulmonary complications among lung cancer patients who underwent pulmonary resection. J Korean Biol Nurs Sci 2021;23:11-21.
  14. Kwon MH, Han B, Cho SJ, Cho JH. Analysis of body fat mass index for Korean adults. Korean J Fam Pract 2021;11:81-5.
  15. Sim SJ, Park HS. The cut-off values of body fat to identify cardiovascular risk among Korean adults. J Korean Soc Study Obes 2004;13:14-21.
  16. Korean Society for the Study of Obesity. Clinical practice guidelines for obesity. Seoul: Korean Society for the Study of Obesity; 2022.
  17. Pt-Global. The scored patient-generated subjective global assessment (PG-SGA(C)) [Internet]. Available from https://pt-global.org/pt-global/ [cited 2021 February]. c2014.
  18. Isenring E, Bauer J, Capra S. The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 2003;57:305-9.
  19. National Cancer Information Center. My eating habit assessment [Internet]. Available from https://www.cancer.go.kr/lay1/S1T226C228/contents.do [cited 2013 October 18]. 2013.
  20. The Korean Dietetic Association. Manual of medical nutrition therapy. 4th ed. Seoul: The Korean Dietetic Association; 2022.
  21. Park J, Kim JH, Lee HJ, Park SJ, Hong SP, Cheon JH, Kim WH, Park JS, Jeon JY, Kim TI. The effects of physical activity and body fat mass on colorectal polyp recurrence in patients with previous colorectal Cancer. Cancer Prev Res (Phila) 2017;10:478-84.
  22. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 2004;4:579-91. 
  23. Xiao J, Caan BJ, Cespedes Feliciano EM, Meyerhardt JA, Peng PD, Baracos VE, Lee VS, Ely S, Gologorsky RC, Weltzien E, Kroenke CH, Kwan ML, Alexeeff SE, Castillo AL, Prado CM. Association of low muscle mass and low muscle radiodensity with morbidity and mortality for colon cancer surgery. JAMA Surg 2020;155:942-9.
  24. Jung HW, Kim JW, Kim JY, Kim SW, Yang HK, Lee JW, Lee KW, Kim DW, Kang SB, Kim KI, Kim CH, Kim JH. Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy. Support Care Cancer 2015;23:687-94.
  25. Wagner AD, Grothey A, Andre T, Dixon JG, Wolmark N, Haller DG, Allegra CJ, de Gramont A, VanCutsem E, Alberts SR, George TJ, O'Connell MJ, Twelves C, Taieb J, Saltz LB, Blanke CD, Francini E, Kerr R, Yothers G, Seitz JF, Marsoni S, Goldberg RM, Shi Q. Sex and adverse events of adjuvant chemotherapy in colon cancer: an analysis of 34 640 patients in the ACCENT database. J Natl Cancer Inst 2021;113:400-7.
  26. Gala D, Wright HH, Zigori B, Marshall S, Crichton M. Dietary strategies for chemotherapy-induced nausea and vomiting: a systematic review. Clin Nutr 2022;41:2147-55.
  27. Marse H, Van Cutsem E, Grothey A, Valverde S. Management of adverse events and other practical considerations in patients receiving capecitabine (Xeloda). Eur J Oncol Nurs 2004;8:S16-30.
  28. Larkin PJ, Cherny NI, La Carpia D, Guglielmo M, Ostgathe C, Scotte F, Ripamonti CI; ESMO Guidelines Committee. Diagnosis, assessment and management of constipation in advanced cancer: ESMO clinical practice guidelines. Ann Oncol 2018;29:iv111-25.
  29. Staats PS, Markowitz J, Schein J. Incidence of constipation associated with long-acting opioid therapy: a comparative study. South Med J 2004;97:129-34.
  30. Fernandez E, Negri E, La Vecchia C, Franceschi S. Diet diversity and colorectal cancer. Prev Med 2000;31:11-4.
  31. Nomura AM, Hankin JH, Henderson BE, Wilkens LR, Murphy SP, Pike MC, Le Marchand L, Stram DO, Monroe KR, Kolonel LN. Dietary fiber and colorectal cancer risk: the multiethnic cohort study. Cancer Causes Control 2007;18:753-64.
  32. van Duijnhoven FJ, Bueno-De-Mesquita HB, Ferrari P, Jenab M, Boshuizen HC, Ros MM, Casagrande C, Tjonneland A, Olsen A, Overvad K, Thorlacius-Ussing O, Clavel-Chapelon F, Boutron-Ruault MC, Morois S, Kaaks R, Linseisen J, Boeing H, Nothlings U, Trichopoulou A, Trichopoulos D, Misirli G, Palli D, Sieri S, Panico S, Tumino R, Vineis P, Peeters PH, van Gils CH, Ocke MC, Lund E, Engeset D, Skeie G, Suarez LR, Gonzalez CA, Sanchez MJ, Dorronsoro M, Navarro C, Barricarte A, Berglund G, Manjer J, Hallmans G, Palmqvist R, Bingham SA, Khaw KT, Key TJ, Allen NE, Boffetta P, Slimani N, Rinaldi S, Gallo V, Norat T, Riboli E. Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr 2009;89:1441-52.
  33. Lin J, Zhang SM, Cook NR, Rexrode KM, Liu S, Manson JE, Lee IM, Buring JE. Dietary intakes of fruit, vegetables, and fiber, and risk of colorectal cancer in a prospective cohort of women (United States). Cancer Causes Control 2005;16:225-33.
  34. Aune D, Lau R, Chan DS, Vieira R, Greenwood DC, Kampman E, Norat T. Dairy products and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. Ann Oncol 2012;23:37-45.
  35. Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, Guha N, Mattock H, Straif K; International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of consumption of red and processed meat. Lancet Oncol 2015;16:1599-600.
  36. Hoang T, Kim H, Kim J. Dietary intake in association with all-cause mortality and colorectal cancer mortality among colorectal cancer survivors: a systematic review and meta-analysis of prospective studies. Cancers (Basel) 2020;12:3391.
  37. Weimann A, Braga M, Carli F, Higashiguchi T, Hubner M, Klek S, Laviano A, Ljungqvist O, Lobo DN, Martindale R, Waitzberg DL, Bischoff SC, Singer P. ESPEN guideline: clinical nutrition in surgery. Clin Nutr 2017;36:623-50.
  38. Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Hutterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Muhlebach S, Oldervoll L, Ravasco P, Solheim TS, Strasser F, de van der Schueren M, Preiser JC, Bischoff SC. ESPEN practical guideline: clinical nutrition in cancer. Clin Nutr 2021;40:2898-913.
  39. Kim YS, Kim SY, Jung KA, Kwon SH, Jang YK, Park MH, Hwang SJ. Dietary behaviors and consumption of health food among the cancer patients. J East Asian Soc Diet Lif 2005;15:516-23.
  40. Jun M, Kim M, Choi K, Kim D. The effect factors of quality of life on patients undergoing chemotherapy after stomach cancer surgery. J Korean Oncol Nurs 2002;2:83-93.
  41. Kim AS, Lee ES, Kim SH. Effects of telephone intervention as supportive nursing on self-care practices and qualify of life for gynecological cancer patients under chemotherapy. J Korean Acad Nurs 2007;37:744-53.
  42. Pullar JM, Chisholm A, Jackson C. Dietary information for colorectal cancer survivors: an unmet need. N Z Med J 2012;125:27-37.
  43. Lewandowska A, Religioni U, Czerw A, Deptala A, Karakiewicz B, Partyka O, Pajewska M, Sygit K, Cipora E, Kmiec K, Augustynowicz A, Mekal D, Waszkiewicz M, Baranska A, Minarikova D, Minarik P, Merks P. Nutritional treatment of patients with colorectal cancer. Int J Environ Res Public Health 2022;19:6881.
  44. Mahan LK. Krause's food & the nutrition care process. 14th ed. St. Louis (MO): Elsevier; 2017.