Quality of life and symptom burden improve in patients attending a multidisciplinary clinical service for cancer cachexia : A retrospective observational review

Journal article

Bland, Kelcey A., Harrison, Meg, Harrison, Meg, Zopf, Eva M., Sousa, Mariana S., Currow, David C., Ely, Matthew, Agar, Meera, Butcher, Belinda E., Vaughan, Vanessa, Dowd, Anna and Martin, Peter. (2021). Quality of life and symptom burden improve in patients attending a multidisciplinary clinical service for cancer cachexia : A retrospective observational review. Journal of Pain and Symptom Management. 62(3), pp. e164-e176. https://doi.org/10.1016/j.jpainsymman.2021.02.034
AuthorsBland, Kelcey A., Harrison, Meg, Harrison, Meg, Zopf, Eva M., Sousa, Mariana S., Currow, David C., Ely, Matthew, Agar, Meera, Butcher, Belinda E., Vaughan, Vanessa, Dowd, Anna and Martin, Peter
Abstract

Background
Cancer cachexia negatively affects quality of life (QoL) and increases symptom burden. A multimodal treatment approach may optimize cachexia outcomes, including QoL. We evaluated QoL and symptoms over time among patients attending a multidisciplinary clinical service for cancer cachexia.

Methods
Adults with cancer who attended the clinical service three times between 2017 and 2020 were included. Quality of life and symptoms were assessed using the European Organization for Research and Treatment of Cancer Quality of life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL) and the Functional Assessment Anorexia/Cachexia Therapy (FAACT) questionnaires. Physical function was assessed using the 30s sit-to-stand test and handgrip strength.

Results
Overall, 162 patients (age = 67.2 ± 12.0 years) were included. Mean six-month weight loss at baseline was 10.4% ± 9.4%. Mean body weight was stable between clinic visits (P = 0.904) and no change in sit-to-stand repetitions (P = 0.133) or handgrip strength (P = 0.734) occurred over time. Improvements in EORTC QLQ-C15-PAL overall QoL (Δ10.7 ± 2.5, P < 0.001), physical function (Δ8.0 ± 2.4, P = 0.003) and emotional function (Δ11.4 ± 2.9, P < 0.001) occurred by the second visit. EORTC QLQ-C15-PAL fatigue (Δ13.8 ± 2.9, P < 0.001), pain (Δ10.3 ± 3.3, P = 0.007), nausea/vomiting (Δ16.1 ± 3.0, P < 0.001) and appetite symptoms (Δ25.9 ± 3.8, P < 0.001) also improved by the second visit. FAACT total score (Δ14.6 ± 2.7, P < 0.001), anorexia-cachexia symptoms (Δ6.6 ± 1.1, P< 0.001), and physical (Δ3.7 ± 0.70, P < 0.001), emotional (Δ1.9 ± 0.60, P = 0.005) and functional wellbeing (Δ2.7 ± 0.71, P = 0.001) improved by the second visit. All improvements in EORTC QLQ-C15-PAL and FAACT outcomes were maintained at the third visit.

Conclusion
Significant improvements in QoL and symptoms were associated with attending a cancer cachexia clinical service. Our findings support using multidisciplinary, multimodal cancer cachexia treatment approaches to improve patient wellbeing.

Keywordspalliative care; cachexia; quality of life; multidisciplinary; multimodal treatment
Year2021
JournalJournal of Pain and Symptom Management
Journal citation62 (3), pp. e164-e176
PublisherElsevier Inc.
ISSN0885-3924
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jpainsymman.2021.02.034
Scopus EID2-s2.0-85104345461
Research or scholarlyResearch
Page rangee164-e176
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Output statusPublished
Publication dates
Online27 Feb 2021
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Deposited22 Nov 2021
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