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Articles

Older Adult Cancer Patients Under Palliative Care With a Prognosis of 30 Days or More: Clinical and Nutritional Changes

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Pages 148-154 | Received 05 Nov 2019, Accepted 20 Mar 2020, Published online: 10 Apr 2020
 

Abstract

Objective: The aim of this study was to characterize nutritional status, body composition, oxidative stress, and inflammatory activity and to determine the possible associations between nutritional status and clinical variables in advanced cancer patients.

Method: This was a cross-sectional study of 46 elderly cancer patients under palliative care with a prognosis of 30 days or more. Nutritional status, food intake, anthropometry, body composition (deuterium oxide method), metabolic profile, inflammation damage (C-reactive protein), oxidative damage (8-hydroxy-2’-deoxyguanosine), and symptom intensity were evaluated.

Results: Among elderly cancer patients, 36.9% were malnourished or at risk of malnutrition. Systemic inflammation was detected, with a correlation between worse nutritional status and higher C-reactive protein levels (p < 0.01, r= −0.57), while lower lean mass (p < 0.01, r = 0.62) and higher fat mass percentages (p < 0.01, r = 0.62) correlated with higher levels of 8-hydroxy-2’-deoxyguanosine. Furthermore, daily energy (n = 25; 57.4%) and protein intake (n = 24; 52.2%) were lower than recommended in more than half the patients. The most prevalent symptoms were anxiety, impairment of well-being, drowsiness, tiredness, and lack of appetite.

Conclusions: Despite preserved functionality, patients already had clinical and laboratory changes that, together with inadequate food intake, risk of malnutrition, systemic inflammation, and the presence of uncontrolled symptoms, alerted to the importance of an early and comprehensive palliative approach.

Additional information

Funding

Supported by the Teaching, Research and Assistance Support Foundation (FAEPA) of the University Hospital – Ribeirão Preto Medical School, University of São Paulo, Brazil, number: 1690/2015, and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), PhD Scholarship, number: 38200629805

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