Association between cachexia, chemotherapy and outcomes in older cancer patients: A systematic review.

About 50% of all patients with cancer eventually develop anorexia/cachexia syndrome, which represents a complex clinical syndrome occurring in several illnesses, including cancer. The syndrome is characterized by systemic inflammation and primarily loss of body fat and body mass. In this review we shortly summarize the pathomechanism of anorexia/cachexia syndrome and list the current pharmacological approaches.

Cachexia in cancer patients

Nutrition is recognized as an essential component in the prevention of a number of chronic diseases, including periodontal disease. Based on these considerations, a better understanding is required regarding how the diet, and more particularly the intake of macronutrients and micronutrients, could impact the potential relationship between nutrition and periodontal diseases, periodontal diseases and chronic diseases, nutrition and chronic diseases. To overcome this complexity, an up-to-date literature review on the nutriments related to periodontal and chronic diseases was performed. High-sugar, high-saturated fat, low-polyols, low-fiber and low-polyunsaturated-fat intake causes an increased risk of periodontal diseases. This pattern of nutrients is classically found in the Western diet, which is considered as an ‘unhealthy’ diet that causes cardiovascular diseases, diabetes and cancers. Conversely, low-sugar, high-fiber and high-omega-6-to-omega-3 fatty acid ratio intake reduces the risk of periodontal diseases. The Mediterranean, DASH, vegetarian and Okinawa diets that correspond to these nutritional intakes are considered as ‘healthy’ diets, reducing this risk of cardiovascular diseases, diabetes and cancers. The role of micronutrients, such as vitamin D, E, K and magnesium, remains unclear, while others, such as vitamin A, B, C, calcium, zinc and polyphenols have been shown to prevent PDs. Some evidence suggests that probiotics and prebiotics could promote periodontal health. Periodontal and chronic diseases share, with a time delay, nutrition as a risk factor. Thus, any change in periodontal health should be considered as a warning signal to control the dietary quality of patients and thus reduce the risk of developing chronic diseases later on.

https://www.mdpi.com/2077-0383/10/2/197/pdf

Nutrition as a Key Modifiable Factor for Periodontitis and Main Chronic Diseases.

Taste and smell changes are common side effects in cancer patients undergoing chemotherapy treatments (CT). This can lead to a reduced food enjoyment and an inadequate nutrient intake with a high impact on nutritional status and quality of life. The aim of this study was to evaluate the self-reported chemosensory alterations of patients undergoing chemotherapy according to CT type. An observational study was conducted with 151 patients undergoing CT at Oncology Outpatient Unit from Onkologikoa Foundation. An interviewer-assisted questionnaire was designed to investigate chemosensory changes in patients undergoing CT. Seventy-six percent patients reported taste disorders and 45% smell changes. Xerostomia is the most frequent symptom reported by patients receiving chemotherapy in our study (63.6%), and it is strongly associated to bad taste in mouth (OR = 5.96; CI = 2.37–14.94; p value = 0.000) and taste loss (OR = 5.96; CI = 2.37–14.94; p value = 0.000). Anthracyclines, paclitaxel, carboplatin, and docetaxel were the CT agents producing the highest taste disturbance rates. Cisplatin and 5-Fluorouracil are the CT resulting in the lowest complaints. Logistic regression revealed statistically significant associations between taste loss and carboplatin and docetaxel (OR = 3.50; CI = 1.12–10.90; p value = 0.031) and cold hypersensitivity and oxaliplatin (OR = 12.14; CI = 4.18–35.25; p value = 0.000). Not only platin-based CT such as carboplatin produced dysgeusia, but also anthracyclines and paclitaxel treatments. The better knowledge of taste and smell alterations according to CT type may provide valuable information for the design of new strategies to tackle CT side effects. It is important to take into account taste and smell dysfunctions and other alterations such as xerostomia together.

Assessing taste and smell alterations in cancer patients undergoing chemotherapy according to treatment.

https://hal.archives-ouvertes.fr/hal-02195266/document

Relationship between food behavior and taste and smell alterations in cancer patients undergoing chemotherapy: A structured review

Patients undergoing cancer treatment experience a multitude of symptoms that can influence their ability to complete treatment as well as their quality of life during and after treatment. This cross-sectional study sought to describe the dietary changes experienced by cancer patients and to identify associations between these changes and common treatment symptoms. A convenience sample of 1199 cancer patients aged 18 yr and older undergoing active treatment were recruited from 7 cancer centers to complete a self-administered paper-and-pencil survey. Descriptive analyses were conducted to estimate prevalence of dietary changes and chi-squared tests were used to examine associations between dietary changes and health outcomes. Approximately 40% of patients reported a decreased appetite since beginning treatment, and 67.2% of patients reported at least 1 chemosensory alteration. Increased taste sensitivities were more common than decreased taste sensitivities, with increased sensitivity to metallic being the most common taste sensitivity (18.6%). Patients also had increased sensitivities to certain smells including cleaning solutions (23.4%), perfume (22.4%), and food cooking (11.4%). Patients reported a wide range of food preferences and aversions. Patients who had less energy or lost weight since beginning treatment were more likely than others to report treatment-related dietary changes.

https://oralmedicinepacific.com/docs/whats-new/Diet-and-food-preferences-in-HNC-Nutri-Cancer-2015-(1).pdf

The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment

To describe how cancer treatment influences the dietary behaviors and food preferences of older adult cancer patients and explore associations between these dietary changes and common cancer symptoms.\nA convenience sample of 800 cancer patients age 55 years and older undergoing cancer treatment completed a self-administered questionnaire which assessed patients’ dietary changes, food preferences and aversions since starting treatment, and health outcomes. Descriptive statistics were conducted to examine associations between dietary changes and age groups (categorized as 55-64 years old, 65-74 years old, and 75 years old and older), and multivariable logistic regression was used to assess associations between dietary changes and health outcomes\nThe majority of participants experienced at least one cancer symptom, with fatigue and poor appetite being most commonly reported. About half of respondents reported no change in appetite or thirst, but those who did report a change were more likely to report a decrease in appetite rather than an increase, and more likely to report an increase in thirst rather than a decrease. Most of the patterns were consistent across age groups but the oldest age group (75+) was less likely to report eating less frequently, and less likely to report certain increased taste and smell sensitivities.\nCharacterizing the nutritional needs of older adult cancer patients is the first step in being able to address these needs. Future research is needed to evaluate potential strategies to address nutritional concerns, and to better understand the unique needs of specific subgroups of older adult cancer patients at high risk of experiencing dietary changes (e.g., those with head and neck cancer).

/pdf/dietary-changes-and-food-preferences-experienced-by-older-3fie5imwtk.pdf

Dietary Changes and Food Preferences Experienced by Older Adult Cancer Patients and the Impact on Health Outcomes

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The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment

Dietary Changes and Food Preferences Experienced by Older Adult Cancer Patients and the Impact on Health Outcomes