Quality of Life and Symptom Burden Improve in Patients Attending a Multidisciplinary Clinical Service for Cancer Cachexia: A Retrospective Observational Review

Kelcey A Bland; Meg Harrison; Eva M Zopf; Mariana S Sousa; David C Currow; Matthew Ely; Meera Agar; Belinda E Butcher; Vanessa Vaughan; Anna Dowd; Peter Martin

doi:10.1016/j.jpainsymman.2021.02.034

Quality of Life and Symptom Burden Improve in Patients Attending a Multidisciplinary Clinical Service for Cancer Cachexia: A Retrospective Observational Review

J Pain Symptom Manage. 2021 Sep;62(3):e164-e176. doi: 10.1016/j.jpainsymman.2021.02.034. Epub 2021 Feb 27.

Authors

Affiliations

¹ Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne VIC, Australia.
² School of Medicine, Deakin University, Geelong, VIC, Australia; Palliative Care, Barwon Health, Geelong, VIC, Australia.
³ Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
⁴ Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia; Wolfson Palliative Care Research Centre, University of Hull, Hull, UK.
⁵ Palliative Care, Barwon Health, Geelong, VIC, Australia.
⁶ WriteSource Medical Pty Ltd., Lane Cove, NSW, Australia; School of Medical Sciences, University of New South Wales, UNSW, Sydney, Australia.
⁷ School of Medicine, Deakin University, Geelong, VIC, Australia.
⁸ School of Medicine, Deakin University, Geelong, VIC, Australia; Palliative Care, Barwon Health, Geelong, VIC, Australia. Electronic address: peter.martin@deakin.edu.au.

PMID: 33652095
DOI: 10.1016/j.jpainsymman.2021.02.034

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.

Keywords: Palliative care; cachexia; multidisciplinary; multimodal treatment; quality of life.

Publication types

Review

MeSH terms

Aged
Cachexia* / therapy
Hand Strength
Humans
Middle Aged
Neoplasms* / complications
Neoplasms* / therapy
Observation
Palliative Care
Quality of Life*
Retrospective Studies
Surveys and Questionnaires