Nutritional Risk in the Cancer Patient 65 and Older Undergoing Systemic Treatment Via Phase I Clinical Trials

Abstract

Abstract One of the greatest risk factors for contracting cancer is aging. By the year 2030 the number of new cancer cases will balloon to 2.3 million per year. Malnutrition is a common problem identified in cancer patients and is recognized as an important component of adverse outcomes, including increased morbidity and mortality and decreased quality of life (QOL). Nutritional risk is not consistently assessed in the older adult cancer patient population. The purpose of this study was to identify variables related to nutritional risk in the cancer patient 65 years and older receiving systemic treatments via Phase I clinical trials. The study described the relationship between nutritional risk and the four domains of QOL (physical, social, emotional, and functional). This study was guided conceptually by an adapted version of the City of Hope QOL model, focusing on the four key domains of QOL. The instrument chosen to measure QOL was the FACT-G (Version 4), created by Cella, et al. (1993), is a cancer specific version of the FACIT (Functional Assessment of Chronic Illness Therapy) Measurement System. It contains a 27-item compilation of general questions divided into the four QOL domains. A sample of 73 patients, with a mean age of 71, were successfully accrued for this study from an NCI RO1 aimed at integrating supportive care for cancer patients on Phase I clinical trials using the MNA-SF instrument to assess for nutritional risk. The population was predominantly Caucasian and overall well-educated. Most of the patients were Protestant and were married or partnered, living with a spouse or child. Most were retired with an annual income of $50,000 or greater. The participants were almost equally divided by male and female. Study findings revealed that the strongest correlation with nutritional risk was BMI status (r = .47, p < .0001). Multiple regression analysis demonstrated that the factors associated with nutritional risk included BMI, previous chemotherapy and physical subscale of the FACT-G QOL instrument. Additional descriptive data reinforced the importance of nursing assessment and intervention to support nutritional status. Nutrition impacts all dimensions of QOL and will be even more important in an aging population. Nursing research can contribute greatly to advancing this area of practice.