Department of Translational and Precision Medicine (formerly Department of Clinical Medicine), Sapienza University of Rome, Rome, Italy.
Healthware International c/o Palazzo Innovazione, Salerno, Italy.
J Cachexia Sarcopenia Muscle. 2019 Jun;10(3):517-525. doi: 10.1002/jcsm.12420. Epub 2019 Apr 5.
The prevalence of nutritional derangements in patients with cancer is high. This survey assessed patients' awareness of cancer-related nutritional issues and evaluated how important they perceive the impact of nutrition on cancer and treatment to be.
A structured questionnaire was developed to determine: presence of feeding problems, perception of nutrition importance, and perception of physicians' approach to nutrition. The European Cancer Patient Coalition disseminated the questionnaire to its members in 10 countries. The Mediterranean cluster (Italy, Spain, and Greece) was analysed separately to further determine specific patterns in answers.
In total, 907 respondents completed the questionnaire (68.8% female participants; 51.7% with cancer; 48.3% cancer survivors; 59.3% diagnosed with cancer ≤3 years ago; 46.2% receiving treatment for <1 year). Feeding problems during illness/therapy were experienced by 72.5% (628/867) of all respondents (Italian: 90.0%, 117/130), although up to 53.9% (467/867) reported that physicians did not check their feeding status. Overall, 69.6% (586/842) of respondents reported weight loss after cancer diagnosis (moderate to severe: 36.7%, 309/842). For Italian respondents, the percentages of overall weight loss and moderate-to-severe weight loss were 85.1% (109/128) and 70.3% (90/128), respectively. Only 35.0% (295/842) of all respondents reported having their weight measured regularly during treatment; 45.7% (385/842) believed their physician considered cancer-related weight loss unimportant. Respondents [all: 56.9% (472/830); Italian: 73.0% (92/126); Spanish: 68.9% (42/61); Greek: 79.7% (47/59)] were unaware of supplements' negative effects during therapy or the need to inform their physician about these supplements [all: 43.6% (362/830); Italian: 55.6% (70/126); Spanish: 47.5% (29/61); Greek: 49.2% (29/59)]. The term 'cachexia' was generally unknown to respondents [all: 72.9% (603/827); Italian: 64.3% (81/126); Spanish: 68.9% (42/61); Greek: 47.5% (28/59)] and most respondents [all: 92.4% (764/827); Italian: 91.3% (115/126); Spanish: 91.8% (56/61); Greek: 86.4% (51/59)] received no cachexia-related information.
Patients reported differences in perspective between them and physicians on cancer-related nutritional issues and the specific nutritional approaches available for cancer treatment. Increasing physician focus on nutrition during treatment, particularly among Italian physicians, and providing information on optimizing nutrition to patients are essential factors to improving patients' quality of life.
癌症患者的营养失调患病率很高。本调查评估了患者对癌症相关营养问题的认识，并评估了他们认为营养对癌症和治疗的影响有多重要。
制定了一份结构化问卷，以确定：存在喂养问题、对营养重要性的认识，以及对医生处理营养方法的看法。欧洲癌症患者联盟（European Cancer Patient Coalition）在其 10 个成员国的成员中分发了该问卷。地中海群组（意大利、西班牙和希腊）单独进行了分析，以进一步确定答案中的具体模式。
共有 907 名受访者完成了问卷（68.8%为女性参与者；51.7%患有癌症；48.3%为癌症幸存者；59.3%在 3 年前被诊断出患有癌症；46.2%正在接受不到 1 年的治疗）。72.5%（628/867）的所有受访者（意大利：90.0%，117/130）在患病/治疗期间经历了喂养问题，尽管多达 53.9%（467/867）的受访者报告医生没有检查他们的喂养状况。总体而言，69.6%（586/842）的受访者报告在癌症诊断后体重减轻（中度至重度：36.7%，309/842）。对于意大利受访者，总体体重减轻和中度至重度体重减轻的百分比分别为 85.1%（109/128）和 70.3%（90/128）。只有 35.0%（295/842）的所有受访者报告在治疗期间定期测量体重；45.7%（385/842）的受访者认为医生认为与癌症相关的体重减轻不重要。受访者[所有：56.9%（472/830）；意大利：73.0%（92/126）；西班牙：68.9%（42/61）；希腊：79.7%（47/59）]不知道治疗期间补充剂的副作用，也不知道需要告知医生这些补充剂[所有：43.6%（362/830）；意大利：55.6%（70/126）；西班牙：47.5%（29/61）；希腊：49.2%（29/59）]。术语“恶病质”通常不为受访者所知[所有：72.9%（603/827）；意大利：64.3%（81/126）；西班牙：68.9%（42/61）；希腊：47.5%（28/59）]，大多数受访者[所有：92.4%（764/827）；意大利：91.3%（115/126）；西班牙：91.8%（56/61）；希腊：86.4%（51/59）]没有接受与恶病质相关的信息。
患者报告了他们与医生在癌症相关营养问题以及癌症治疗具体营养方法方面的看法存在差异。增加医生在治疗期间对营养的关注，特别是在意大利医生中，以及向患者提供有关优化营养的信息，是改善患者生活质量的重要因素。
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