Head and Neck Cancer Survivors’ Experiences with Chronic Nutrition Impact Symptom Burden after Radiation: A Qualitative Study

Crowder, Sylvia L.; Najam, Natasha; Sarma, K.V.S.; Fiese, Barbara H.; Arthur, Anna E.

doi:10.1016/j.jand.2020.04.016

Cited by 22 publications

(16 citation statements)

References 25 publications

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“…The increase in lycopene consumption was significantly related to the protective effect of this CTD against radiation damage in experiments carried out in animal models; lycopene supplementation after the use of external beam radiation therapy reduced the frequency of weight loss and the parameters of oxidative stress [ 208 ]. Nutrition-based multicentre interventions to reduce the incidence of NIS in people with HNSCC have also been postulated; the use of such clinical interventions may contribute to improvement in the quality of life, functional status, and implementation of healthy dietary habits in this population [ 209 , 210 ].…”

Section: Resultsmentioning

confidence: 99%

Dietary Carotenoids in Head and Neck Cancer—Molecular and Clinical Implications

Starska

2022

Nutrients

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Head and neck cancer (HNC) is one of the most common cancers in the world according to GLOBCAN. In 2018, it was reported that HNC accounts for approximately 3% of all human cancers (51,540 new cases) and is the cause of nearly 1.5% of all cancer deaths (10,030 deaths). Despite great advances in treatment, HNC is indicated as a leading cause of death worldwide. In addition to having a positive impact on general health, a diet rich in carotenoids can regulate stages in the course of carcinogenesis; indeed, strong epidemiological associations exist between dietary carotenoids and HNS, and it is presumed that diets with carotenoids can even reduce cancer risk. They have also been proposed as potential chemotherapeutic agents and substances used in chemoprevention of HNC. The present review discusses the links between dietary carotenoids and HNC. It examines the prospective anticancer effect of dietary carotenoids against intracellular cell signalling and mechanisms, oxidative stress regulation, as well as their impact on apoptosis, cell cycle progression, cell proliferation, angiogenesis, metastasis, and chemoprevention; it also provides an overview of the limited preclinical and clinical research published in this arena. Recent epidemiological, key opinion-forming systematic reviews, cross-sectional, longitudinal, prospective, and interventional studies based on in vitro and animal models of HNC also indicate that high carotenoid content obtained from daily supplementation has positive effects on the initiation, promotion, and progression of HNC. This article presents these results according to their increasing clinical credibility.

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Section: Resultsmentioning

confidence: 99%

Dietary Carotenoids in Head and Neck Cancer—Molecular and Clinical Implications

Starska

2022

Nutrients

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“…Malignancies are usually treated through surgery, chemotherapy, and radiotherapy, which can be given individually or, more commonly, in combination. All these methods can increase the incidence of diet-related problems [7][8][9]. Moreover, the use of chemotherapy or radiotherapy, especially when combined, can increase the incidence of adverse effects, such as oropharyngeal mucositis, odynophagia, taste disturbances, xerostomia, nausea, vomiting and fatigue; all of these can contribute to dehydration and significant weight loss [10,11], impaired nutritional status, functional capacity, and quality of life [12,13].…”

Section: Introductionmentioning

confidence: 99%

The health risks of dysphagia for patients with head and neck cancer: a multicentre prospective observational study

et al. 2021

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It is well known that malnutrition is a frequent co-morbidity in cancer patients, especially in those with head and neck neoplasms. This may be due both to the presence of dysphagia symptoms and to the appearance of adverse effects on chemotherapy and / or radiotherapy. The aim of this retrospective observational multicentric study is to evaluate the nutritional status between dysphagia cancer patients and non-dysphagia cancer patients. Data from 60 patients were analysed, 31 of which without dysphagia and 29 with dysphagia. Results highlight that patients with dysphagia had higher involuntary body weight loss than non-dysphagia ones (p < 0.001). By analysing the entire population, it stands out a weight loss rate of 12 ± 9% compared to the usual weight was observed and a prevalence of moderate / severe malnutrition diagnosis of 53%. Furthermore, 76% of the population who manifested the symptom of dysphagia presented severe malnutrition already at the first visit, compared to 32% of non-dysphagia subjects.

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“…However, few studies have examined the chronic impact of aggregated NIS burden on overall and domain-specific quality of life and functional status. This is of the upmost importance as one of the most important quality of life factors is nutrition [ 13 ] and adaptations to eating and psychological concerns regarding dysphagia and xerostomia may further reduce functional status in survivors [ 2 , 14 , 15 ]. The HNC population faces unique nutritional challenges as compared to other cancer types, likely decreasing functional status and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Chronic Nutrition Impact Symptoms Are Associated with Decreased Functional Status, Quality of Life, and Diet Quality in a Pilot Study of Long-Term Post-Radiation Head and Neck Cancer Survivors

Crowder

Sarma

et al. 2021

Nutrients

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Background: As a result of tumor location and treatment that is aggressive, head and neck cancer (HNC) survivors experience an array of symptoms impacting the ability and desire to eat termed nutrition impact symptoms (NISs). Despite increasing cancer survival time, the majority of research studies examining the impact of NISs have been based on clinical samples of HNC patients during the acute phase of treatment. NISs are often chronic and persist beyond the completion of treatment or may develop as late side effects. Therefore, our research team examined chronic NIS complications on HNC survivors’ functional status, quality of life, and diet quality. Methods: This was a cross-sectional study of 42 HNC survivors who were at least 6 months post-radiation. Self-reported data on demographics, NISs, quality of life, and usual diet over the past year were obtained. Objective measures of functional status included the short physical performance battery and InBody© 270 body composition testing. NISs were coded so a lower score indicated lower symptom burden, (range 4–17) and dichotomized as ≤10 vs. >10, the median in the dataset. Wilcoxon rank sum tests were performed between the dichotomized NIS summary score and continuous quality of life and functional status outcomes. Diet quality for HNC survivors was calculated using the Healthy Eating Index 2015 (HEI-2015). Wilcoxon rank sum tests examined the difference between the HNC HEI-2015 as compared to the National Health and Nutrition Examination Survey (NHANES) data calculated using the population ratio method. Results: A lower NIS score was statistically associated with higher posttreatment lean muscle mass (p = 0.002). A lower NIS score was associated with higher functional (p = 0.0006), physical (p = 0.0007), emotional (p = 0.007), and total (p < 0.0001) quality of life. Compared to NHANES controls, HNC survivors reported a significantly lower HEI-2015 diet quality score (p = 0.0001). Conclusions: Lower NIS burden was associated with higher lean muscle mass and functional, physical, emotional, and total quality of life in post-radiation HNC survivors. HNC survivors reported a significantly lower total HEI-2015 as compared to healthy NHANES controls, providing support for the hypothesis that chronic NIS burden impacts the desire and ability to eat. The effects of this pilot study were strong enough to be detected by straight forward statistical approaches and warrant a larger longitudinal study. For survivors most impacted by NIS burden, multidisciplinary post-radiation exercise and nutrition-based interventions to manage NISs and improve functional status, quality of life, and diet quality in this survivor population are needed.

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Head and Neck Cancer Survivors’ Experiences with Chronic Nutrition Impact Symptom Burden after Radiation: A Qualitative Study

Cited by 22 publications

References 25 publications

Dietary Carotenoids in Head and Neck Cancer—Molecular and Clinical Implications

Dietary Carotenoids in Head and Neck Cancer—Molecular and Clinical Implications

The health risks of dysphagia for patients with head and neck cancer: a multicentre prospective observational study

Chronic Nutrition Impact Symptoms Are Associated with Decreased Functional Status, Quality of Life, and Diet Quality in a Pilot Study of Long-Term Post-Radiation Head and Neck Cancer Survivors

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