Improving Colorectal Cancer Survivors’ Nutrition Status and Quality of Life

Colorectal cancer awareness medical concept.
Researchers examined the outcomes of personalized nutrition intervention in addition to telephone-based education among colorectal cancer survivors.

Personalized nutrition interventions combined with telephone-based education from community health service centers can improve the nutritional status and quality of life (QOL) in survivors of colorectal cancer (CRC), according to a study in Nutrition.

The randomized, parallel-controlled trial was conducted at a health service center in Shanghai from July 1, 2020, to June 30, 2021.

Eligible participants were aged at least 18 years and had a first diagnosis of CRC between September 1, 2015, and July 31, 2020. All patients were randomly assigned to either the routine care or intervention group.

The routine care group received community follow-up by telephone, which included assessment of disease-relevant symptoms, lifestyle guidance, and psychological rehabilitation. The nutrition intervention group received personalized nutrition intervention from registered dietitians every 4 weeks for 6 months and telephone-based education with the WeChat app for 6 months, in addition to the follow-up in the routine care group. WeChat is a popular social media network in China and has been used as a tool for disease management.

The primary endpoint was patient-generated subjective global assessment (PG-SGA) score.

Of 72 CRC survivors identified, researchers included 56 in the final intention-to-treat analysis set: nutrition intervention group (n=28; mean age, 69.07±6.53 years; men, 50%) and routine care group (n=28; mean age, 67.50±9.34 years; men, 60.7%).

The nutrition intervention group had a statistically lower PG-SGA score (3 vs 4.5), higher energy intake (1602.38±148.95 kcal/day vs 1397.45±244.88 kcal/day), and higher protein intake (78.80±16.99 g/day vs 53.46±13.09 g/day) compared with the routine care group after 6 months. In addition, the nutrition intervention group gained more weight (2.00 kg; 95% CI, 0.25-3.00) compared with the routine care group (0.00 kg; 95% CI, -1.75 to 0.00).

The nutrition intervention and routine care groups had comparable European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire scores at baseline. After the intervention, the nutrition intervention group had significantly higher global health status, physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning (P <.05) compared with the routine care group.

The nutrition intervention group had significantly lower fatigue, pain, dyspnea, insomnia, appetite loss, and financial difficulties, as well as a significantly higher mean change of functional scores and lower symptom scores vs the routine care group, which indicates a better overall QOL after 6 months.

Study limitations include the relatively small sample size and short follow-up, as well as variations in the participants’ age and education. Also, masking of participants was not possible, and there was no crossover between the 2 treatment groups. Furthermore, only 1 return visit was planned, which was a major limitation for assessing nutrient intakes, the researchers noted.

“Taken together, personalized nutrition interventions provided by community health service centers in combination with telephone-based education were feasible and can improve the nutritional status and quality of life of colorectal cancer survivors in the community,” the study authors commented. “Personalized nutrition intervention for cancer survivors warrants further investigation in confirmatory studies.”

Reference

Wang X, Zeng H, Li L, et al. Personalized nutrition intervention improves nutritional status and quality of life of colorectal cancer survivors in the community: a randomized controlled trial. Nutrition. Published online August 28, 2022. doi:10.1016/j.nut.2022.111835