Article Text

PDF
A multidisciplinary rehabilitation programme for cancer cachexia improves quality of life
  1. Monica P Parmar1,
  2. Brandy L Vanderbyl1,
  3. Mary Kanbalian1,
  4. Tamara Y Windholz1,
  5. Anh-Thi Tran1,2 and
  6. R Thomas Jagoe1,2
  1. 1 McGill Cancer Nutrition Rehabilitation Program, Segal Cancer Centre, Jewish General Hospital, Montreal, Canada
  2. 2 Peter Brojde Lung Cancer Centre, Segal Cancer Centre, Jewish General Hospital, Montreal, Canada
  1. Correspondence to Dr R Thomas Jagoe, Jewish General Hospital, 3755 Ch de la Cote-Sainte-Catherine, Montreal QC, Canada; thomas.jagoe{at}mcgill.ca

Abstract

Objectives Patients with cancer cachexia have severely impaired quality of life (QoL). Multidisciplinary, multimodal treatment approaches have potential for stabilising weight and correcting other features of this syndrome, but the impact on QoL is unknown.

Methods A retrospective analysis of QoL in patients with advanced cancer, referred for the management of cachexia by a specialised multidisciplinary clinic (The McGill Cancer Nutrition Rehabilitation Program clinic at the Jewish General Hospital (CNR-JGH)). QoL was assessed at visits 1–3 using a dedicated QoL tool for cachexia, and the change in QoL was calculated for each patient. The correlation between clinical features and QoL at baseline and subsequent change in QoL was analysed, to determine what factors predict improvements in QoL during the CNR-JGH intervention.

Results 374 patients assessed at visit 1 with mean weight loss of 10.2% over the preceding 6 months. Baseline QoL scores were severely impaired but clinically important improvements were observed over visits 1–3 to the CNR-JGH clinic. Improvements in QoL were not determined by baseline characteristics and were similar in all patient subgroups. However, those patients who gained weight and increased their 6 min walk test (6MWT) had the greatest improvements in QoL.

Conclusions Improving management of all facets of the cancer cachexia syndrome, including poor QoL, remains a priority. The multimodal approach to management of cancer cachexia offered by the CNR-JGH results in clinically important improvements in QoL. All patients who are able to receive this type of intervention have similar potential to improve their QoL, but the greatest benefits are seen in those who gain weight and improve their 6MWT.

  • Cancer cachexia
  • quality of life
  • anorexia
  • fatigue
  • weight loss
  • performance status
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors RTJ and MP conceived study. AT, TW collected data on exercise groups and performed functional testing. MK administered questionnaires, processed and calculated data from quality of life questionnaires and assembled all additional data. RTJ performed analysis. RTJ, MP, BV wrote the initial manuscript. All authors contributed to editing and correcting the final manuscript.

  • Funding AT and RTJ received salary support from the Peter Brojde Lung Cancer Centre and RTJ received salary support from the Backler Foundation, Jewish General Hospital Foundation. The CNR-JGH received financial support from funds raised by the Angel Ball, Stephen and Lillian Vineberg and the Lila Sigal Hockey Marathon.

  • Competing interests None declared.

  • Ethics approval Jewish General Hospital Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.