Transcript 10 (36%) - BC Cancer Agency

Nutrition Information Needs of Lung Cancer Patients
Yeung T2, BSc candidate, (Dietetics); Sekhon S1, Bsc, RD; Levy-Milne R1,2, PhD, RD
1. B.C. Cancer Agency, Vancouver, B.C. 2. University of British Columbia, Vancouver, British Columbia
Introduction
• Lung cancer is one of the most common causes of cancer death
for both men and women in North America. Lung cancer patients
typically have a 5-year survival rate of 17% among women and
14% among men.
• Upon diagnosis, cancer patients express motivation for
changing dietary behaviour to increase well-being and prevent
cancer recurrence.
• Recent pilot studies conducted at the BC Cancer Agency
demonstrated that nutrition is one of the main concerns among
lung cancer patients and Chinese cancer support group
participants. However, there are few reports in the literature that
have examined the specific nutrition-related concerns of these
patients.
•Health care providers are challenged to develop information
resources for the complex needs of these patients.
Table 1. Patient Demographics
Table 4. Levels of Interest in Cancer-Related Symptoms
Patient Characteristics
Number of
Patients
(n=35)
Cancer-Related
Symptoms
Not
Slightly
Interested Interested
Interested Very
Interested
Nausea
4 (15%)
6 (22%)
10 (37%)
7 (26%)
Male
19 (54%)
Shortness of Breath
2 (7%)
4 (13%)
10 (32%)
14 (45%)
Female
16 (45%)
Fatigue
1 (3%)
4 (14%)
10 (35%)
14 (48%)
< 50
7 (20%)
Taste Changes
2 (7%)
5 (18%)
7 (25%)
14 (50%)
50-64
16 (46%)
3 (10%)
6 (21%)
10 (25%)
10 (35%)
 65
12 (34%)
Mouth and Swallowing
Problems
Caucasian
22 (63%)
Loss of Appetite
3 (11%)
3 (11%)
9 (32%)
13 (46%)
Asian
13 (37%)
Weight Loss
2 (7%)
5 (17%)
11 (38%)
11 (38%)
< 18.5
1 (3%)
Diarrhea
5 (18%)
2 (7%)
10 (36%)
11 (39%)
18.5-29.9
30 (88%)
Constipation
0 (0%
4 (14%)
14 (50%)
10 (36%)
> 29.9
3 (9%)
< 2002
2 (6%)
2003-2005
5 (15%)
> 2006
0 (0%)
Received Past
Treatment
24 (69%)
Presently
Receiving
Treatment
10 (29%)
Gender
Age (years)
Ethnicity
BMI
Year of Cancer
Diagnosis
Cancer
Treatment
Note: Out of a possible35 responses; responses indicating unsure are not
included
Figure 5. Top 3 Sources for
Diet and Nutrition Information
Doctor
20
19
17
18
• Identify nutrition and information needs of lung cancer patients
and how they would like to receive this information.
Nutrition-Related
Topics
Vegetables and Fruit
Not
Interested
0 (0%)
Slightly
Interested
2 (6%)
Interested
Very
Interested
11 (32%)
15
16
Number of Respondents
Project Purpose
Table 2. Levels of Interest in Diet and Nutrition
Topics
Other Health
Professionals
Registered Dietitian
Naturopathic/Homeopathi
c Practitioner
Support Group/Support
Services
Family Members and
Friends
Media
14
12
11
9
10
8
0 (0%)
6 (18%)
3
4
5
Pamphlets
3
2
Internet
15 (45%)
0
Telephone Hotlines
0
Milk and Milk Alternatives 2 (7%)
Methods
• Ethical approval was obtained from the UBC BCCA Research
Ethics Board.
4 (13%)
5 (16%)
11 (37%)
13 (43%)
Meat and Meat
Alternatives
3 (10%)
14 (45%)
Fat Content
3 (10%)
8 (28%)
8 (28%)
8 (28%)
Sugar
3 (9%)
3 (9%)
9 (28%)
14 (44%)
Nutritional Supplements
4 (13%)
6 (16%)
11 (36%)
14 (32%)
Food-Drug Interactions
4 (13%)
3 (10%)
14 (45%)
9 (29%)
Vegetarian Diets
7 (23%)
3 (10%)
8 (27%)
11 (37%)
S e rie s 1
Health Care
Organizations
Sources of Information
9 (29%)
Figure 6. Top 3 Methods of Receiving Diet
and Nutrition Information
30
• Patients were also asked to select their top three sources of
nutrition information and preferred methods of information
modality.
• The questionnaire was translated into Chinese and
administered to participants including patients and caregivers
that participated in the Chinese Support Group. However, not all
patients in the Chinese Support group had lung cancer and
therefore only those with lung cancer were included in the data
analysis and results.
Lessons Learned and Limitations
•Demographic bias was expected as most of the respondents were
educated and therefore more likely to participate in health studies.
9 (28%)
12 (38%)
6 (19%)
Meal Preparation
6 (19%)
8 (26%)
8 (26%)
6 (19%)
Juicing
5 (17%)
9 (30%)
9 (30%)
4 (13%)
Healthy Eating
1 (3%)
6 (19%)
8 (25%)
15 (47%)
Organic Foods
2 (6%)
7 (23%)
8 (26%)
11 (36%)
Boosting Immune
System
0 (0%)
2 (7%)
11 (37%)
14 (47%)
High Calorie, High
Protein Foods
2 (6%)
9 (29%)
6 (19%)
11 (36%)
Internet/Web-based
Electronic Format
20
Email or Mailed
Information
Video-linked Sessions
20
15
•Language posed a barrier to study participation. A greater number
of Chinese-speaking patients from the lung clinic and Chinese
support group consented to participate upon translation of the
survey.
•Participants identified taste changes, fatigue, loss of appetite,
shortness of breath, diarrhea, weight loss, and mouth and
swallowing problems as cancer-related topics of interest to
them (Table 4).
•Registered dietitians were not considered a primary source for
nutrition information (Figure 5). Sources most often consulted
were doctors, family members and friends and other health
professionals.
•Majority of respondents preferred to receive written nutrition
information via pamphlet, mai or email (Figure 6).
•Most participants felt that nutrition plays a role by helping with
cancer recovery, improving quality of life and looking or feeling
better (Figure 7).
14
Phone Contact
13
Home Visit
Office Visit
Note: Out of a possible35 responses; responses indicating unsure are not
included
Conclusions
7
•Lung cancer patients are interested in healthy eating,
nutritional supplements and symptom management strategies
through pamphlets, mail or emailed information.
5
5
4
3
2
0
Methods
Dietary Supplements
Not
Interested
Slightly
Interested
Interested Very
Interested
Multi-Vitamin and
Mineral Supplements
1 (3%)
10 (29%)
12 (35%)
11 (32%)
Vitamin A
5 (18%)
9 (32%)
6 (21%)
5 (18%)
Beta-Carotene
4 (14%)
10 (36%)
8 (29%)
4 (14%)
Vitamin E
2 (8%)
7 (27%)
10 (39%)
5 (19%)
Vitamin C
2 (7%)
8 (29%)
9 (32%)
8 (29%)
Vitamin B Complex
2 (8%)
4 (15%)
10 (39%)
6 (23%)
Vitamin D
3 (10%)
6 (20%)
10 (33%)
10 (33%)
Fish Oil Complex
5 (19%)
5 (19%)
7 (27%)
7 (27%)
Flax
4 (14%)
3 (11%)
10 (36%)
10 (36%)
Other Omega-3
Supplements
2 (7%)
3 (11%)
12 (44%)
8 (30%)
Calcium
3 (10%)
4 (13%)
13 (43%)
9 (30%)
Iron
3 (11%)
5 (19%)
9 (33%)
9 (33%)
Protein Powders
6 (22%)
10 (37%)
7 (26%)
3 (11%)
Fibre Supplements
7 (27%)
9 (35%)
8 (31%)
1 (4%)
•Complementary and alternative therapies were not a topic of
great interest for this group.
Figure 7. Top 3 Roles Nutrition Plays in Relation to
Diagnosis
30
Increased Control
Over Life
25
25
Help with Cancer
Recovery
20
Note: Out of a possible35 responses; responses indicating unsure are not
included
•Lung patients primarily turn to their doctors and other health
care providers for nutritional counsel and guidance. Registered
dietitians are not considered a primary source for nutrition
information. Thus doctors could play a key role in the
dissemination of nutrition information.
•Addressing information needs of lung cancer patients is
important to improve patient care and satisfaction.
Improved Quality of
Life
To Look or Feel
Better
15
15
To Prevent/Delay
Recurrence
10
9
Achieve Another
Health Goal
I Do Not Feel
Nutrition Plays a
Role
5
5
3
•The survey was administered in-person while patients waited for
their physician appointment. It was labour intensive to have
someone available to approach patients and administer the survey.
•Contrary to the literature, over 60% of respondents cited no
interest in complementary and alternative therapies (data not
shown).
Group Sessions
7
•The short duration of the study resulted in a small sample size.
•Multi-vitamin and mineral supplements, flax, iron, and vitamin
D received greater interest (Table 3).
25
10
Table 3. Levels of Interest in Dietary Supplements
Diet and Nutrition
•Lung patients are very interested in healthy eating, and want
more information on vegetables and fruit, organic foods, whole
grains, nutritional supplements, sugar, boosting the immune
system, and high calorie, high protein foods (Table 2).
Pamphlets
25
Number of Respondents
• The 22-item survey gathered data on demographics, medical
history, nutritional concerns, complementary therapies, and
information seeking behaviors. On a likert rating scale from ‘not
interested’ to ‘very interested’, 35 patients rated the importance
of the following: general nutrition, dietary supplements,
complementary and alternative therapies, and cancer-related
symptoms.
3 (9%)
Number of Respondents
• A questionnaire was administered to lung cancer patients
attending the outpatient Lung Cancer Clinic and the Chinese
Cancer Support Group at the BCCA Vancouver Centre.
Cooking Methods
Demographics
• The majority of participants (n=35) were between 50 to 64
years of age with slightly more females than males (Table 1).
• Most participants had at least a high school
diploma and consisted mainly of cancer survivors.
• More than half of the participants were currently not receiving
treatment.
Bookes and Journals
5
6
20 (59%)
11 (33%)
• Out of 37 surveys that were collected, 35 surveys were used
in the study.
8
2
Whole Grains
Summary of Findings
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