Predictors of Malnutrition and Quality of Life among Advanced Cervical Cancer Patients with Cachexia in Uganda

Authors: Innocent Atuhe, Alfred Jatho, Yusuf Mulumba, Babra Nalwadda, Jackson Orem

Abstract:

Statement of the Problem: Malnutrition and cachexia are common in cancer and often contribute to poor health outcomes. Advanced cervical cancer patients are at an increased risk of malnutrition, chemo-toxicity, poor quality of life (QoL), and higher mortality. It is recommended to assess all cancer patients for malnutrition, risk of malnutrition, and QoL in order to provide targeted care, especially for advanced cancer patients. Objective: The aim of this study was to assess the prevalence of malnutrition or risk of malnutrition and health-related quality of life in advanced cervical cancer patients with cachexia. Methodology: This was a longitudinal study of 212 advanced cervical cancer patients with a confirmed diagnosis of cachexia receiving chemotherapy at the Uganda Cancer Institute between January 2022 and September 2023. We confirmed the diagnosis of cachexia using the international consensus definition. We evaluated each patient for malnutrition using the Mini Nutritional Assessment (MNA) tool and assessed their QoL using the Feeling of well-being (FWB) on the Edmonton Symptom Assessment System (ESAS) questionnaire and the Distress Thermometer (DT) questionnaire. Data was analyzed using Excel and presented using frequencies and percentages. Results: Of the 212 advanced cervical cancer patients with cachexia, 65 (31.7%) of the respondents were malnourished, and 118 (57.6%) were at risk of malnutrition; the average ESAS score was 3, indicating less symptom burden while 115 (54.2%) were extremely distressed with pain as major distress. Conclusion and Significance: The majority of the patients with advanced cervical cancer cachexia were at risk of malnutrition. There is an urgent need to assess all patients with advanced cancer for malnutrition and risk of malnutrition and immediate referral of those with malnutrition to the nutritionist for interventions to improve QoL and overall survival.

Keywords: malnutrition, QoL, cachexia, cancer