• Journal of Society of Preventive Korean Medicine
• /
• v.17 no.3
• /
• pp.129-141
• /
• 2013

Objectives : Anorexia is the primary symptom impinging cancer patients' Quality of Life. It is usually accompanied by gastrointestinal symptoms(GI symptoms). Thus, to measure anorexia symptom precisely, assessing anorexia and GI symptoms together is recommended. This study was designed to analyze cancer-related anorexia assessment tools, extract GI symptoms included in these tools and investigate usefulness of instruments in clinical trials. Methods : Instruments were selected by searching PubMed, PROQOLID database. We analyzed instruments by number of items, assessment method, type of question, GI symptoms. Results : 9 instruments were selected to assess cancer-related anorexia symptom. Most tools adopt Likert scale as response scale and 'during past week' as recall period. Assessment method of all 9 instruments is the self-administration. Questions measuring anorexia are able to be sorted into 3 forms (frequency, severeness, distress of anorexia symptom). Among the GI symptoms, nausea is included in all 9 instruments. In clinical trials of cancer-related anorexia, Edmonton Symptom Assessment Scale(ESAS) and Functional Assessment of Anorexia/Cachexia Therapy Questionnaire(FAACT) were selected as endpoint measure. Conclusions : The result showed that FAACT is the only specialized tool to assess cancer-related anorexia. To measure cancer-related anorexia precisely, the need to develop new instrument exists.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.2 no.1
• /
• pp.19-35
• /
• 1995

This study was designed to identify the severity of anorexia and the diet patterns in receiving chemotherapy. The identification of anorexia would provide useful and basic information to oncology nursing care. The subjects of this study were 102 hospitalized chemotherapy patients in a September 10, 1994. The subjects were 20 years old or above and who agreed to participate in this study and could understand the questionnaire. Three-days diet history were collected and analysed. The study subjects change, food aversions, the severity of anorexia. Data related to demographic and other mecdical characteristics such as age, diagnosis, and medication were collected by review of patient medical record. The results of this study were summarized as follows : 1) The score of anorexia was 73.7 in Anorexia Visual Analogue Scales and mean amount of fool intake per a day was 823cc. The larger the anorexia VAS score, the more severe of anorexia. 2) The food preferences of subjects were identified. Those were aversions, or dislikes the meat such as beef, pork, and chicken, and greesy or fried foods. The Caffeinated drinks such as coffee and tea were disgusted, also. The patients preferred vegetables and Korean traditional food especially kimchee and soy bean soap. 3) Those who were administered analgesics and cisplatin suffered more severe in anorexia than those who analgesics and cisplatin was not administarted. The patients with gastrointestinal cancer has more severe anorexia than those who have the other site cancer ; head and neck, genirourinary etc. The result of this study in turn provide valuable nursing practice guidelines for nutritional counseling in cancer chemotherapy patient. Nurses working with chemotherapy ward should identify the severity of anorexia and diet patterns. In conclusion, the severity of anorexia in cancer chemotherapy patients is very important problems. Health care personnels recognize the potential problems of anorexia and encourage the nutritional counseling in cancer chemotherapy patients.

• Journal of East-West Nursing Research
• /
• v.16 no.1
• /
• pp.1-10
• /
• 2010

Purpose: This study tested the effects of Nei-Guan acupressure on nausea, vomiting, and anorexia of lung cancer patients on chemotherapy. Methods: A nonequivalent control group pre-post test design was used to identify the effect of Nei-Guan acupressure on nausea, vomiting, and anorexia of lung cancer patients on chemotherapy. The participants were 60 patients who were admitted to a hospital for chemotherapy from February 1 to October 28, 2009. The patients were randomly assigned to the control group (n=30) or experimental group (n=30). The data were analyzed using Mann-Whitney test. Results: Nausea, vomiting, and anorexia were significantly decreased in the experiment group compared to the control group on the day of discharge from the hospital. However, the levels of nausea, vomiting, and anorexia between two groups were not statistically significant seven days after the discharge. Conclusions: Nei-Guan acupressure is effective in decreasing nausea, vomiting and anorexia of the patients with lung cancer on chemotherapy on the on the day of the discharge while the effectiveness is not certain 7 days after the discharge. Further study is needed to confirm these findings.

• Journal of Hospice and Palliative Care
• /
• v.17 no.1
• /
• pp.18-26
• /
• 2014

Purpose: Anorexia is a common symptom in terminal cancer patients. Some data have suggested a role of visfatin in regulating feeding behavior. We studied the relationship of a serum visfatin level and anorexia in cancer patients provided with hospice care. Methods: After informed consent was obtained, 69 cancer patients over 20 years old at a hospice center were enrolled in the study from July 2009 to July 2010. We characterized patients by age, sex, body mass index, primary cancer site, and Eastern Cooperative Oncology Group (ECOG) performance status, etc. Also, blood tests were performed to measure the level of hemoglobin, white blood cell (WBC), C-reactive protein (CRP), total cholesterol, albumin, lymphocyte count, glucose, blood urea nitrogen (BUN), creatinine, tumor necrosis factor-alpha (TNF-${\alpha}$), interukin-6, leptin and visfatin. Results: The mean age of subjects was 65.5 years old, According to univariate analysis, pulse, ECOG performance scale, opioid use and visfatin level were different between the anorexia and non-anorexic group (P<0.05). The median visfatin level was higher in the anorexia group than the good appetite group (P=0.0323). Serum visfatin concentrations were not related with either body mass index or serum leptin or total cholesterol levels, but it was negatively correlated with serum albumin levels (P=0.0198) and lymphocyte counts (P=0.0013). Conclusion: This study did not identify a novel link between visfatin levels and anorexia in cancer patients at a hospice.

• The Journal of Internal Korean Medicine
• /
• v.39 no.5
• /
• pp.1032-1041
• /
• 2018

Despite a considerable improvement in antiemetic chemotherapy and the use of antiemetic prophylaxis for decades, there are still numerous cancer patients suffering from anorexia and nausea after chemotherapy, which forces them to postpone or refuse treatment. This case report is about a 66-year-old female patient diagnosed with malignant lymphoma of the small intestine who underwent right hemicolectomy. After the tumor and the colon adjacent to it were surgically removed, the patient continued to undergo chemotherapy. Chemotherapy-induced anorexia and nausea appeared but were well treated with administration of Dokhwaljihwang-tang-gamibang. During the treatment, no adverse effect related to this Korean medicine was reported. The outcome was evaluated by the functional assessment of anorexia/cachexia therapy (FAACT); the total score increased from 85 to 130 within 12 days, and the symptoms were alleviated. This improvement might suggest the feasibility of Dokhwaljihwang-tang-gamibang to help cancer patients suffering from chemotherapy-induced anorexia and nausea.

• Journal of Korean Academy of Nursing
• /
• v.30 no.3
• /
• pp.720-730
• /
• 2000

Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.

• Journal of Korean Academy of Nursing
• /
• v.29 no.4
• /
• pp.755-765
• /
• 1999

Most people experience fatigue at some point in their lives, and they say the word ‘fatigue’ in their ordinary conversational speech. The ordinary word is used as a military or engineering term and has been studied in various different disciplines, such as ergonomics, physiology, psychology, medicine, and nursing. In spite of its widespread uses, however, fatigue has not been well defined. The term of fatigue Is thus often used with different meanings and is applied in diverse contexts that had led to a confusion of ideas. In people with cancer, fatigue is reported as a major distress. Despite the importance of fatigue in cancer patients, the phenomena of fatigue is poorly understood. Therefore, the purpose of the present study is to analyze the concept of fatigue in people with cancer. The process for the concept analysis was guided by Walker and Avant's conceptual analysis methodology. The identified attributes of fatigue in the present study were subjective feeling, lack of energy, sustenance, and multidimensions. The antecedents were cancer treatment and economic status. The consequences were decreased daily, vocational, leisure, and social activities, uncertainty, and difficulties in adjustment. Symptoms (pain, anorexia, and insomnia) and emotional disturbance were not clear whether they are antecedents or consequences. However, they are related with cancer related fatigue. Even though still in the beginning stage, instruments measuring cancer related fatigue have been developed by some nursing investigators.

• Korean Journal of Biological Psychiatry
• /
• v.13 no.2
• /
• pp.59-69
• /
• 2006

Bidirectional relationships exist between cancer and depression; the prevalence of depression in cancer patients is higher than in the general population, and depression predicts cancer progression and mortality. The mechanisms through which depression contributes to the progression of cancer are related with dysregulation of the hypothalamic-pituitary-adrenal axis and impairment of immune function. However, depression in cancer patients tends to be underdiagnosed and not appropriately treated. The methods of diagnosis and assessment of depression in cancer patents have been debated because physical symptoms of depression mimic both cancer symptoms per se and the side effects of cancer treatment. Many studies have shown that various psychosocial and/or pharmacological interventions are effective at improving de-pressive symptoms and quality of life in cancer patients. Furthermore, antidepressant treatments are effective for various physical symptoms related to cancer, such as fatigue, anorexia, pain, hot flashes, and itching. This article reviews and discusses current knowledge about depression in cancer patients.

• Journal of Nutrition and Health
• /
• v.27 no.8
• /
• pp.844-855
• /
• 1994

The purpose of this study is to investigate the nutritional status and dietary intake of gastrectomized cancer patients. For this study, from 1993. 1 to 1993. 8, 50 postoperative gastric cancer patients were selected to examine anthropometric and laboratory data(Body Weight, Body Fat, serum Albumin, Total Lympocyte count), and dietary intake related symptoms. The results were 1) All anthropometric and laboratory data were significantly deteriorated by gastrectomy(s-Albumin, TLC. Body Fat : p<0.001). Weight loss of gastrectomized patients was 8.23$\pm$3.72% from admission to discharge. 2) In many gastrectomized cancer patients, preoperative dietary intake was decreased by abdominal discomfort, indigestion, early satiety, and anorexia. 3) Postoperative energy intake was 602$\pm$158㎉, and it is correspond to 31.18$\pm$.90% of daily energy requirement(1918$\pm$236㎉). The cause of poor oral intake is mostly fear, abdominal distension and fullness, and early satiety. In consideration of the fact that an inadequate energy intake was the main cause of the decreasing nutritional status, a careful nutritional care and dietary education is necessry after gastrectomy.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.19
• /
• pp.8475-8478
• /
• 2014

Purpose: This systematic analysis was conducted to evaluate the efficacy and safety of pemetrexed-based chemoradiotherapy in treating patients with locally advanced or metastatic esophageal cancer. Methods: Clinical studies evaluating the efficacy and safety of pemetrexed based regimens on response and safety for relevant patients were identified using a predefined search strategy. Pooled response rates (RRs) were calculated. Results: For pemetrexed-based regimens, 4 clinical studies including 47 patients with locally advanced or metastatic esophageal cancer were considered eligible for inclusion. Systematic analysis showed that, in all patients, the pooled RR was 51% (24/47). Major adverse effects of grade III/IV were esophagitis, neutropenia, thrombocytopenia, anemia anorexia, fatigue, diarrhea, dysphagia and vomiting. No treatment related death occurred with pemetrexed-based treatment. Conclusion: This systematic analysis suggests that pemetrexed based radiotherapy is associated with reasonable activity and good tolerability in treating patients with locally advanced or metastatic esophageal cancer.