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Management of Anorexia-Cachexia in Late-Stage Lung Cancer Patients

Del Ferraro, Catherine MSN, Ed, BSN, PHN, RN, CCRP; Grant, Marcia DNSc, RN, FAAN; Koczywas, Marianna MD; Dorr-Uyemura, Laura A. RD

Journal of Hospice & Palliative Nursing: August 2012 - Volume 14 - Issue 6 - p 397–402
doi: 10.1097/NJH.0b013e31825f3470
Symptom Management Series

Nutritional deficiencies are experienced by most adults with advanced lung cancer during the course of their disease and treatment. Well-nourished individuals tolerate cancer treatment with less morbidity, mortality, and increased response to treatment as compared with those who are malnourished. Novel anticancer therapies cause many deficits that impact nutritional and functional status during the treatment process. Nutritional deficits include weight loss, malnutrition, and anorexia-cachexia. Anorexia-cachexia is complex, not well understood and seen in many solid tumors in late-stage disease. Assessing adequate nutrition is one of the most challenging problems for nurses, their patients, and patient’s families. The purpose of this review was to define and describe cancer anorexia-cachexia in late-stage lung cancer, through case presentation, and to describe palliative strategies for prevention, assessment, and management in the palliative care setting. Early assessment for nutritional imbalances must be done regularly with reevaluation for intervention effectiveness and should continue throughout the illness trajectory. Management of adverse effects of cancer and cancer-related treatment is critical to improving quality of life. Palliative care and hospice nurses play a critical role in early assessment, education, and prevention to support nutritional needs for patients and their families.

Catherine Del Ferraro, MSN, Ed, BSN, PHN, RN, CCRP, is Senior Research Specialist, Department of Population Sciences, Division of Nursing Research and Education, City of Hope, Duarte, CA.

Marcia Grant, DNSc, RN, FAAN, is Director and Professor, Department of Population Sciences, Division of Nursing Research and Education, City of Hope, Duarte, CA.

Marianna Koczywas, MD, is Clinical Professor, Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA.

Laura A. Dorr-Uyemura, RD, is Director, Clinical Nutrition Services, City of Hope, Duarte, CA.

Address correspondence to Catherine Del Ferraro, MSN, Ed, BSN, PHN, RN, CCRP, Division of Nursing Research and Education, City of Hope, 1500 E Duarte Rd, Population Science Bldg #173, Room 169, Duarte, CA 91010 (cdelferraro@coh.org).

The authors have no conflict of interest to disclose.

This work is supported by a grant from the National Cancer Institute (PO1 CA 136396–Palliative Care for Quality of Life and Symptom Concerns in Lung Cancer; B. Ferrell, principal investigator).

© 2012 The Hospice and Palliative Nurses Association