Analysis of current status and influencing factors of cancer-related anorexia in patients undergoing chemotherapy for gynecological malignancies

This study aims to assess the prevalence of cancer-related anorexia in patients undergoing chemotherapy for gynecological malignancies, including cervical cancer, endometrial cancer and ovarian cancer, as well as identify the corresponding influencing factors and potential countermeasures. Using a convenience sampling method, a total of 210 patients with gynecological malignancies who underwent chemotherapy between 2022 and 2023 at our hospital were identified. These patients were surveyed using a general data questionnaire, the Anorexia/Cachexia Subscale-12 (A/CS-12), and the Social Support Rating Scale (SSRS). Among them, 108 (51.4%) were found to have cancer-related anorexia. Univariate analysis revealed that age, marital status, economic level, chemotherapy stage, and social support level were statistically significant factors associated with the prevalence of cancer-related anorexia (p < 0.05). Further analysis using binary logistic regression identified economic level, chemotherapy stage, and social support level as independent risk factors for cancer-related anorexia in this patient population (p < 0.05). In conclusion, our findings indicate that cancer-related anorexia is prevalent among patients with gynecological malignancies undergoing chemotherapy and is influenced by multiple factors. Thus, it is essential that clinical staff develop individualized treatment plans based on patient’s specific conditions to reduce the risk of cancer-related anorexia and improve overall quality of life.

Gynecologic malignancy; Cancer-related anorexia; Influencing factors; Chemotherapy

[1] Piechocki M, Koziołek W, Sroka D, Matrejek A, Miziołek P, Saiuk N, et al. Trends in incidence and mortality of gynecological and breast cancers in Poland (1980–2018). Clinical Epidemiology. 2022; 14: 95–114.

[2] Wang Z, Guo E, Yang B, Xiao R, Lu F, You L, et al. Trends and age-period-cohort effects on mortality of the three major gynecologic cancers in China from 1990 to 2019: cervical, ovarian and uterine cancer. Gynecologic Oncology. 2021; 163: 358–363.

[3] Yeom E, Yu K. Understanding the molecular basis of anorexia and tissue wasting in cancer cachexia. Experimental & Molecular Medicine. 2022; 54: 426–432.

[4] Yeom E. Recent studies on anorexia and tissue wasting induced by cancer cachexia. Journal of Life Science. 2022; 32: 263–269. (In Korean)

[5] Peixoto da Silva S, Santos JMO, Costa ESMP, Gil da Costa RM, Medeiros R. Cancer cachexia and its pathophysiology: links with sarcopenia, anorexia and asthenia. Journal of Cachexia, Sarcopenia and Muscle. 2020; 11: 619–635.

[6] Fonseca G, von Haehling S. An overview of anamorelin as a treatment option for cancer-associated anorexia and cachexia. Expert Opinion on Pharmacotherapy. 2021; 22: 889–895.

[7] D’Augè TG, Giannini A, Bogani G, Dio CD, Lagana AS, Donato VD, et al. Prevention, screening, treatment and follow-up of gynecological cancers: state of art and future perspectives. Clinical and Experimental Obstetrics & Gynecology. 2023; 50: 160.

[8] Harris BS, Bishop KC, Kuller JA, Ford AC, Muasher LC, Cantrell SE, et al. Hormonal management of menopausal symptoms in women with a history of gynecologic malignancy. Menopause. 2020; 27: 243–248.

[9] Morton M, Patterson J, Sciuva J, Perni J, Backes F, Nagel C, et al. Malnutrition, sarcopenia, and cancer cachexia in gynecologic cancer. Gynecologic Oncology. 2023; 175: 142–155.

[10] Zhao J, Kong Y, Xiang Y, Yang J. The research landscape of the quality of life or psychological impact on gynecological cancer patients: a bibliometric analysis. Frontiers in Oncology. 2023; 13: 1115852.

[11] Zhang L, Zhou C, Wu Y, Du D, He L, He L, et al. Assessment and nonpharmacological management for patients with cancer anorexia-cachexia syndrome: a best practice implementation project. JBI Evidence Implementation. 2022; 20: 334–343.

[12] Sun J, Sun R, Jiang Y, Chen X, Li Z, Ma Z, et al. The relationship between psychological health and social support: evidence from physicians in China. PLOS ONE. 2020; 15: e0228152.

[13] Puckett L, Grayeb D, Khatri V, Cass K, Mehler P. A comprehensive review of complications and new findings associated with anorexia nervosa. Journal of Clinical Medicine. 2021; 10: 2555.

[14] Abdallah Hasaneen M AIK, Gamal A M, Khalil AK. Assessment of health problems caused by gynecological malignancies treatments. Menoufia Nursing Journal. 2021; 6: 51–64.

[15] Spagnoletti BRM, Bennett LR, Keenan C, Shetty SS, Manderson L, McPake B, et al. What factors shape quality of life for women affected by gynaecological cancer in South, South East and East Asian countries? A critical review. Reprod Health. 2022; 19: 70.

[16] Zuo Y, Luo BR, Peng WT, Liu XR, He YL, Zhang JJ. Informal caregiver burden and influencing factors in gynaecological oncology patients hospitalized for chemotherapy: a cross-sectional study. Journal of International Medical Research. 2020; 48: 300060520974927.

[17] Ma SG, Deng X, Xing L, Huang Y. Postoperative health-related quality of life of patients with gynecological malignancy: a meta-analysis. Support Care Cancer. 2021; 29: 4209–4221.

[18] Opheim L, Engeskaug I, Bjerre Trent PK, Thorsen L, Staff AC, Nordskar NJ, et al. Associations between modifiable lifestyle factors and health-related quality of life among endometrial carcinoma survivors—a cross-sectional study. Gynecologic Oncology. 2023; 179: 52–62.

[19] Andreyev HJN, Lalji A, Mohammed K, Muls ACG, Watkins D, Rao S, et al. The FOCCUS study: a prospective evaluation of the frequency, severity and treatable causes of gastrointestinal symptoms during and after chemotherapy. Supportive Care in Cancer. 2021; 29: 1443–1453.

[20] Jafarimanesh H, Akbari M, Hoseinian R, Zarei M, Harorani M. The effect of peppermint (Mentha piperita) extract on the severity of nausea, vomiting and anorexia in patients with breast cancer undergoing chemotherapy: a randomized controlled trial. Integrative Cancer Therapies. 2020; 19: 1534735420967084.

[21] Oakvik J, Ready D. Updates in cancer-related symptom management of anorexia and cachexia syndrome. Seminars in Oncology Nursing. 2022; 38: 151254.

[22] Oh GH, Yeom CW, Shim EJ, Jung D, Lee KM, Son KL, et al. The effect of perceived social support on chemotherapy-related symptoms in patients with breast cancer: a prospective observational study. Journal of Psychosomatic Research. 2020; 130: 109911.

[23] Baba MR, Buch SA. Revisiting cancer cachexia: pathogenesis, diagnosis, and current treatment approaches. Asia-Pacific Journal of Oncology Nursing. 2021; 8: 508–518.

[24] Gaafer OU, Zimmers TA. Nutrition challenges of cancer cachexia. Journal of Parenteral and Enteral Nutrition. 2021; 45: 16–25.

[25] Ukovic B, Porter J. Nutrition interventions to improve the appetite of adults undergoing cancer treatment: a systematic review. Supportive Care in Cancer. 2020; 28: 4575–4583.

[26] Darakhshandeh A MM. Cachexia and anorexia in cancer; a systematic review. Immunopathologia Persa. 2020; 7: e20.

[27] Aprile G, Basile D, Giaretta R, Schiavo G, La Verde N, Corradi E, et al. The clinical value of nutritional care before and during active cancer treatment. Nutrients. 2021; 13: 1196.

[28] Arends J, Strasser F, Gonella S, Solheim TS, Madeddu C, Ravasco P, et al. Cancer cachexia in adult patients: ESMO clinical practice guidelines. ESMO Open. 2021; 6: 100092.