Balogun, Nyaladzi; (2018) Nutritional status of women referred to a gynaecological cancer centre for treatment of a pelvic mass. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Background: Malnutrition is a major challenge for patients diagnosed with ovarian cancer and affects between 28% and 67% of women at some point in their cancer trajectory. It is strongly associated with poor health outcomes and decreased survival. Few studies have evaluated nutritional status in this population. The impact of nutritional intervention on outcomes such as body composition and survival is also not well understood. Characterising changes in nutritional status and understanding how women perceive a cancer diagnosis to affect their diet and nutritional needs is required. // Aim: This study characterises nutritional status of women diagnosed with ovarian cancer during the period of acute first-line treatment. It also explores the perceptions of women regarding their nutrition and dietary needs and their preferences for supportive intervention. // Methods: A mixed-method (quantitative/qualitative) study was conducted to prospectively assess nutritional status. 58 newly diagnosed women and 27 controls were recruited and anthropometric/body composition measures (weight, body fat, dry lean mass, lean mass total body water and extracellular water) and biochemical markers (prealbumin, albumin, C-reactive protein, CA125) assessed at baseline, during treatment and at the end of treatment. Women also completed a study specific questionnaire on their health and dietary intake as well as quality of life questionnaires. Data was analysed using SPSS. Two focus groups with 8 eight women were conducted and discussions centred on the importance of nutrition. The group sessions were recorded, transcribed verbatim and analysed using thematic analysis. // Results: The findings are that some women (43%) are malnourished by the time they attend a cancer centre for investigation or treatment of ovarian their cancer. They have lost weight, have decreased lean mass and a low prealbumin. Their quality of life is also affected. Women in the study consider their diet and nutrition to be important and do not feel adequately supported by their clinical team. Nutritional support based on current practice does not seem to improve nutrition outcomes. // Conclusion: Well-designed, targeted, randomised controlled trials with specific interventions aimed at early treatment and prevention of further nutritional complications in ovarian cancer patients are urgently required.

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