Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Cancer Nutrition and Exercise rehabilitation program (CaNE) for patients with advanced cancer at risk of cancer cachexia syndrome: qualitative findings (#238)

Sim Yee (Cindy) Tan 1 2 , Janette Vardy 1 2 , Jane Turner 1 , Sarah Ratcliffe 3 , Mona Faris 4 , Prunella Blinman 1 , Haryana Dhillon 3 4
  1. Concord Cancer Centre , Concord Hospital, Concord, NSW, Australia
  2. Sydney Medical School, University of Sydney, Concord, NSW, Australia
  3. Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, NSW, Australia
  4. Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology,, University of Sydney, Sydney, Sydney, New South Wales , Australia

Background

Cancer cachexia syndrome occurs in up to 15-20% of patients with advanced cancer, but it is poorly understood and the pathophysiology is likely multifactorial.  We conducted a feasibility study assessing a 12-week supervised resistance exercise program with protein and fish oil supplements in patients with advanced upper gastrointestinal (UGI) cancer or lung cancer.

 

Aims: Here we aimed to report the participants’ perceptions of the program.

 

Methods:

The study population comprised people diagnosed with upper gastro-intestinal or lung cancers without weight loss >10% in past month or >3 kg over prior 3 months. All provided informed consent. Participants were randomised 2:1 to intervention (twice weekly supervised exercise sessions + protein supplement drinks for 12 weeks + daily fish oil supplement) or standard of care.  Patients randomised to intervention arm were invited to complete an exit interview post-intervention or at withdrawal.  Interviews were audio-recorded, transcribed, and analysed using codebook thematic analysis by two coders in an iterative process to ensure rigor.

 

Results:

The population comprised 21 participants (13 male, 8 female) with median age 61 years (range 21 -84), with 13 randomised to intervention and invited to interview.  Interviews were completed with nine participants.  We identified four thematic areas: Program Specific, Program Influences, Cancer-related, Statements.  Within the program influences area five subthemes were extracted: affect and coping; behaviour; physical function; cognitive function; and, weight.  Experiences of affect and coping varied with some participants valuing the programs’ contribution to how they were feeling physically and emotionally.  Others indicated difficulty with coping, largely related to their deteriorating health condition.  Improved physical function largely manifest as increased energy, strength, and stamina.

 

Conclusions: Intervention participants reported broad impacts of the intervention across a range of physical, emotional, and functional domains.  Incorporating theoretically-derived approaches are important to ensuring improved coping and self-efficacy for self-management.