Evaluation of the prevalence, and relationship between nutritional status, malnutrition, and quality of life in cancer patients undergoing chemotherapy in Mashhad, Iran in 2023

  • Ali Zeyghami University of Pecs Medical School, Pecs, Hungary
  • Hanieh Keikhay Moghadam Varastegan institute for Medical Sciences, Mashhad, Iran
  • Arvin Babaei Tabriz University of Medical Sciences, Tabriz, Iran
  • Ali-Reza Bari Mashhad University of Medical Sciences, Mashhad, Iran
  • Soudabeh Hamedi‑Shahraki Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
  • Soodabeh Shahidsales Mashhad University of medical science, Mashhad, Iran
  • Monir Dahri Varastegan institute for Medical Sciences, Mashhad, Iran
Keywords: malnutrition, chemotherapy, PG-SGA, quality of life

Abstract

Introduction: Cancer patients face high risks of malnutrition, low muscle mass, and sarcopenia due to decreased intake and treatment side effects. This malnutrition can lead to longer hospital stays, higher mortality, lower quality of life, and poor treatment tolerance. The purpose of this study is to evaluate the prevalence and relationship between nutritional status, malnutrition and quality of life in cancer patients undergoing chemotherapy in Mashhad, Iran in 2023. Method: In a cross-sectional study, we evaluated 237 cancer patients from Razavi, Nazeran, Qhaem, and Omid Hospitals using the Patient-Generated Subjective Global Assessment (PG-SGA). Data analysis was conducted with SPSS version 21. Results: Among the 237 patients assessed, 61.6% were identified as female. The PG-SGA scores indicated that the prevalence of malnutrition and the risk of malnutrition were 89.9% (n=213) and 7.2% (n=17), respectively. Our findings revealed significant differences in physical function, role function, and emotional status dimensions between the malnourished group and the normal/at-risk malnutrition group (P < 0.001). In contrast, no significant differences were found in cognitive function and social function. Furthermore, there were significant variations in fatigue, pain, and appetite levels between the malnourished group and the normal/at-risk malnutrition group, as assessed by the QoL questionnaire. Conclusion: It was determined that 89.9% of cancer patients across all treatment modalities were malnourished and required immediate care. Gastrointestinal cancer was found to have the highest malnutrition rates when compared to other cancer types.

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Author Biographies

Ali Zeyghami, University of Pecs Medical School, Pecs, Hungary
Department of biotechnology & immunology
Hanieh Keikhay Moghadam, Varastegan institute for Medical Sciences, Mashhad, Iran
Department of nutrition sciences
Arvin Babaei, Tabriz University of Medical Sciences, Tabriz, Iran
Departement of nutrition sciences
Ali-Reza Bari, Mashhad University of Medical Sciences, Mashhad, Iran
Department of adult haematology and oncology
Soudabeh Hamedi‑Shahraki, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
Department of Epidemiology and Biostatistics
Soodabeh Shahidsales, Mashhad University of medical science, Mashhad, Iran
Cancer research center
Monir Dahri, Varastegan institute for Medical Sciences, Mashhad, Iran
Department of nutrition sciences

References

Viana ECRdM, Oliveira IdS, Rechinelli AB, Marques IL, Souza VFd, Spexoto MCB, et al. Malnutrition and nutrition impact symptoms (NIS) in surgical patients with cancer. PLoS One. 2020;15(12):e0241305.

Liu T, Liu C, Deng L, Song M, Lin S, Shi H. The prognostic effect of sixteen malnutrition/inflammation-based indicators on the overall survival of chemotherapy patients. Frontiers in Immunology. 2023;14:1117232.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021;71(3):209-49.

Hettiarachchi J, Madubhashini P, Miller M. Agreement between the malnutrition universal screening tool and the patient-generated subjective global assessment for cancer outpatients receiving chemotherapy: a cross-sectional study. Nutrition and cancer. 2018;70(8):1275-82.

Kan Y, Yang S, Wu X, Wang S, Li X, Zhang F, et al. The quality of life in nasopharyngeal carcinoma radiotherapy: a longitudinal study. Asia-Pacific Journal of Oncology Nursing. 2023:100251.

Sheikh-Wu SF. The Effects of Positive Psychology on Symptoms and Quality of Life Among Colorectal Cancer Survivors During Acute Cancer Survivorship. 2022.

Sanguanwongthong K, Suprasert P. Prevalence of malnourishment and predictive factors associated with the nutritional status of gynecologic cancer patients undergoing chemotherapy: a cross-sectional analysis. Obstetrics & Gynecology Science. 2022;65(3):234-43.

Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48.

Alsaleh K, Almomen FA, Altaweel A, Barasain O, Alqublan A, Binsalamah A, et al. Malnutrition in Cancer Patients Receiving Chemotherapy in a Single Oncology Center. Journal of Nature and Science of Medicine. 2021;4(2):170-4.

Gebremedhin TK, Cherie A, Tolera BD, Atinafu BT, Demelew TM. Prevalence and risk factors of malnutrition among adult cancer patients receiving chemotherapy treatment in cancer center, Ethiopia: cross-sectional study. Heliyon. 2021;7(6).

Muhamed AN, Tesema BB, Hiruy EG, Shiferaw SM, Aycheh DT, Abate MD. Nutritional Status and Its Determinants among Adult Cancer Patients Undergoing Chemotherapy Treatment at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia. J Nutr Metab. 2022;2022:8740272.

Ravasco P, Monteiro‐Grillo I, Marques Vidal P, Camilo ME. Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head & Neck: Journal for the Sciences and Specialties of the Head and Neck. 2005;27(8):659-68.

Rasmussen IKL. Individualized dietary counseling on nutritional status in head and neck cancer patients undergoing radiotherapy: A systematic review. 2021.

Curtis AR, Livingstone KM, Daly RM, Brayner B, Abbott G, Kiss N. Dietary patterns, malnutrition, muscle loss and sarcopenia in cancer survivors: findings from the UK Biobank. Journal of Cancer Survivorship. 2023:1-14.

Kiss N, Prado CM, Daly RM, Denehy L, Edbrooke L, Baguley BJ, et al. Low muscle mass, malnutrition, sarcopenia, and associations with survival in adults with cancer in the UK Biobank cohort. Journal of Cachexia, Sarcopenia and Muscle. 2023.

Pingili S, Ahmed J, Sujir N, Shenoy N, Ongole R. Evaluation of malnutrition and quality of life in patients treated for oral and oropharyngeal cancer. The Scientific World Journal. 2021;2021:1-6.

Maia FCP, Silva TA, Generoso SV, Correia M. Malnutrition is associated with poor health-related quality of life in surgical patients with gastrointestinal cancer. Nutrition. 2020;75-76:110769.

Shadmand Foumani Moghadam MR, Dahakzade F, Shariatmadar Tehrani N, Molavi SF, Kavoosi F, Hosseini Z. The High Prevalence of Malnutrition in the Cancer Patients Admitted to Omid Hospital in Mashhad, Iran Based on the PG-SGA Questionnaire (2020). Journal of Nutrition, Fasting and Health. 2021;9(1):43-9.

Heery CR, Ibrahim NK, Arlen PM, Mohebtash M, Murray JL, Koenig K, et al. Docetaxel alone or in combination with a therapeutic cancer vaccine (PANVAC) in patients with metastatic breast cancer: a randomized clinical trial. JAMA oncology. 2015;1(8):1087-95.

Safaee A, Moghim Dehkordi B. Validation study of a quality of life (QOL) questionnaire for use in Iran. Asian Pac J Cancer Prev. 2007;8(4):543-46.

Van Tap N, Bang HT, Huong DT, Chi PC, Anh LTN. Malnutrition in hospitalized cancer patients: A single-center, cross-sectional study in Southern Vietnam. SAGE Open Medicine. 2023;11:20503121231171491.

Movahed S, Tabrizi FV, Pahlavani N, Toussi MS, Motlagh A, Eslami S, et al. Comprehensive assessment of nutritional status and nutritional-related complications in newly diagnosed esophageal cancer patients: a cross-sectional study. Clinical Nutrition. 2021;40(6):4449-55.

Allahyari M, Salek M, Zabeti P, Movahed S. Malnutrition Prevalence among Iranian Cancer Patients: A Systematic Review. Journal of Nutrition, Fasting & Health. 2022;10.

Khoshnevis N, Shahid Sales S, Alizadeh M, MirSadraei M, Akbari ME. Nutritional assessment of cancer patients by PG-SGA questionnaire in Cancer Research Center (CRC) of Shahid Beheshti University of Medical Sciences, Tehran, Iran, 2010. Research in medicine. 2012;36(3):132-8.

Sullivan E, Bhuachalla EN, Cushen S, Power D, Ryan A, Daly L. Malnutrition and body composition predict poor quality of life and reduced survival in ambulatory oncology patients receiving chemotherapy: a cross sectional study of 1015 patients. Proceedings of the Nutrition Society. 2018;77(OCE1):E5.

Badrasawi M, Al-Adhame A, Doufish A. Association of malnutrition and low quality of life among cancer patients receiving chemotherapy, Palestine. Eastern Mediterranean Health Journal. 2021;27(5):459-66.

Nakayama N, Nakayama K, Ishibashi T, Katayama S, Kyo S. Effect of Muscle Loss but Not Fat Loss during Primary Debulking Surgery and Chemotherapy on Prognosis of Patients with Ovarian Cancer. J Clin Med. 2022;11(11).

Ohnuma T, Ali MA, Adigun R. Anorexia and Cachexia. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2025, StatPearls Publishing LLC.; 2025.

Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489-95.

Halpern-Silveira D, Susin LR, Borges LR, Paiva SI, Assunção MC, Gonzalez MC. Body weight and fat-free mass changes in a cohort of patients receiving chemotherapy. Support Care Cancer. 2010;18(5):617-25.

Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. European journal of clinical nutrition. 2002;56(8):779-85.

Sarvarian R, Khoshnevis N, Amiri Z, Haghighian Roudsari A, Rashidi A. Prevalence of malnutrition and its relationship to socio-economic variables for cancer patients admitted to Shohada-ye-Tajrish hospital in 2010. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(3):261-7.

Nayak MG, George A, Vidyasagar M, Mathew S, Nayak S, Nayak BS, et al. Quality of life among cancer patients. Indian journal of palliative care. 2017;23(4):445.

Kenkhuis M-F, Van Roekel EH, Koole JL, Breedveld-Peters JJ, Breukink SO, Janssen-Heijnen ML, et al. Increases in adipose tissue and muscle function are longitudinally associated with better quality of life in colorectal cancer survivors. Scientific reports. 2021;11(1):12440.

Gellrich N-C, Handschel J, Holtmann H, Krüskemper G. Oral cancer malnutrition impacts weight and quality of life. Nutrients. 2015;7(4):2145-60.

Marshall KM, Loeliger J, Nolte L, Kelaart A, Kiss NK. Prevalence of malnutrition and impact on clinical outcomes in cancer services: a comparison of two time points. Clinical nutrition. 2019;38(2):644-51.

Submitted

2024-12-15
Published
2025-02-28