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Abstract
Introduction/Background Over 1400 gynaecological cancers are diagnosed in Ireland annually (1). Cancer treatment is multi-modal, and can impact the body in various ways which may continue after treatment. Up to 90% of women with gynaecological cancer experience severe changes in bowel habits (2). Our aim was to capture symptoms, nutritional profile and our dietetic practice in women previously treated for gynaecological cancer.
Methodology Clinical data was collected on excel retrospectively from dietetic records for patients seen by the dietitian between April 2021 and February 2023
Results 38 patients were referred to the dietitian by the gynaecological team. The most common diagnosis was cervical squamous cell carcinoma (53%), treatment dates ranged from 2010–2022. 58% received chemoradiation and 40% received a combination of chemoradiation and surgery. Reason for referral included GI symptoms (58%), MST and GI symptoms (37%) or MST alone (5%). The average BMI was 26.3 kg/m2, 19% had a BMI >30 kg/m2.
12 women (32%) reported at least 11 symptoms as ’Frequently affecting your life’ or ’Causes major changes in your life’.The most prevalent GI symptoms included urgency (71%), incomplete evacuation (63%) and borborygmus (53%). See figure 1 for the range of dietetic interventions. 12 women received micronutrient-specific education; including advice on vegan and vegetarian diets, calcium intake, vitamin b12 supplementation and iron supplementation. Additional testing included vitamin D measurement (n=9), seCHAT (n=5), faecal elastase (n=4). 45% of women returned for dietetic review. An average of 7.7 symptoms was reported as ’frequently’ or causes major changes’ on repeat GSRS (compared to 11.2 symptoms for same group pre dietetic input).
Conclusion This review has shown that GI symptoms are prevalent in gynaecological cancer survivors in Ireland. Individualized dietetic assessments may help to improve these symptoms and available investigational algorithm (2) should be used to support management.
References
National Cancer Registry Ireland (2020) Cancer in Ireland 1994–2018 with estimates for 2018–2020: Annual report of the National Cancer Registry. NCRI, Cork, Ireland. Available at https://www.ncri.ie/sites/ncri/files/pubs/NCRI_Annual%20Report_2020_01122020.pdf
Muls A, Taylor A, Lalondrelle S, Kabir M, Norton C, Hart A, Andreyev HJ. ‘A proposed tailored investigational algorithm for women treated for gynaecological cancer with long-term gastrointestinal consequences’, Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 2020;28(10):4881–4889. https://doi.org/10.1007/s00520-020-05309-z.
Range of dietetic interventions