Oncology Nursing Society Congress

Pain and Functional Status Predict Malnutrition in Elderly Women With Breast Cancer

Avatar photoBryant Furlow
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A young female oncologist doctor is checking in on an older woman patient of hers who has cancer. She has one hand on her patient’s shoulder as she is providing her with moral encouragement during chemotherapy treatment.
A multivariable, cross-sectional study of older women with breast cancer to determine the relationship between pain, functional status, and malnutrition.

Elderly women with breast cancer who report pain or have impaired functional status should be screened for malnutrition, reported Janine Overcash, PhD, APRN-CNP, FAANP, FAAN, and coauthors at the 48th Annual Oncology Nursing Society (ONS) Congress.

“Proactive screening prior to clinical signs and symptoms is important to the health of older people undergoing cancer treatment and care,” noted Overcash, a professor of clinical nursing at The Ohio State University in Columbus, Ohio.

Nutrition is a key component of supportive care during cancer treatment but among older patients undergoing chemotherapy, 85% are malnourished, Overcash noted. Her team conducted a multivariate cross-sectional study of women with any stage of breast cancer diagnosed at age 70 years or older, to identify comorbidity predictors of malnutrition, pain, functional status, and depression, and to improve timely nutritional interventions “before serious weight loss can affect cancer treatment.”

Using the Comprehensive Geriatric Assessment (CGA), the team sought to “evaluate the relationships among pain, functional status, depression, and malnutrition and to determine if pain, Activities of Daily Living (ADL) and Geriatric Depression Scale (GDS) scores predict scores on the Mini Nutritional Assessment (MNA),” Overcash explained.

The average age of the 72 patients included in the study was 79.9 years (range, 70 to 93 years). Most (52 [72.2%]) had a diagnosis of infiltrating ductal carcinoma. Thirty patients (41.7%) had stage 1 tumors, 25% had stage 2, 6.9% had stage 3 breast cancer, and 19 (26.4%) had metastatic disease. Treatment for approximately half of the patients included aromatase inhibitors and 18.1% received chemotherapy.

The average MNA score was 12.2 (malnourished). In multivariate statistical analyses, MNA score correlated significantly with ADL and tumor stage.

“Pain and ADL scores predict nutritional status,” the authors concluded. “Combining geriatric care with oncology management provides a more comprehensive approach to caring for the older person who is diagnosed with cancer.”

Reference

Overcash J, Goetz R, Williams N. Pain, depression, and impaired functional status predict malnutrition in older women who are diagnosed with breast cancer. Poster presentation at: 48th Annual ONS Congress; April 26-30, 2023; San Antonio, Texas.