Project Purpose Identify nutrition and information needs of lung cancer patients and how they would like to receive this information. Nutrition Information Needs of Lung Cancer Patients 1. B.C. Cancer Agency, Vancouver, B.C. 2. University of British Columbia, Vancouver, British Columbia Yeung T 2, BSc candidate, (Dietetics); Sekhon S 1, Bsc, RD; Levy-Milne R 1,2, PhD, RD Introduction Methods Lung cancer is one of the most common causes of cancer death for both men and women in North America. Lung cancer patients typically have a 5-year survival rate of 17% among women and 14% among men. Upon diagnosis, cancer patients express motivation for changing dietary behaviour to increase well-being and prevent cancer recurrence. Recent pilot studies conducted at the BC Cancer Agency demonstrated that nutrition is one of the main concerns among lung cancer patients and Chinese cancer support group participants. However, there are few reports in the literature that have examined the specific nutrition-related concerns of these patients. Health care providers are challenged to develop information resources for the complex needs of these patients. Out of 37 surveys that were collected, 35 surveys were used in the study. Demographics The majority of participants (n=35) were between 50 to 64 years of age with slightly more females than males (Table 1). Most participants had at least a high school diploma and consisted mainly of cancer survivors. More than half of the participants were currently not receiving treatment. Diet and Nutrition Lung patients are very interested in healthy eating, and want more information on vegetables and fruit, organic foods, whole grains, nutritional supplements, sugar, boosting the immune system, and high calorie, high protein foods (Table 2). Multi-vitamin and mineral supplements, flax, iron, and vitamin D received greater interest (Table 3). Contrary to the literature, over 60% of respondents cited no interest in complementary and alternative therapies (data not shown). Participants identified taste changes, fatigue, loss of appetite, shortness of breath, diarrhea, weight loss, and mouth and swallowing problems as cancer-related topics of interest to them (Table 4). Registered dietitians were not considered a primary source for nutrition information (Figure 5). Sources most often consulted were doctors, family members and friends and other health professionals. Majority of respondents preferred to receive written nutrition information via pamphlet, mai or (Figure 6). Most participants felt that nutrition plays a role by helping with cancer recovery, improving quality of life and looking or feeling better (Figure 7). Conclusions Lung cancer patients are interested in healthy eating, nutritional supplements and symptom management strategies through pamphlets, mail or ed information. Complementary and alternative therapies were not a topic of great interest for this group. Lung patients primarily turn to their doctors and other health care providers for nutritional counsel and guidance. Registered dietitians are not considered a primary source for nutrition information. Thus doctors could play a key role in the dissemination of nutrition information. Addressing information needs of lung cancer patients is important to improve patient care and satisfaction. Lessons Learned and Limitations Demographic bias was expected as most of the respondents were educated and therefore more likely to participate in health studies. The short duration of the study resulted in a small sample size. The survey was administered in-person while patients waited for their physician appointment. It was labour intensive to have someone available to approach patients and administer the survey. Language posed a barrier to study participation. A greater number of Chinese-speaking patients from the lung clinic and Chinese support group consented to participate upon translation of the survey. Summary of Findings Ethical approval was obtained from the UBC BCCA Research Ethics Board. A questionnaire was administered to lung cancer patients attending the outpatient Lung Cancer Clinic and the Chinese Cancer Support Group at the BCCA Vancouver Centre. The 22-item survey gathered data on demographics, medical history, nutritional concerns, complementary therapies, and information seeking behaviors. On a likert rating scale from ‘not interested’ to ‘very interested’, 35 patients rated the importance of the following: general nutrition, dietary supplements, complementary and alternative therapies, and cancer-related symptoms. Patients were also asked to select their top three sources of nutrition information and preferred methods of information modality. The questionnaire was translated into Chinese and administered to participants including patients and caregivers that participated in the Chinese Support Group. However, not all patients in the Chinese Support group had lung cancer and therefore only those with lung cancer were included in the data analysis and results. Patient CharacteristicsNumber of Patients (n=35) GenderMale19 (54%) Female16 (45%) Age (years) < 507 (20%) (46%)  (34%) EthnicityCaucasian22 (63%) Asian13 (37%) BMI < (3%) (88%) > (9%) Year of Cancer Diagnosis < (6%) (15%) > (0%) Cancer Treatment Received Past Treatment 24 (69%) Presently Receiving Treatment 10 (29%) Table 1. Patient Demographics Nutrition-Related Topics Not Interested Slightly Interested InterestedVery Interested Vegetables and Fruit0 (0%)2 (6%)11 (32%)20 (59%) Whole Grains0 (0%)6 (18%)11 (33%)15 (45%) Milk and Milk Alternatives2 (7%)4 (13%)11 (37%)13 (43%) Meat and Meat Alternatives 3 (10%)5 (16%)14 (45%)9 (29%) Fat Content3 (10%)8 (28%) Sugar3 (9%) 9 (28%)14 (44%) Nutritional Supplements4 (13%)6 (16%)11 (36%)14 (32%) Food-Drug Interactions4 (13%)3 (10%)14 (45%)9 (29%) Vegetarian Diets7 (23%)3 (10%)8 (27%)11 (37%) Cooking Methods3 (9%)9 (28%)12 (38%)6 (19%) Meal Preparation6 (19%)8 (26%) 6 (19%) Juicing5 (17%)9 (30%) 4 (13%) Healthy Eating1 (3%)6 (19%)8 (25%)15 (47%) Organic Foods2 (6%)7 (23%)8 (26%)11 (36%) Boosting Immune System 0 (0%)2 (7%)11 (37%)14 (47%) High Calorie, High Protein Foods 2 (6%)9 (29%)6 (19%)11 (36%) Table 2. Levels of Interest in Diet and Nutrition Topics Dietary SupplementsNot Interested Slightly Interested InterestedVery Interested Multi-Vitamin and Mineral Supplements 1 (3%)10 (29%)12 (35%)11 (32%) Vitamin A5 (18%)9 (32%)6 (21%)5 (18%) Beta-Carotene4 (14%)10 (36%)8 (29%)4 (14%) Vitamin E2 (8%)7 (27%)10 (39%)5 (19%) Vitamin C2 (7%)8 (29%)9 (32%)8 (29%) Vitamin B Complex2 (8%)4 (15%)10 (39%)6 (23%) Vitamin D3 (10%)6 (20%)10 (33%) Fish Oil Complex5 (19%) 7 (27%) Flax4 (14%)3 (11%)10 (36%) Other Omega-3 Supplements 2 (7%)3 (11%)12 (44%)8 (30%) Calcium3 (10%)4 (13%)13 (43%)9 (30%) Iron3 (11%)5 (19%)9 (33%) Protein Powders6 (22%)10 (37%)7 (26%)3 (11%) Fibre Supplements7 (27%)9 (35%)8 (31%)1 (4%) Cancer-Related Symptoms Not Interested Slightly Interested InterestedVery Interested Nausea4 (15%)6 (22%)10 (37%)7 (26%) Shortness of Breath2 (7%)4 (13%)10 (32%)14 (45%) Fatigue1 (3%)4 (14%)10 (35%)14 (48%) Taste Changes2 (7%)5 (18%)7 (25%)14 (50%) Mouth and Swallowing Problems 3 (10%)6 (21%)10 (25%)10 (35%) Loss of Appetite3 (11%) 9 (32%)13 (46%) Weight Loss2 (7%)5 (17%)11 (38%) Diarrhea5 (18%)2 (7%)10 (36%)11 (39%) Constipation0 (0%4 (14%)14 (50%)10 (36%) Table 4. Levels of Interest in Cancer-Related Symptoms Table 3. Levels of Interest in Dietary Supplements References National Cancer Institute Canada, Five-year relative cancer survival in Canada, _ _langId-en,00.html, accessed March 2, 2008 W. Demark-Wahnefried, N.M Aziz J.H. Rowland, and B.M. Pinto, Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer, J Clin Oncol. 23 (2005), pp C. Doyle, L.H. Kushi, T. Byers, K.S. Courneya, W. Demark-Wahnefried, B. Grant, A. McTiernan, C.L. Rock, C. Thompson, T. Gansler, and K.S. Andrews, Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices, CA Cancer J Clin. 56 (2006), pp M. Wells, L. Sarna, M.E. Cooley, J.K. Brown, C. Chernecky, R.D. Williams, G. Padilla, L.L. Danao, Use of Complementary and Alternative Medicine Therapies to Control Symptoms in Women Living with Lung Cancer. Cancer Nurs. 30 (2007), pp Note: Out of a possible35 responses; responses indicating unsure are not included Note: Out of a possible35 responses; responses indicating unsure are not included Note: Out of a possible35 responses; responses indicating unsure are not included