A Retrospective Audit of the Nutritional Status and Management of Adolescents and Young Adults (AYAS) with Cancer During and after Treatment (#294)
Aim: While AYAs with cancer have identified nutritional issues as an unmet need, there is a lack of literature addressing the nutritional status and management of this age-group during and after cancer treatment.
Methods: We conducted a retrospective case note audit of 93 AYAs (median age at diagnosis: 19.4 years; range: 14.6-25.4 years) diagnosed during 2004-2009. Data was collected monthly during treatment and annually for 3 years after completing treatment.
Results: Measurement of body mass index (BMI) (for ≥20-year olds) or BMI z-scores (for <20-year olds) at diagnosis indicated that 8% of AYAs were underweight (BMI <18.5kg/m2 or BMI z-score <-2) and 24% were overweight or obese (BMI≥25kg/m2 or BMI z-score >+1). 47% of AYAs were referred to a dietitian during treatment. 41% experienced ≥5% loss of weight (LOW) during treatment, and 21% of those were not referred to a dietitian at any stage. 86% of patients with acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia had ≥5% LOW during treatment, compared with only 17% of Hodgkin’s lymphoma patients. 85% of all AYAs (79% of those with ALL) did not have dietetic involvement in the month after reaching greatest %LOW. Post-treatment follow-up data was available for 61% of AYAs. Of these, 7% had dietetic involvement in either year 1 or 2 of follow-up. At 3 years post-treatment, no patients had a dietitian involved despite 36% being overweight or obese (67% of those with ALL).
Conclusions: AYAs, particularly those with ALL, are at risk of significant weight loss during treatment and the development of overweight and obesity during follow up. Dietetic involvement was suboptimal and inconsistent in our cohort. This data may guide which disease groups warrant pre-emptive dietetic input during treatment. It also highlights the importance of dietetic involvement during survivorship to minimise the risk of developing weight-related chronic diseases, especially for those with ALL.