Abstract
Description of the cellular and systemic consequences of cancer and its treatment shows that biochemical and nutritional changes may affect both nutritional status (NS) and quality of life (QL); techniques of measuring both parameters are considered. A new technique of QL measurement is described and found valid, reliable and feasible for clinical use; it is shown to be sensitive to changes in the patient's condition, to have discriminative ability and to yield meaningful results. Tiredness, identified as the symptom causing most distress, appears to result primarily from discomfort arising from physical symptoms; changes in mobility, appearance and mood also caused distress. The activities of daily living most affected were recreation, sleeping patterns and eating behaviour. Investigation of the relationships between food intake, NS and QL showed that food consumption in cancer patients is generally inadequate and closely linked to QL, although no clear cause and effect relationship was demonstrated. Similarly, although NS clearly depends on food intake, no relationship was found between NS and QL, perhaps because no current method of nutritional assessment is satisfactory in this population. However, marked differences in the pattern of weight change were observed between male and female patients. Attempts to improve food intake using nutritional supplements found that the products tested were organoleptically unacceptable to both normal and cancer-bearing subjects. Recipes, incorporating the products, were developed in attempts to improve acceptability but it was not possible to try these in a patient population. Overall the studies revealed that many of the changes accompanying cancer may significantly affect QL causing tiredness, changes in mood, appearance and the ability to eat and affecting normal patterns of activity. Although there are indications that QL and NS are inter-related this was not confirmed. Suggestions are made for future research.