Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Audit of clinical practice on monitoring micronutrient status of UGI cancer survivors attending Sydney Cancer Survivorship Clinic (SCSC) (#373)

Sim Yee (Cindy) Tan 1 2 3 , Man Wah Cheung 4 , Sheena Singh 2 , Kim Kerin-Ayres 1 5 , Carolyn Wildbore 1 5 , Ashanya Malalasekera 1 , Janette Vardy 1 3
  1. Concord Cancer Centre , Concord Hospital, Concord, NSW, Australia
  2. Nutrition and Dietetics Department, Concord Hospital, Concord, NSW, Australia
  3. Sydney Medical School, University of Sydney, Concord, NSW, Australia
  4. Faculty of Health and Medicine, The University of Sydney, Sydney, NSW
  5. Nursing Services, Concord Hospital, Concord, NSW, Australia

Background

Patients with upper gastrointestinal (UGI) cancer after surgery with curative intent could be at nutritional risk, especially for micronutrient deficiencies.  There are no recommendations for UGI survivors for vitamin/mineral supplementation or surveillance of micronutrient status. This study aimed to explore practice of clinicians monitoring micronutrient status and investigate prevalence of UGI survivors taking supplements.

Methods:

Fifty-three UGI survivors attended the SCSC from July 2015 to April 2022; 48 survivors consented to be included in the data analysis, 28 had longitudinal data. Survivors’ discharge summary after surgery, letter correspondence with surgeon, general practitioner, clinical notes written by SCSC team and biochemistry results (if available) during the first 12-months after initial SCSC visit were audited.

Results:

Median age 63 years (range 43-88); 67% male; 58% gastric cancer. Median time from diagnosis to initial SCSC consult was 10-months. At initial survivorship appointment, 23/48 (48%) survivors were taking at least one vitamin or mineral supplement; most commonly vitamin D.  In longitudinal follow-up the SCSC team made at least one dietary supplement recommendation to 22/28 (79%) survivors, surgeons to 6 (21%), GPs to 3 (11%) and endocrinologists to 2 (7%) survivors. Other clinicians each made at least one recommendation to one (4%) survivor. Overall, 87% (42/48) of survivors were documented to be taking supplements at some stage during their SCSC visits. In total, 38 survivors had at least one blood test to determine vitamin/mineral status: the SCSC team ordered tests for 27/38 (71%) survivors, GPs 18 (47%), and surgeons 15 (39%). Other clinicians (endocrinologists, gastroenterologists) each ordered tests for 3 (8%) or fewer survivors.  

 

Conclusions:

Not all UGI survivors were taking supplements.  Clinical practice regarding vitamin/mineral surveillance and supplementation for UGI cancer survivors after surgery is inconsistent.  Further research should focus on developing evidence-based clinical pathways to ensure best standard practice.