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Duo helping cancer patients overcome mealtime problems; In association with the NHS Cancer specialists are helping patients in County Durham overcome eating problems linked to their illness thanks to backing from charity Macmillan Cancer Support. Health reporter JANE PICKEN has the details.


COPING with cancer is difficult enough, but many patients find themselves falling victim to a uncomfortable and even painful condition which can put them off eating.

Known as cachexia, healthcare professionals believe it is caused by changes in the body due to the cancer and it leads to symptoms including loss of appetite, nausea and indigestion

What is ingested cannot be processed properly by the body and someone with the condition could eat a full, nutritious meal but could still end up losing weight.

But now medics in County Durham, led by Macmillan consultant in palliative medicine Dr Colette Hawkins, and Inga Andrew, Macmillan senior clinical pharmacist, have developed a project to help deal with the symptoms of the condition.

Although there is no cure for the condition itself, the symptoms can be effectively managed, easing the discomfort for the patient. Both work from Durham's University Hospital, part of the County Durham and Darlington NHS Foundation Trust, and are preparing to officially launch their project by sending out a research and information pack on cachexia to other professionals working with cancer patients.

"No-one really understands a lot about cachexia but it occurs in the vast majority of people with advanced cancer," explained Dr Hawkins. "The whole problem with eating is something I felt personally I didn't have the skills to deal with, and in palliative care we're supposed to be able to address anything that is concerning the patient.

"So we decided to look at developing a project to help medics with patients who have cachexia. I put together a bid for funding from Macmillan and they were happy to help out.

"We've been working on this for three years, with a lot of that time spent on background work and preparation, and Inga saw the first patient in September last year."

Although the project is in its early stages, it has already made a huge difference to 69-year-old grandmother-of-six Nora Sowerby from County Durham.

Nora, who has been receiving treatment at Durham's University Hospital, had been experiencing a number of problems all linked to eating since developing stomach cancer earlier this year.

Constipation, indigestion, constant nausea and swallowing problems caused by the cancer, were all affecting the mum-ofthree.

"I would eat something and feel full very quickly," said Nora, who retired from her job working with adults who have learning difficulties seven years ago.

"It got quite bad, so I went to see my GP, who referred me to a dietician, who in turn thought I would benefit from the cachexia project. It wasn't until I spoke to Inga in June that I realised all these small symptoms could be helped.

"The project was a tremendous help and it gave me a lot of relief from the discomfort the cachexia was causing. It meant taking more medication but I've not had any side effects to any degree.

"Although the symptoms didn't disappear altogether they certainly got better and there have been no problems since."

All of Nora's food must now be liquidised to help it pass through her body properly and medication four times a day helps her cope with the pain and cachexia symptoms.

"I had not even heard of the cachexia project so it was all very strange to me until I spoke to the Macmillan pharmacist," explained Sunderland-born Nora.

"But I'm the kind of person who always needs to be doing something, so I decided to take part and it was a great privilege because I know it will go on to benefit other people.

"It's certainly something which is worthwhile and I'm very thankful to all the work Inga and Colette have done for me in providing relief from pain and discomfort."

So far the service has had 80 referrals, 40 of which have been eligible for some kind of care or treatment through the project.

"It's made a big difference to the people we've helped," said Inga. "After we've sorted the patient's symptoms out we can see them looking better.

"The symptoms are wide ranging, with the most common being loss of appetite, nausea, vomiting, constipation, dry or sore mouth and altered taste.

Coping can be very difficult, especially in families where food plays a big role - with things like Sunday lunch and evening meals.

"We can't treat the underlying problem, but we can improve the way the patients feel in terms of the symptoms. And that will improve their quality of life."

It got quite bad so I went to see my GP, who referred me to a dietician, who thought I would benefit from the cachexia project. It wasn't until I spoke to Inga in June that I realised I could be helped


VITAL ADVICE - cancer patient Nora Sowerby, right, from Durham, with Dr Colette Hawkins from Macmillan service for cancer MANAGING SYMPTOMS - Nora with Inga Andrew from Macmillan, who has been treating Nora's cachexia
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Publication:Evening Chronicle (Newcastle, England)
Date:Nov 19, 2007
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