Article Text

Download PDFPDF

12 Nutrition and weight related issues in Irish Cancer Survivors indicate a need for provision of nutrition advice and intervention from credible sources
  1. Laura Keaver1,
  2. Niamh O’Callaghan1 and
  3. Pauline Douglas2
  1. 1Institute of Technology Sligo, Sligo, Ireland
  2. 2School of Biomedical Sciences, Ulster University, Coleraine, UK


Background In Ireland, continuing increases in cancer survivorship rates have placed cancer survivorship care to the forefront in terms of strategic planning and service requirements.1 Nutrition is an important component of the cancer care continuum,2 however despite this those with cancer report poor access to credible nutrition advice.3

Aims The aim of this research was to investigate 1) current nutritional issues; 2) proportion receiving nutrition advice from a dietitian and 3) additional sources of nutrition advice.

Methods This cross-sectional study recruited Irish cancer survivors over the age of 18, who were not palliative and had completed active cancer treatment at least six months ago. A questionnaire on Microsoft Forms consisting of open and closed demographic, clinical and nutritional questions was developed and recruitment took place via social media platforms between October and December 2020.

Results Participants (n=169) were mainly female (n=145, 85.8%); diagnosed with breast cancer (n=109, 64.5%); living in the Republic of Ireland (n=154, 91.1%) and had completed active treatment in the last five years (n=101, 59.9%). The mean age was 51.4 ± 10.9 years. 3.6% were underweight and 56.5% overweight or obese. One third (n=57, 33.3%) had experienced weight gain in the previous six months, 10.1% (n-17) weight loss and 22.5% (n=38) weight fluctuations. The majority reported decreased energy levels post treatment (n=87, 51.5%) and fatigue (n=129, 76.3%). Other nutrition related impact symptoms were still present: pain (n=61, 36.1%); constipation (n=56, 33.1%); diarrhoea (n=28, 16.6%); dry mouth (n=44, 26%); no appetite (n=23, 13.6%); sore mouth (n=21, 12.4%); taste changes (n=21, 12.4%); smells bothering them (n=18, 10.7%). One-fifth (n=35, 10.7%) had access to a dietitian during treatment, only 11.8% (n=20) had access post treatment. One quarter sought advice elsewhere (n=42, 24.9%); with the main additional source of advice being online (n=16; 9.5% of total cohort).

Conclusion The majority of this cohort were classified as overweight or obese with one third reporting recent weight gain. This can increase risk of recurrence and decrease overall survival in those with cancer (4,5), in particular breast cancer (6,7). The majority were still experiencing fatigue, which has been shown to affect those with cancer more than any other symptom (8). The persistence of other nutrition impact symptoms could further impact quality of life. There is a clear need for the provision of nutrition advice to Irish Cancer Survivors. There is a role for all healthcare professionals to provide basic nutrition advice or signpost to evidence-based nutrition resources.


  1. O’Connor M, O’Donovan B, Drummond F. The Unmet needs of cancer survivors in Ireland: A Scoping Review 2019. Cork: National Cancer Registry Ireland; 2019. 90p.

  2. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F et al. ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition. 2017;36(1):11–48. doi:10.1016/j.clnu.2016.07.015.

  3. Sullivan ES, Rice N, Kingston E, Kelly A, Reynolds JV, Feighan J, Power DG, Ryan AM. A national survey of oncology survivors: examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey. Clinical Nutrition. 2021;41:331–339.

  4. Wright ME, Chang SC, Schatzkin A, et al. Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality. Cancer 2007;109:675–684.

  5. Siegel EM, Ulrich CM, Poole EM, Holmes RS, Jacobsen PB, Shibata D. The effects of obesity and obesity-related conditions on colorectal cancer prognosis. Cancer Control 2010;17:52–57.

  6. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 2010;123:627–635.

  7. Patterson RE, Cadmus LA, Emond JA, Pierce JP. Physical activity, diet, adiposity and female breast cancer prognosis: a review of the epidemiologic literature. Maturitas 2010;66:5.

  8. Stone P, Richardson A, Ream E, Smith AG, Kerr DJ, Kearney N. Cancer-related fatigue: inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Cancer Fatigue Forum. Ann Oncol 2010;11(8):971–5. doi: 10.1023/a:1008318932641.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.