Bibliography: leaves 253-286 / vi, 299 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Faculty of Medicine, 1988

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / Background: Cancer patients have been documented to use complementary and alternative medicine (CAM) frequently, a subject that has been extensively researched. There is however a lack in the current literature of controlled studies that investigate the prevalence of CAM use among cancer patients compared to non-cancer controls. Aim: To assess and compare the prevalence of dietary related CAM use among adult cancer patients and non-cancer controls in the Norwich area, England. Methods: Self-administered questionnaires were used to survey cancer patients attending a comprehensive cancer centre in Norwich, and non-cancer controls attending three dental surgeries also in the Norwich area. Questions addressed patient demographics, information relating to cancer diagnosis (cancer cases only) and information on CAM use. CAM users were asked about types and duration of CAM use, reasons for use, information sources used, disclosure to health professionals, reported side effects and benefits and satisfaction with CAM therapies. Results: Questionnaires were distributed to 132 cancer cases and 126 controls, with 98 and 96 assessable replies received from the cases and controls respectively. Overall, 47% of the cancer cases used CAM, in comparison to 53% of the control group, with no significant difference (p=0.673) between the two groups. Large quantities of juice, multivitamins, fish oils and glucosamine were the most popular CAM therapies among the two groups. Usage was significantly associated with the cancer site (p=0.036) and duration of cancer diagnosis (p=0.050). Only 54% of the cancer cases and 44% of the controls informed a health professional about their CAM use. The main reasons for using CAM were to boost the immune system and to improve quality of life. Reported benefits included increased optimism and hope. Conclusions: Although CAM was commonly used by British cancer patients, there was no significant difference in comparison to the non-cancer controls. Therefore, increased awareness and knowledge of CAM use should not be limited only to those working with oncology patients, but be extended to health professionals in all patient groups.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Background This study aimed to define the prevalence of side-effects and the change in weight and BMI during radical radiotherapy for head and neck malignancies (HNM) at Tygerberg Academic Hospital (TBH), Western Cape, South Africa. Acute side-effects may delay or prevent the delivery of a complete curative radiotherapy dose. Weight loss has been shown to significantly worsen prognosis and increase prevalence of treatment complications. However, weight maintenance may lead to beneficial outcomes. Assessing the impact of radical radiotherapy on patients with HNM is therefore critical and can promote development and implementation of medical and nutritional interventions. Methods Patients were weighed before and weekly during radiotherapy. Blood was drawn before, during and at the end of radiotherapy so that the Prognostic Inflammatory and Nutritional Index (PINI) could be calculated. Selected clinical data, clinical grades of mucositis and the diagnosis of a fungal infection of the oral cavity were extracted from clinical records. The McMaster Head and Neck Radiotherapy Questionnaire and a Lifestyle and Dietary Questionnaire were administered weekly. Descriptive statistics and the following were used: ANOVA, Repeated Measures ANOVA and McNemar Chi-square tests. Results Thirty-eight patients were recruited and 21 completed the study. Follow-up occurred over a maximum of nine weeks. A decrease in the weight (p = 0.01) and BMI (p = 0.01) and increase in the PINI (p = 0.04) occurred during radiotherapy. The mean absolute weight loss was 3.2kg (4.8), the mean percentage weight loss was 4.5% (6.7) and the mean decrease in BMI was 1.2kg/m2 (1.8). There was an increase in the prevalence of malnutrition (p = 0.02), as defined in this study. Oral mucositis occurred in all participants from Week 4; the majority developing Grade II or III Mucositis. Fungal infection of the oral cavity was prevalent throughout radiotherapy, with the highest prevalence (30%) in Week 4. Increases in severity of symptoms related to the mouth (p = 0.0000), throat (p = 0.05) and skin domains (p = 0.0000) occurred. Fifty-nine percent of inpatients and 45% of outpatients were prescribed supplementation drinks and most participants reported that a dietitian had not consulted them, in each week of radiotherapy. Discussion Severe side-effects in the mouth, throat and skin were experienced and a decline in nutritional status was observed. The poor nutritional status prior to commencing and weight loss during radiotherapy could have increased the severity of side-effects. The induction of the acute phase response indicated that this could have contributed to the decline in nutritional status observed. In addition, the infrequent nutritional support is likely to have further contributed to the lack of weight maintenance. Conclusion This first study conducted in South Africa has demonstrated the prevalence of significant side-effects and change in weight and BMI in this patient population. It is recommended that more effective analgesic medication is prescribed and that measures are taken to improve oral hygiene of participants to prevent fungal infection of the oral cavity. Improved nutritional support in terms of regular dietetic follow-up of all patients and more frequent prescription of supplementation drinks during radiotherapy is also recommended.