A trial looking at nutritional supplement drinks for people with bowel cancer who are losing weight (POSiCC)

Cancer type:

Bowel (colorectal) cancer

Colon cancer

Rectal cancer

Status:

Results

Phase:

Other

This trial was done to see if having supplement drinks before surgery for bowel cancer can help people recover more quickly.

More about this trial

We know from research that people who have bowel cancer often lose weight. This can lead to problems because the body is weaker, and it can be harder to cope physically with treatment.

Having liquid food through a tube into the stomach, or through a drip into a vein, can help people gain weight. This can help reduce complications after surgery and the length of time people are in hospital.

But it is complicated and expensive to have extra food in this way. People need to have a drip, or a tube put into their stomach. Some people need to stay in hospital for a while before their operation, or have equipment and supplies delivered to their home.

Researchers in this trial wanted to see if standard food supplement drinks can help people with this cancer related weight loss, and if people are happy to take them.

Half the people taking part in this trial had standard advice on how to improve their diet. The other half had nutritional supplement drinks as well as dietary advice.

The main aim of this trial was to see if people who have supplement drinks before surgery have fewer complications after their operation.

Summary of results

The research team found that nutrition supplements before surgery for bowel cancer did help reduce complications after surgery.

This trial was open for people to join between 2013 and 2015. The research team published the results in 2017.

About this trial

About 100 people with bowel cancer took part in this trial. They had all lost weight without meaning to in the weeks before they joined the trial, and were due to have an operation.

The people taking part were put into 1 of 2 groups at random:

46 had advice about diet
55 had advice about diet and had nutritional supplement drinks for at least 5 days before their operation

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They kept a diary about what they had to eat and drink while they were taking part. The research team used this to calculate how much energy and protein people were having.

Results

The group who had the supplement drinks had a diet that was higher in energy and protein than those who just had dietary advice.

The research team looked at how many people developed an infection after surgery. They were interested in the number of people who had either an infection at their operation site, a lung (chest) infection or a water (urine) infection. They found it was:

21 out of 45 people (47%) who had dietary advice
17 out of 55 people (30%) who had dietary advice and supplement drinks

They also took several measurements such as weight and body fat:

when people joined the trial
1-2 days before their operation
5-7 days after the operation

They found that people in both groups lost weight. But those who had dietary advice and supplements didn’t lose as much weight as those who just had dietary advice.

Between joining the trial and 1-2 days before their operation, people who had dietary advice lost 6.7% of their body weight. And people who had dietary advice and supplements lost 4.1% of their body weight.

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Between joining the trial and 5-7 days after their operation, people who had dietary advice lost 10.2% of their body weight. And people who had dietary advice and supplements lost 7.4% of their body weight.

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They also found that people who had the supplements had more muscle mass after surgery than those who just had dietary advice.

But they found there wasn’t any difference in:

how long people stayed in hospital
their grip strength (a measure of muscle strength)
the amount of body fat

Side effects

About 3 out of 4 people taking part (74%) had 2 cartons of supplements each day, as planned. But some people found the them difficult to drink, and had less than this.

Some reported that they didn’t taste nice at all, and some found that they caused problems such as feeling sick, tummy (abdominal) pain or diarrhoea.

Conclusion

The research team concluded that having nutritional supplements before surgery for bowel cancer can reduce weight loss and infection rate after surgery.

They suggest this may be especially useful for people who have a course of chemotherapy before their operation, as they will be able to take the supplements for longer.

Where this information comes from

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item

) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.