Impact of pre-treatment nutritional status on psychosocial outcomes and cancer treatment in newly diagnosed adult oncology patients: A longitudinal study

Abstract

BACKGROUND: In Sub-Saharan Africa, new diagnosed cancer cases surpassed 800,000 in 2020. However, the impact of pre-treatment nutritional status on treatment-related and psychosocial outcomes remains inadequately understood, particularly in resource-limited settings. OBJECTIVE: This study aimed to assess the effect of pre-treatment nutritional status on cancer treatment-related and psychosocial outcomes among newly diagnosed cancer patients at Jimma University Medical Center (JUMC). METHODS: A prospective study was conducted among 231 new cancer patients at the oncology department of JUMC between 2024 and 2025. Psychosocial outcomes were assessed using the World Health organization QoL short version and the National Comprehensive Cancer Network distress thermometer version 1.2024. Chemotherapy-related toxicity was measured using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events short-form tool. Data management and analysis were performed using R statistical software. Independent variables with a p-value < 0.05 were considered significantly associated with outcome variables. RESULTS: Pre-treatment nutritional status was significantly associated with differences in physical and psychological quality of life (QoL) following chemotherapy. Compared with well-nourished patients, malnourished patients had lower scores in the physical-domain (β=-4.88), psychological-domain (β=-5.80), and over-all QoL (β=-5.10). Malnourished patients prior to chemotherapy were more than three times more likely to experience psychological distress (AOR= 3.29) and had nearly twice the hazard of developing chemotherapy-related toxicity (AHR= 1.97) compared with well-nourished patients. CONCLUSIONS: Patients who were malnourished at baseline consistently exhibited poorer physical and psychological domains QoL, greater psychological distress, and an increased risk of chemotherapy-related toxicity. These findings underscore the importance of early nutritional assessment and timely intervention as integral components of comprehensive cancer care, particularly in resource-limited settings where vulnerabilities to malnutrition and psychosocial distress are most pronounced.