May 10, 2018
Researchers with The University of Kansas Cancer Center have received a five-year National Institutes of Health R01 grant to study how immune-enhancing nutrition affects the outcome of a radical cystectomy.
A radical cystectomy is performed on bladder cancer patients whose cancer has either spread into the bladder wall or recurred after initial treatment. This method involves removal of the entire bladder, nearby lymph nodes, part of the urethra and any nearby organs that may contain cancer.
While effective in treating the cancer, there can be a high cost in terms of post-operative long-term complications. Post-operative complications are reported in 65 percent of radical cystectomy cases, and infection accounts for 25 percent of these complaints between 30 and 90 days after surgery.
Jill Hamilton-Reeves, PhD, RD, CSO, associate member of KU Cancer Center’s Prevention and Survivorship research program and co-leader of the Nutrition shared resource, is the principal investigator of this study. According to Hamilton-Reeves, variations in immune function and nutritional status can affect the way patients respond to this operation. The long-term goal of this research effort is to unlock the potential of nutrition interventions to improve outcomes, survival and quality of life in cancer patients.
“We are looking at how specialized nutritional support may affect surgical outcomes, as well as how nutrients alter the underlying mechanisms,” Hamilton-Reeves says.
Her team predicts that nutrient-enriched Specialized IMmunonutrition (SIM) will decrease complications after surgery by improving patient immune response and nutrition status.
“The nutrients in the SIM diet – L-arginine (an amino acid), fish oil and dietary nucleotides (which are the RNA and DNA found in foods) –support the immune system and wound healing, after surgery,” Hamilton-Reeves said.
In the initial study run by Hamilton-Reeves and her team, patients in the SIM group reported a 39 percent decrease in their infection rate at 90 days post-surgery when compared to those receiving nutrition support without the extra nutrients.
“There was a significant difference in the immune response – the results were so striking that we needed to take our study to the next step,” Hamilton-Reeves said.
With this grant, the team will test their theory in a large group of bladder cancer patients from multiple sites across the nation.
“This low-cost, low-risk, high-yield approach has the potential for a much broader application. Right now we are looking at patients undergoing radical cystectomy, but our findings may be applied to other surgical patients in the future,” Hamilton-Reeves said. “It could transform the way we approach nutrition preparation and recovery after surgeries.”