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Ahead of Our Time

Understanding the energy needs of ovarian cancer patients

Ovarian cancer is one of the most common cancers affecting women and one of the most fatal, with a five-year survival rate of just 45 per cent. It's also associated with muscle loss, which worsens a patient’s prognosis.

“Cancer is a condition that makes us waste away. Even before the cancer is detected, it is causing muscle loss,” says Carla Prado, director of the University of Alberta’s Human Nutrition Research Unit (HNRU) which conducts clinical nutrition research using cutting-edge techniques. HNRU research has shown that anyone can have low muscle mass, but patients with cancer are particularly susceptible, especially those with ovarian cancer.

One contributing factor is the high risk of malnutrition for those with ovarian cancer, as well as the tendency of patients to either gain or lose weight during treatment. Malnutrition can affect how well a person’s cancer treatment works, their strength, how fast they recover, their quality of life and can reduce lifespan. It can also increase both the time spent in the hospital and the likelihood of getting an infection.

Although the research is ongoing, preliminary results show that one-third of the participants had low muscle quality and/or quantity, and one-third had very different calorie needs than what was predicted using standard techniques.

“Any time you have weight change, you can have unfavourable changes to body composition, especially the muscle and fat mass in the body,” says Ana Paula Pagano, a PhD candidate in the Faculty of Agricultural, Life & Environmental Sciences. She is examining the energy – or caloric – needs of women with ovarian cancer both during and after treatment.

Funded by a WCHRI Graduate Studentship, Pagano is studying patients recently diagnosed with ovarian cancer who are being treated at the Royal Alexandra Hospital and Cross Cancer Institute. During the study, participants visit the HRNU three times — shortly after the start of treatment, after treatment, and a few months following treatment — where they undergo body composition and energy metabolism testing. Pagano, who is supervised by Prado, will also use data from blood tests measuring inflammation, which is a sign of muscle loss.

Although the research is ongoing, preliminary results show that one-third of the participants had low muscle quality and/or quantity, and one-third had very different calorie needs than what was predicted using standard techniques. These findings suggest the need to provide early, targeted nutritional assessment and intervention for patients with ovarian cancer, in order to prevent muscle loss and improve outcomes after treatment, says Pagano.

Once the study concludes, Prado’s lab will use the findings to create targeted interventions and create a way to use muscle mass to make dietary and supplement recommendations.

“I love that Ana’s bringing the spotlight to the importance of nutrition research to women with cancer,” says Prado. On top of this, Pagano is helping the patients involved with the study by providing detailed information about their body composition and teaching about the role of nutrition and muscle mass in cancer survivorship.

Pagano, who was a dietician in Brazil before pursuing her PhD work, says the support from WCHRI has helped her earn other scholarships and awards, including the prestigious Izaak Walton Killam Memorial Scholarship. Her involvement with the institute has also connected her with a number of prominent clinician-scientists, including gynecologic oncologist Helen Steed, who has become a mentor.

“WCHRI has opened doors to amazing opportunities,” Pagano says. “The institute was the first to believe in my potential as a graduate student.”


Ana Paula Pagano is supervised by Carla Prado. Her Graduate Studentship was funded by the Alberta Women’s Health Foundation through the Women and Children’s Health Research Institute.

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