Anorexia and anxiety in advanced malignancy:
the relative problem

Background and aims Anorexia is frequently reported by patients with advanced malignancy and can be a source of considerable distress. This study was designed to quantify the anxiety related to anorexia in both patients and their relatives. Predisposing factors were also evaluated. A questionnaire was used to quantify anorexia in 145 patients with advanced malignancy and to examine demographic and disease factors associated with anorexia. Anxiety consequent to anorexia was also evaluated for patients and their relatives. Results Anorexia amongst patients was reported by 115 patients (79%) and 83/101 (82%) of their relatives. Anorexia was found to be associated with upper gastrointestinal malignancy, metastatic disease and short estimated prognosis. Only 41 anorectic patients (36%) reported anxiety as a consequence of their anorexia compared with 72 (87%) of their relatives. Certain patient groups (younger age and community location) were more likely to report anxiety related to anorexia. Conclusions The potential influence of anxiety on management decisions is discussed. The frequency of anxiety reported amongst relatives may reflect an unmet need. This may be an area for improving practice.