Disease specific substrates in cancer cachexia – Reality and anticipation

Abstract

In recent years, the concept of nutrition in patients with tumour diseases has been changing very significantly. The article discusses the pathogenesis of tumour cachexia and sarcopenia, which have been intensively studied, particularly in the last ten years. The possibilities and modern approaches in nutritional support in oncology are reviewed with a special emphasis on the group of elderly patients. Also, a detailed list of the most frequently used pharmaconutrients in oncology is presented. The recommendations for nutritional care of elderly oncological patients are given and discussed.

Malnutrition and cachexia in patients with head and neck cancer treated with (chemo)radiotherapy

“…This leads to predominance of anorexigenic signals, such as pro-opiomelanocortin, and lack of orexigenic signals, such as neuropeptide Y. 10,24,25 A three-stage classification system of cancer cachexia was proposed by Fearon et al, distinguishing between precachexia, cachexia, and refractory cachexia (Fig. 1).…”

“…21 The principal initial mechanisms in cancer cachexia that lead to hypercatabolism are systemic inflammatory response with increased production of pro-inflammatory cytokines (interleukins, interferon-␥, TFN␣, NFk␤), reactive oxygen species and catabolic mediators produced by tumour and host cells. 10,26 This causes changes in metabolism in terms of altered metabolism of carbohydrates, lipids and proteins. Insulin resistance, glucose intolerance, increased gluconeogenesis from amino acids and lactate are the most important changes in carbohydrate metabolism.…”

Effectiveness of Nutritional Counseling in Improving the Nutritional Status of Head and Neck Cancer Patients undergoing Concurrent Chemotherapy and Radiotherapy through continuous Guidance on Nutrition

“…Studies have reported the malnutrition prevalence rate of head-neck cancer patients as high as 74.2% [5]. This is not only due to cancer cachexia that causes hypercatabolism due to the systemic inflammatory response with increased production of pro-inflammatory cytokines, reactive oxygen species and catabolic mediators produced by tumor and host cells but also decreased food intake due to mouth ulceration, mucositis, toxicities of radiotherapy, swallowing difficulties and taste alteration which play a significant role in making the head and neck cancer patients more prone to malnutrition [6]. Moreover, the multimodal treatment for head and neck cancer that includes surgery, chemotherapy or radiotherapy also create challenger for the patients [7].…”

Cancer in the elderly

“…which can improve the treatment results and quality of life. 12 Zadak 13 offers a complex insight into the pathogenesis of tumor cachexia and sarcopenia and recommendations for nutritional care of elderly patients.…”