Cancer Cachexia: Cause, Diagnosis, and Treatment

Mattox, Todd W.

doi:10.1177/0884533617722986

Cited by 72 publications

(56 citation statements)

References 47 publications

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“…Of notable interest, underweight MF patients reported markedly higher symptom burden compared with all other patients across MPN subtypes and BMI categories, indicating that their low BMI might be due to cachexia. A syndrome characterized by the loss of skeletal muscle and fat mass [ 83 , 84 ].…”

Section: Discussionmentioning

confidence: 99%

Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association

Christensen

Scherber

Brochmann

et al. 2020

Cancers

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Elevated body mass index (BMI) is a global health problem, leading to enhanced mortality and the increased risk of several cancers including essential thrombocythemia (ET), a subtype of the Philadelphia-chromosome negative myeloproliferative neoplasms (MPN). Furthermore, evidence states that BMI is associated with the severity of symptom burden among cancer patients. MPN patients often suffer from severe symptom burden. The purpose of this study was to examine whether deviations from a normal BMI in an MPN population are associated with higher symptom burden and reduced quality of life (QoL). A combined analysis of two large cross-sectional surveys, the Danish Population-based Study, MPNhealthSurvey (n = 2044), and the international Fatigue Study (n = 1070), was performed. Symptoms and QoL were assessed using the validated Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF). Analysis of covariance was used to estimate the effects of different BMI categories on symptom scores while adjusting for age, sex, and MPN subtype. A U-shaped association between BMI and Total Symptom Burden was observed in both datasets with significantly higher mean scores for underweight and obese patients relative to normal weight (mean difference: underweight 5.51 (25.8%), p = 0.006; obese 5.70 (26.6%) p < 0.001). This is an important finding, as BMI is a potentially modifiable factor in the care of MPN patients.

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Section: Discussionmentioning

confidence: 99%

Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association

Christensen

Scherber

Brochmann

et al. 2020

Cancers

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“…However, the beneficial effects of these molecules for this complication are still questionable [101]. Particularly, there are no treatment plans for anorexia-cachexia syndrome in virtue of the multifactorial characteristics of this syndrome [102], demonstrating that an open discussion on the benefits of low-cost management, such as fish oil supplementation, is extremely important for clinical practice.…”

Section: Anorexia-cachexia Syndromementioning

confidence: 99%

Protective Effects of Omega-3 Fatty Acids in Cancer-Related Complications

2019

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Omega-3 polyunsaturated fatty acids (PUFAs) are considered immunonutrients and are commonly used in the nutritional therapy of cancer patients due to their ample biological effects. Omega-3 PUFAs play essential roles in cell signaling and in the cell structure and fluidity of membranes. They participate in the resolution of inflammation and have anti-inflammatory and antinociceptive effects. Additionally, they can act as agonists of G protein-coupled receptors, namely, GPR40/FFA1 and GPR120/FFA4. Cancer patients undergo complications, such as anorexia-cachexia syndrome, pain, depression, and paraneoplastic syndromes. Interestingly, the 2017 European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines for cancer patients only discuss the use of omega-3 PUFAs for cancer-cachexia treatment, leaving aside other cancer-related complications that could potentially be managed by omega-3 PUFA supplementation. This critical review aimed to discuss the effects and the possible underlying mechanisms of omega-3 PUFA supplementation in cancer-related complications. Data compilation in this critical review indicates that further investigation is still required to assess the factual benefits of omega-3 PUFA supplementation in cancer-associated illnesses. Nevertheless, preclinical evidence reveals that omega-3 PUFAs and their metabolites might modulate pivotal pathways underlying complications secondary to cancer, indicating that this is a promising field of knowledge to be explored.

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“…Cachexia occurs in many end-stage illnesses, including cancers, chronic kidney diseases, chronic cardiac diseases, chronic obstructive pulmonary diseases, chronic liver diseases, severe burns, HIV infections, rheumatoid arthritis, and aging (Mattox, 2017;von Haehling et al, 2017;Baracos et al, 2018;Scicchitano et al, 2018;Thakur et al, 2018). Roughly, 30% of patients with chronic lung, liver, heart or kidney diseases develop cachexia, while around 50% of cancer patients develop that syndrome, either as a direct consequence of the disease itself or as a consequence of treatment.…”

Section: Resultsmentioning

confidence: 99%

Regulatory Role of the Transcription Factor Twist1 in Cancer-Associated Muscle Cachexia

Atfi

2020

Front. Physiol.

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Muscle cachexia is a catabolic response, usually takes place in various fatal diseases, such as sepsis, burn injury, and chronic kidney disease. Muscle cachexia is also a common co-morbidity seen in the vast majority of advanced cancer patients, often associated with low quality of life and death due to general organ dysfunction. The triggering events and underlying molecular mechanisms of muscle wasting are not yet clearly defined. Our recent study has shown that the ectopic expression of Twist1 in muscle progenitor cells is sufficient to drive muscle structural protein breakdown and attendant muscle atrophy, reminiscent of muscle cachexia. Intriguingly, muscle Twist1 expression is highly induced in cachectic muscles from several mouse models of pancreatic ductal adenocarcinoma (PDAC), raising the interesting possibility that Twist1 may mediate PDAC-driven muscle cachexia. Along these lines, both genetic and pharmacological inactivation of Twist1 function was highly significant at protecting against cancer cachexia, which translated into a significant survival benefit in the experimental PDAC animals. From a translational perspective, elevated expression of Twist1 is also detected in cancer patients with severe muscle wasting, implicating a role of Twist1 in cancer cachexia, and further providing a possible target for therapeutic attenuation of cachexia to improve cancer patient survival. In this article, we will briefly summarize how Twist1 acts as a master regulator of tumor-induced cachexia, and discuss the relevance of our findings to muscle wasting diseases in general. The mechanism of decreased muscle mass in various catabolic conditions is thought to rely on similar pathways, and, therefore, Twist1-induced cancer cachexia may benefit diverse groups of patients with clinical complications associated with loss of muscle mass and functions, beyond the expected benefits for cancer patients.

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Cancer Cachexia: Cause, Diagnosis, and Treatment

Cited by 72 publications

References 47 publications

Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association

Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association

Protective Effects of Omega-3 Fatty Acids in Cancer-Related Complications

Regulatory Role of the Transcription Factor Twist1 in Cancer-Associated Muscle Cachexia

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