Components of the anorexia–cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia

Yavuzşen, Tuğba; Walsh, Declan; Davis, Mellar P.; Kirkova, Jordanka; Jin, Tao; LeGrand, Susan B.; Lagman, Ruth; Bicanovsky, Lesley; Estfan, Bassam; Cheema, Bushra; Haddad, Abdo

doi:10.1007/s00520-009-0623-5

Cited by 37 publications

(24 citation statements)

References 45 publications

(70 reference statements)

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“…However, the subjective assessment of changes in taste and smell has been proven to be accurate in patients with other chronic disease. 7 Nevertheless, the study has some strengths. First, the study included a large sample of patients representative of the hemodialysis population of the town of Rome and used a method to assess appetite largely validated in HD patients.…”

Section: Discussionmentioning

confidence: 98%

“…1,2 In cancer, anorexia does not appear to be an isolated symptom but part of a complex symptom that includes, among others, gastrointestinal symptoms such as changes in taste and smell, altered circadian eating patterns, and food aversion. [4][5][6][7] Indeed, gastrointestinal symptoms are very frequent in HD patients and significantly alter the quality of life. [8][9][10][11] However, little is known about the relationship between anorexia and gastrointestinal symptoms in HD patients.…”

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confidence: 99%

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Appetite and Gastrointestinal Symptoms in Chronic Hemodialysis Patients

Bossola

Luciani

Rosa

et al. 2011

Journal of Renal Nutrition

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Appetite and Gastrointestinal Symptoms in Chronic Hemodialysis Patients

Bossola

Luciani

Rosa

et al. 2011

Journal of Renal Nutrition

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“…17 Even cancer patients with good performance status have a high incidence of GI symptoms, particularly abdominal fullness. 18 Most of our patients had a normal BMI (median 21) even though the median weight loss at referral (over a period of 100 days) was 9%.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Contributors to Weight Loss in a Cancer Cachexia Clinic

Fabbro

Hui

Dalal

et al. 2011

Journal of Palliative Medicine

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Background: Cancer cachexia is considered intractable, with few therapeutic options. Secondary nutrition impact symptoms (S-NIS) such as nausea may further contribute to weight loss by decreasing nutrient intake. In addition, treatable metabolic abnormalities such as hypogonadism, vitamin B12 deficiency, hypothyroidism, and hypoadrenalism could exacerbate anorexia and muscle wasting in patients with cancer cachexia. We determined the frequency and type of contributors to appetite and weight loss, and the effect of the cachexia clinic on clinical outcomes. Methods: Review of 151 consecutive patients referred to a cachexia clinic. All received dietary counseling and exercise recommendations. Assessments included weight, body mass index (BMI), S-NIS, resting energy expenditure by indirect calorimetry, serum thyroid stimulating hormone (TSH), cortisol, total testosterone, and vitamin B12. Results: Median weight loss in the 100 days before referral was 9% (4%-13%); median BMI at presentation was 20.8. Median number of S-NIS was 3 (2-4), most commonly treated by metoclopramide, laxatives, and antidepressants. Forty-one percent (24/59) of patients were hypermetabolic and 73% (52/71) of males hypogonadic, whereas hypoadrenalism (0/101, 0%), hypothyroidism (4/113, 4%), and low vitamin B12 (3/107, 3%) were uncommon. Poor appetite and weight loss before referral (r ¼ 0.18, p ¼ 0.036) were associated with increased S-NIS (r ¼ 0.22, p ¼ 0.008). Appetite improved ( p < 0.001) and 31/92 (34%) of patients returning for a second visit gained weight. Conclusions: Patients had a high frequency of multiple S-NIS, hypogonadism, and hypermetabolism. A combination of simple pharmacological and nonpharmacological interventions improved appetite significantly, and increased weight in one third of patients who were able to return for follow-up. Cachexia clinics are feasible and effective for many patients with advanced cancer.

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“…Patients with PC experience many of these symptoms and problems during the disease course [8,9]. Gastrointestinal problems such as abdominal pain, nausea, vomiting and early satiety are common and may lead to appetite loss [9,10].…”

Section: Introductionmentioning

confidence: 99%

Symptoms in advanced pancreatic cancer are of importance for energy intake

Bye

Jordhøy

Skjegstad

et al. 2012

Support Care Cancer

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Purpose: Cancer cachexia and low energy intake (EI) probably contribute to weight loss in advanced pancreatic cancer (PC). However, little is known about the actual EI in this disease. Aims were to assess EI, weight loss and symptoms during the disease course and investigate associations between symptoms and EI.Methods: Thirty-nine patients (21 males) with advanced PC were consecutively included and followed every 4 weeks until the end of life. A 24-hour dietary recall was used to assess EI. The Edmonton Symptom Assessment System (ESAS) and the PC-specific health-related quality of life questionnaire (QLQ-PAN26) were used for symptom assessment. Conclusion:In this study several symptoms influenced EI negatively. Low EI did not completely explain weight loss in this patient group, but careful monitoring and early follow-up of symptoms may be important interventions to reduce weight loss in advanced PC.

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Components of the anorexia–cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia

Cited by 37 publications

References 45 publications

Appetite and Gastrointestinal Symptoms in Chronic Hemodialysis Patients

Appetite and Gastrointestinal Symptoms in Chronic Hemodialysis Patients

Clinical Outcomes and Contributors to Weight Loss in a Cancer Cachexia Clinic

Symptoms in advanced pancreatic cancer are of importance for energy intake

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