Optimal management of cancer anorexia–cachexia syndrome

Abstract

According to a recent consensus, cachexia is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss. Cachexia occurs in the majority of cancer patients before death and it is responsible for the deaths of 22% of cancer patients. Although bodyweight is the most important endpoint of any cachexia treatment, body composition, physical performance and quality of life should be monitored. From the results presented here, one can speculate that a single therapy may not be completely successful in the treatment of cachexia. From this point of view, treatments involving different combinations are more likely to be successful. The objectives of any therapeutic combination are two-fold: an anticatabolic aim directed towards both fat and muscle catabolism and an anabolic objective leading to the synthesis of macromolecules such as contractile proteins.

Prevalence of Malnutrition and Current Use of Nutrition Support in Patients With Cancer

“…It is a complex syndrome characterized by severe, chronic, unintentional, and progressive weight loss, associated with the underlying disease and characterized by muscle wasting with or without loss of fat mass. Anorexia, inflammation, insulin resistance, and increased muscle protein catabolism are frequently associated with cachexia 3 . In cancer, cachexia is a multiple‐organ syndrome characterized by weight loss, muscle and adipose tissue wasting, and inflammation, often associated with anorexia.…”

Decreased body mass index is associated with impaired survival in lung cancer patients with brain metastases: A retrospective analysis of 624 patients

“…Cancer-associated cachexia is a hyper-catabolic state with a multifactory aetiology that has been reported to be responsible for 22% of cancer-related deaths (Argiles, Olivan, Busquets, & Lopez-Soriano, 2010). Cancer cachexia presents clinically as a complex metabolic syndrome with low body mass index (BMI) that is associated with muscle loss with or without loss of fat mass (Evans et al, 2008).…”

Knowledge, attitudes and practice of surgeons regarding nutritional support in CRS and HIPEC patients: Are we missing something?

“…Malignancies induce a systemic pro‐inflammatory state that leads to thrombosis, insulin resistance and shifts the metabolic balance toward catabolism and muscle wasting (Argiles, Olivan, Busquets, & Lopez‐Soriano, ), leading ~50% of cancer patients to be cachectic (Kern & Norton, ).…”