Psychological symptoms of illness and emotional distress in advanced cancer cachexia

Abstract

Purpose of reviewCachexia induces both physical and psychological symptoms of illness in patients with advanced cancer and may generate emotional distress in patients and families. However, physical symptoms of cachexia received the most emphasis. The aims of this review are to elucidate a link between systemic inflammation underlying cachexia and psychological symptoms and emotional distress, and to advance care strategy for management of psychological symptoms and emotional distress in patients and families. Recent findingsThe main themes in the literature covered by this review are psychological symptoms in patients and emotional distress in patients and families. Studies of the underlying biology of cachexia identify the role of the central nervous system to amplify tumor-induced systemic inflammation. The brain mediates a cluster of symptoms, such as sleep disruption, anxiety, cognitive impairment, and reduction in motivated behavior (notably anorexia). These are distressing to patients as well as to families. SummaryThere is growing recognition that holistic multimodal interventions are needed to alleviate psychological symptoms and emotional distress and to improve quality of life in patients with cancer cachexia and families. This is an approach that addresses not only physical health but also psychological, emotional, and social well being issues.

Perspectives of Health Care Professionals on Multimodal Interventions for Cancer Cachexia

“…Accumulating evidence has shown that systemic inflammation is involved in the mechanisms responsible for cancer cachexia and that proinflammatory cytokines generate various cachexia-related physical and psychological symptoms through alternations in the central nervous system in patients with advanced cancer. 3 , 4 In addition, these symptoms are worsened by cancer treatments and are associated with the emotional distress experienced by patients and families. 4–6 Therefore, the latest evidence-based clinical practice guidelines on the management of cancer cachexia, clinical nutrition in cancer, and end-of-life care for cancer patients have advocated holistic multimodal interventions, which is an approach addressing not only physical health but also psychological, emotional, and social well-being issues by all health care professionals (HCPs) including psychologists and social workers, to meet the physiological and psychological needs of patients and families despite the lack of a clear mandate for diagnosis and treatment of the cachexia-related problems.…”

“… 3 , 4 In addition, these symptoms are worsened by cancer treatments and are associated with the emotional distress experienced by patients and families. 4–6 Therefore, the latest evidence-based clinical practice guidelines on the management of cancer cachexia, clinical nutrition in cancer, and end-of-life care for cancer patients have advocated holistic multimodal interventions, which is an approach addressing not only physical health but also psychological, emotional, and social well-being issues by all health care professionals (HCPs) including psychologists and social workers, to meet the physiological and psychological needs of patients and families despite the lack of a clear mandate for diagnosis and treatment of the cachexia-related problems. 7–10 Although such multimodal approach attends to restoring or sustaining the physical body, it also alleviates distress and supports connectedness with others.…”

Analysis of Herdsmen’s Credit Behavior under the Identification Scheme of Emotional and Psychological State

“…It can help identify individuals' psychological characteristics such as intelligence, personality, and psychological health differences to determine their relative strengths and weaknesses. This will provide a quantitative basis for teaching students according to their aptitude and using their talents best [ 9 ]. In analyzing herdsman's credit behavior, the individual differences between herdsmen's credit behavior are obtained by analyzing and identifying their emotional and psychological states.…”

The effects of integrated palliative care on quality of life and psychological distress in patients with advanced cancer: a systematic review and meta-analysis

“…Palliative care may improve psychological conditions by providing patients with the skills to cope effectively with lifethreatening illness (33). We speculate that it is plausible that inpatient palliative care is more effective for enhancing patients' adaptive coping strategies (34). Future work should examine whether patients' coping skills mediate the effect of different integration models of palliative care intervention on psychological distress in patients with advanced cancer.…”