Understanding and managing cancer‐related weight loss and anorexia: insights from a systematic review of qualitative research

Abstract

The aim of this study was to summarize the existing qualitative literature in order to develop the evidence base for understanding and managing weight loss and anorexia, in order to make recommendations for clinical practice. A systematic search was performed to retrieve English language studies using electronic search and manual checks of selected reference lists. Keywords included qualitative, cancer cachexia, weight loss, anorexia, appetite, malnutrition, food, eating, and drinking. The selection and appraisal of papers were undertaken by two reviewers. Twenty-one qualitative articles were included in the review. There were three major findings emerging from the previous qualitative studies including ‘the multidimensionality of weight loss and anorexia experience’, ‘patients and caregivers' responses to coping with weight loss and anorexia’, and ‘clinical assessment and management of weight loss and anorexia’. The literature review revealed the multidimensional nature of cachexia and weight loss experience by patients and caregivers, which was not recognized and adequately managed by healthcare professionals. Future research in this area would be helpful in enabling a deeper understanding of the complexity of cachexia and weight loss experience in order to move forward to develop an optimal model of supportive care for patients and caregivers.

Perspectives of health care professionals on cancer cachexia: results from three global surveys

“…Treatment is dependent on a variety of factors such as awareness of the condition, clinical practice within the specific therapeutic area, and resources available to dedicate time to assess symptoms and prescribe treatment [16, 17]. Our study provides insight into HCPs' attitudes toward nutritional and metabolic derangements, particularly oncologists who care for patients with the highest prevalence of malnutrition.…”

Protein anabolic resistance in cancer

“…Although the 2006 European Society for Parenteral and Enteral Nutrition (ESPEN) non-surgical oncology guidelines on enteral nutrition suggest that cancer patients should consume at least 1.2-2.0 g protein/kg body weight per day (16), most cancer patients do not reach this level via the diet and/or through nutritional supplementation (11, 17, 18). Besides a reduced appetite (19, 20), the available nutritional supplements for cancer patients are often energy-dense and have a limited amount of high quality protein. This might contribute to the loss of muscle mass in cancer patients while their fat mass is maintained.…”

Prevention of body weight loss and sarcopenia by a novel selective androgen receptor modulator in cancer cachexia models

“…The symptoms appear in up to 80% of patients with cancer and account for at least 20% of cancer-associated deaths (1,2). Cancer cachexia has been reported to be caused by nutritional deficiencies, metabolic disorders, and inflammatory disorders (3)(4)(5)(6). Presently, however, there is no approved therapy for the treatment or prevention of cancer cachexia.…”