From the Guidelines
Cachexia is a common and debilitating manifestation of advanced cancer, affecting approximately half of patients and leading to significant morbidity, mortality, and decreased quality of life. The management of cancer cachexia is a complex and multifaceted challenge, requiring a comprehensive approach that addresses the patient's nutritional, functional, and symptomatic needs 1.
Definition and Diagnosis
Cachexia is characterized by a multifactorial syndrome of weight loss, muscle wasting, and decreased appetite, resulting in fatigue, weakness, and impaired functional status 1. The diagnosis of cachexia is based on a combination of clinical criteria, including weight loss, muscle mass, and inflammatory markers, such as C-reactive protein (CRP) 1.
Treatment and Management
The treatment of cachexia involves a multimodal approach, including nutritional support, pharmacological interventions, and exercise therapy 1. Nutritional support should focus on providing adequate calories and protein to support muscle mass and function, while pharmacological interventions, such as appetite stimulants and anti-inflammatory agents, may be used to manage symptoms and slow disease progression 1. Exercise therapy, including resistance training and aerobic exercise, can help to preserve muscle mass and improve functional status 1.
Key Considerations
When managing cachexia, it is essential to consider the patient's individual needs and circumstances, including their tumor type, treatment plan, and overall health status 1. A personalized approach to care, incorporating a combination of nutritional, pharmacological, and exercise-based interventions, can help to optimize outcomes and improve quality of life for patients with cachexia 1. The use of a multimodal approach, incorporating nutritional support, pharmacological interventions, and exercise therapy, is recommended for the management of cachexia in patients with advanced cancer 1.
From the Research
Cache as a Common Manifestation
- Cache, or more specifically cachexia, is a complex syndrome characterized by weight loss, muscle wasting, and metabolic disturbances 2
- It is commonly associated with cancer, but can also occur in other chronic conditions such as chronic heart failure, chronic kidney disease, and autoimmune disorders 2, 3
- Cachexia is a multifactorial syndrome, involving inflammation, disrupted metabolism, hormonal imbalances, and immune dysfunction 2
Prevalence and Impact
- Cachexia contributes to 20% of all cancer-related deaths, and is a significant challenge in clinical practice 2
- It is estimated that cachexia affects a large proportion of patients with advanced cancer, and is associated with reduced chemotherapeutic effects, increased side effects, and poorer survival 4
- Cachexia can also occur in patients with other chronic diseases, such as AIDS, chronic obstructive pulmonary disease (COPD), and rheumatoid arthritis 5, 3
Treatment and Management
- Treatment of cachexia is currently targeted at correcting anorexia and metabolic disturbances, but new therapeutic possibilities are being developed 3
- Megestrol acetate has been shown to improve appetite and weight gain in patients with cancer-associated anorexia-cachexia syndrome 5, 6
- Other potential treatments for cachexia include drugs acting on hormone receptors or cytokine receptors, myostatin/activin pathway antagonists, beta-adrenoceptor agonists, and cannabinoids 3