An Update on Therapeutics: The Cancer Anorexia/Weight Loss Syndrome in Advanced Cancer Patients

211 Background: Malnutrition and a loss of muscle mass are frequent in cancer patients and have a negative effect on clinical outcome. Nutrition risk screening aims to increase awareness and allow early recognition and treatment of cancer cachexia. Therefore, screenings should be brief, inexpensive, highly sensitive, and have good specificity. SNAQ is a simple screening tool including 4 questions, and validated to predict weight loss within 6 months in community-dwelling adults and nursing home residents. Our study aimed to translate the SNAQ into Korean, and to assess the validity and reliability of the translated screening tool in advanced cancer patients. Methods: The SNAQ was translated into Korean according to linguistic validation. The internal consistency of the SNAQ was evaluated by Cronbach’s alpha coefficient. Test–retest reliability was evaluated using the intraclass correlation coefficient. Concurrent validity was evaluated by measuring the Pearson’s correlation coefficient between the SNAQ and Mini-Nutritional Assessment (MNA) and Patient-Generated Subjective Global Assessment (PG-SGA). Results: In the 194 patients included in full analysis set, cancer stage was predominantly (98.5%) metastatic, the mean age was 60 years, and the mean BMI was 24 kg/m2. According to MNA score ≤11, 57 patients (29.3%) were malnourished. The mean score of the Korean version of the SNAQ was 13.8 (SD = 2.5) with a range of 6–19. Cronbach’s alpha coefficient was 0.74, and intraclass correlation coefficient was 0.87. The SNAQ was moderately correlated with MNA(r = 0.4043, p < 0.0001) and PG-SGA(r = -0.5297, p < 0.0001). A significant weight loss of 5% of the original body weight within 6 months occurred in 46 (24.7%) of the 186 patients. SNAQ score ≤14 predicted 5% weight loss with a sensitivity of 56.5% and a specificity of 44.3%. Conclusions: The Korean version of the SNAQ had high validity and reliability. SNAQ is useful for the screening tool for advanced cancer patients. The SNAQ had a limitation to predict impending weight loss in advanced cancer patients.

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PP075-SUN MORE THAN 5% WEIGHT LOSS BEFORE CHEMOTHERAPY PREDICTS LOSS OF FAT FREE MASS DURING TREATMENT IN ADVANCED CANCER PATIENTS

Clinical Nutrition Supplements ◽

10.1016/s1744-1161(11)70129-6 ◽

2011 ◽

Vol 6 (1) ◽

pp. 52

Author(s):

S. Buskermolen ◽

J. Langius ◽

H. Kruizenga ◽

G. Ligthart-Melis ◽

M. Heymans ◽

...

Keyword(s):

Weight Loss ◽

Cancer Patients ◽

Advanced Cancer ◽

Fat Free Mass ◽

Advanced Cancer Patients

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Secondary vs. primary cachexia in patients with advanced cancer

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.9128 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 9128-9128 ◽

Cited By ~ 3

Author(s):

E. Del Fabbro ◽

S. Dalal ◽

M. Delgado ◽

G. Freer ◽

E. Bruera

Keyword(s):

Weight Loss ◽

Cancer Patients ◽

Advanced Cancer ◽

Oral Candidiasis ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Clinical Effects ◽

Advanced Cancer Patients ◽

Early Satiety ◽

Secondary Causes

9128 Background: Cachexia results in decreased survival and adherence to chemotherapy, and increased treatment toxicity. Primary Cachexia (PC) is characterized by weight loss, anorexia and fatigue and it is the result of tumor-host interactions producing neurohormonal dysfunction and an aberrant pro-inflammatory response. The clinical effects of PC may be exacerbated by complications capable of decreasing energy intake (Secondary Cachexia) such as dysgeusia, anxiety, depression, pain, early satiety, nausea and constipation. The objective of this study was to determine the causes and the frequency of secondary cachexia (SC) in a cohort of patients with PC. Methods: We reviewed the charts of 50 consecutive advanced cancer patients who underwent a structured assessment in a specialized cachexia clinic at a comprehensive cancer center. Results: All patients gathered criteria for cachexia, including a weight loss of >5% within the preceding 6 months. The most frequent causes of SC were early satiety in 40 patients(80%), constipation in 37(74%), depression or anxiety in 30(60%), uncontrolled pain in 31(62%), chronic nausea in 21(42%), dysgeusia in 14(28%),dental problems in 4(8%), dysphagia in 3(6%)chronic aspiration in 2 (4%) and oral candidiasis in 1 (2%).All 50 patients presented with at least 2 secondary causes of cachexia, and 44(88%) presented with = 3. The median number of causes of secondary cachexia was 4 (range 2–5). 211 interventions were used in these patients to treat secondary causes of cachexia. 14(28%) of the patients referred were already on a medication for appetite stimulation (megestrol acetate, dronabinol, corticosteroids). Conclusions: SC should be ruled out in all patients who have PC since the vast majority of patients referred to a cachexia clinic have 2 or more causes of SC. All cancer patients with involuntary weight loss in our series had “mixed cachexia”. Inexpensive effective treatments are available for most of the causes of SC, but they are frequently underused. No significant financial relationships to disclose.

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