Weight and Appetite Loss in Cancer

2021 ◽  
pp. 298-302
Author(s):  
Yesne Alici ◽  
Victoria Saltz
Keyword(s):  
Cancer Patients ◽  
Cancer Cachexia ◽  
Sense Of Self ◽  
Resting Energy Expenditure ◽  
Appetite Loss ◽  
Chronic Inflammatory Response ◽  
Variable Combination ◽  
Cancer Anorexia ◽  
Cachexia Syndrome

Weight and appetite loss in cancer patients, referred to as the cancer anorexia-cachexia syndrome, is a complex, multifactorial syndrome, defined by an ongoing loss of skeletal muscle mass, with or without loss of fat mass, which cannot be fully reversed by conventional nutritional support, and may lead to progressive functional impairment. It is a hypercatabolic state in the context of chronic inflammatory response best described in the setting of cancer but can also be seen in other advanced chronic illness. Cancer cachexia occurs in approximately 50% of cancer patients, and in 80% of those with advanced cancer. It impacts adversely on function, treatment tolerability and treatment response, and health service utilization, but most importantly, dignity, sense of self, quality of life, and survival. The pathophysiology of cancer cachexia is complex and multifactorial. It is characterized by a negative protein and energy balance, driven by a variable combination of reduced food intake, increased resting energy expenditure, and net loss of lean tissue. The best approach to weight and appetite loss among cancer patients is a multimodal therapy, in which a personalized combination of pharmacologic and nonpharmacologic treatments is implemented. This chapter will provide an overview of the cancer anorexia cachexia syndrome as relevant to the practice of clinicians of all disciplines managing cancer patients.

scholarly journals Cancer cachexia syndrome in head and neck cancer patients: Part I. Diagnosis, impact on quality of life and survival, and treatment

Head & Neck ◽  
2007 ◽  
Vol 29 (4) ◽  
pp. 401-411 ◽  
Author(s):  
Marion Couch ◽  
Victor Lai ◽  
Trinitia Cannon ◽  
Denis Guttridge ◽  
Adam Zanation ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Cancer Cachexia ◽  
Cachexia Syndrome

scholarly journals Cachexia and anorexia in cancer; a systematic review

2020 ◽  
Vol 7 (2) ◽  
pp. e20-e20
Author(s):  
Ali Darakhshandeh ◽  
Mahnaz Momenzadeh
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cancer Cachexia ◽  
Cochrane Library ◽  
Mesh Terms ◽  
The Subject ◽  
Cancer Anorexia ◽  
Cachexia Syndrome ◽  
Expected Outcomes

The treatment strategy for cancer cachexia is based on the cachexia stage of the cancer and its phenotypes, therefore interventions and expected outcomes vary. In order for the patient to get the most out of the treatment, it should be done based on the mechanism of intervention and the quality of life of patients should be addressed, including aspects of rehabilitation and reduction of the patient’s suffering using a multidisciplinary team. Given the importance of the subject, the present study aims to investigate cachexia and anorexia in cancer. From the electronic databases, PubMed, Cochrane Library, Embase, Web of Sciences have been used to perform a systematic literature until 2020. Therefore, a software program (Endnote X8) has been utilized for managing electronic titles. Searches were performed with mesh terms. This review recommended that clinicians establish an interaction between cancer anorexia-cachexia syndrome (CACS) treatments and chronic pain treatments and choose the best treatment option.

Abnormality of growth hormone and insulin-like growth factor I axis in advanced cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19671-19671
Author(s):  
T. Takahata ◽  
M. Munakata ◽  
Y. Sakata ◽  
K. Nakagawa ◽  
T. Mukaiyama ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Factor ◽  
Thyroid Hormones ◽  
Cancer Patients ◽  
Performance Status ◽  
Insulin Like Growth Factor ◽  
Igf I ◽  
Cancer Anorexia ◽  
Cachexia Syndrome ◽  
Igfbp 3

19671 Background: Pituitary and thyroid hormones are known to be altered in anorexia nervosa, but few hormonal studies have been performed in cancer anorexia-cachexia syndrome. This study focused on growth hormone (GH) and Insulin-like Growth Factor (IGF)-I axis in cancer patients. Methods: To investigate the relationship among performance status (PS), nutritional and hormonal status, blood sampling was performed to measure GH, IGF-I, IGF-binding protein 3(IGFBP-3), T3, T4, complete blood counts and blood chemistry profiles for 15 cancer patients in each of PS0–1, PS2, PS3 and PS4 after the informed consent was obtained. Results: A total of 58 patients were evaluated including 15 patients in PS0–1, PS2 and PS3 and 13 in PS4. Hemoglobin and albumin levels went down along with progression of PS. GH level was high and T3 was low in poor PS. T4 and IGFBP-3 were lower in PS4 than those of other PS. There is a tendency of low IGF-I and thyroid hormones and high GH levels in poor PS as compared with those of good PS (p=0.0064 for IGF-I, p<0.001 for T3, and T4, not significant for GH analyzed by ANOVA). Conclusions: Abnormal GH - IGF-I axis was more pronounced in poor PS. It is conceivable that normalization of this abnormality can improve cancer anorexia-cachexia syndrome and new drug development for such normalizing agents is warranted. No significant financial relationships to disclose.

scholarly journals Cancer Cachexia: Mechanisms and Clinical Implications

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Claire L. Donohoe ◽  
Aoife M. Ryan ◽  
John V. Reynolds
Keyword(s):  
Host Response ◽  
Cancer Cachexia ◽  
Resting Energy Expenditure ◽  
Poor Quality ◽  
Therapeutic Agents ◽  
Progressive Weight Loss ◽  
Slow Progress ◽  
Definition Of ◽  
The Relationship

Cachexia is a multifactorial process of skeletal muscle and adipose tissue atrophy resulting in progressive weight loss. It is associated with poor quality of life, poor physical function, and poor prognosis in cancer patients. It involves multiple pathways: procachectic and proinflammatory signals from tumour cells, systemic inflammation in the host, and widespread metabolic changes (increased resting energy expenditure and alterations in metabolism of protein, fat, and carbohydrate). Whether it is primarily driven by the tumour or as a result of the host response to the tumour has yet to be fully elucidated. Cachexia is compounded by anorexia and the relationship between these two entities has not been clarified fully. Inconsistencies in the definition of cachexia have limited the epidemiological characterisation of the condition and there has been slow progress in identifying therapeutic agents and trialling them in the clinical setting. Understanding the complex interplay of tumour and host factors will uncover new therapeutic targets.

scholarly journals Exercise as a Time-conditioning Effector in Chronic Disease: a Complementary Treatment Strategy

2004 ◽  
Vol 1 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Luis F. B. P. Costa Rosa
Keyword(s):  
Cancer Patients ◽  
Cancer Cachexia ◽  
Fat Body ◽  
Exercise Program ◽  
The Body ◽  
Progressive Weight Loss ◽  
Important Time ◽  
Complementary Strategy ◽  
Fat Body Mass

Exercise has been widely believed to be a preventive and therapeutic aid in the treatment of various pathophysiological conditions such as cardiovascular disease and cancer. A common problem associated with such pathologies is cachexia, characterized by progressive weight loss and depletion of lean and fat body mass, and is linked to poor prognosis. As this syndrome comprises changes in many physiological systems, it is tempting to assume that the modulation of the psychoneuroimmunoendocrine axis could attenuate or even prevent cachexia progression in cancer patients. Cancer cachexia is characterized by a disruption in the rhythmic secretion of melatonin, an important time-conditioning effector. This hormone, secreted by the pineal gland, transmits circadian and seasonal information to all organs and cells of the body, synchronizing the organism with the photoperiod. Considering that exercise modulates the immune response through at least two different mechanisms—metabolic and neuroendocrine—we propose that the adoption of a regular exercise program as a complementary strategy in the treatment of cancer patients, with the exercise bouts regularly performed at the same time of the day, will ameliorate cachexia symptoms and increase survival and quality of life.

scholarly journals Medical Cannabinoids for Cancer Cachexia: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jing Wang ◽  
Yanling Wang ◽  
Mengting Tong ◽  
Hongming Pan ◽  
Da Li
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Meta Analysis ◽  
Life Quality ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Negative Effects ◽  
Central Register

Objectives. Cancer cachexia (CCA) is an intractable and ineffective metabolic syndrome that attacks 50–80% of cancer patients. It reduces patient’s life quality, affects the efficacy of treatment, and then increases their mortality; however, there are no established therapeutic strategies for CCA in the world. In this study, we assess the positive and negative effects of cannabinoid in the treatment of CCA. Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Web of Science, and PubMed up to December 2017. Results. Of the 256 screened studies, three studies with a total of 592 participants were included. Compared with placebo, cannabinoid increased the appetite (MD 0.27, 95% CI -0.51 to 1.04; n= 3) but failed to improve the overall quality of life (QOL; MD -12.39, 95% CI [-24.21 to -0.57; n = 2), and a total of 441 patients had 607 adverse events (AEs; 496 in the cannabinoid group and 111 in the placebo group). Conclusions. Our analysis showed cannabinoid is effective in increasing appetite in cancer patients. However, it declines the quality of life, which may be due to the side effects of cannabinoid.

Cancer anorexia-cachexia syndrome in advanced lung cancer: An exploratory analysis of patient-reported outcomes data.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17521-e17521
Author(s):  
Ryan David Nipp ◽  
Susan C. Locke ◽  
Gregory Samsa ◽  
Arif Kamal ◽  
Amy Pickar Abernethy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Weight Loss ◽  
Patient Reported Outcomes ◽  
Advanced Lung Cancer ◽  
Small Cell Lung ◽  
Patient Reported ◽  
Cancer Anorexia ◽  
Cachexia Syndrome

e17521 Background: The cancer anorexia-cachexia syndrome (CACS) is a debilitating syndrome of involuntary weight loss, anorexia, declining function, muscle catabolism, and inflammation. It affects many patients with cancer, especially those with advanced disease. We aimed to describe the experience of a group of patients with advanced lung cancer who meet published weight-based criteria for CACS. Methods: Tablet computers were used to collect patient-reported outcomes data from 97 patients with advanced non-small cell lung cancer, using the Patient Care Monitor v2.0 and the FACIT family of questionnaires. 25 patients met published weight criteria for CACS (>=5% weight loss in the past 6 months). 51 patients with stable weights were used as a comparison group; those lacking weight data were excluded. Statistical comparisons were made between these groups to explore differences in symptoms, quality of life, and survival. Results: Patients meeting weight criteria for CACS had lower serum albumins (median 3.7 vs. 3.9, p=0.006) and worse performance status by Karnofsky and ECOG (70 vs. 80, p=0.004, and 2 vs. 1, p=0.027). CACS patients had worse FAACT anorexia-cachexia subscale scores (34.5 vs. 38.5, p=0.018) but were not statistically more likely to be prescribed CACS therapies; only 17% of patients in the CACS group were on medication for this (N=4). FACIT fatigue subscale scores were not statistically different between groups, nor was quality of life by FACT-G. Grip strength and 6-minute walk distance were also not statistically different. Patients in the CACS group had a significantly shorter survival (HR 2.066 [95% CI=1.229,3.474], p=0.005). Conclusions: Patients with advanced non-small cell lung cancer who meet standard weight-based criteria for CACS have inferior survival compared to a similar population without weight loss. Though traditional descriptions of CACS presume a general impairment in quality of life, we did not find statistical differences here aside from the anorexia-cachexia subscale score of FAACT. Few patients were prescribed medication to address symptomatic anorexia/cachexia, suggesting it may be an unmet need in patients with advanced lung cancer.

Cancer cachexia syndrome in head and neck cancer patients: Part II. Pathophysiology

Head & Neck ◽  
2007 ◽  
Vol 29 (5) ◽  
pp. 497-507 ◽  
Author(s):  
Jonathan George ◽  
Trinitia Cannon ◽  
Victor Lai ◽  
Luther Richey ◽  
Adam Zanation ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Cancer Cachexia ◽  
Cachexia Syndrome

scholarly journals A Prospective Randomized Controlled Trial to Study the Impact of a Nutrition-Sensitive Intervention on Adult Women With Cancer Cachexia Undergoing Palliative Care in India

2016 ◽  
Vol 16 (1) ◽  
pp. 74-84 ◽  
Author(s):  
Neha Kapoor ◽  
Jane Naufahu ◽  
Sundus Tewfik ◽  
Sushma Bhatnagar ◽  
Rakesh Garg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Body Weight ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Controlled Trial ◽  
Intervention Group ◽  
Randomized Controlled ◽  
Nutrition Sensitive

Purpose. Advanced cancer patients with disease progression develop cachexia. Nevertheless, cancer patients at nutritional risk have shown improved body weight and quality of life with oral nutritional supplements. Method. This was a randomized controlled trial in adult female cancer patients (n = 63) attending palliative clinics, with symptoms of cachexia. Eligible patients were randomly distributed into control (n = 33) and intervention (n = 30) groups. Both groups were provided with nutritional and physical activity counseling, but the intervention group received an additional 100 g of Improved Atta (IAtta) for 6 months daily consumption. This study was designed to assess the efficacy of IAtta (with counseling) in enhancing the health status of cachexic patients. Anthropometric measurements, dietary intake, physical activity level and quality of life parameters were assessed at baseline, after 3 months, and at the end of 6 months. Results. Patients in the control group (n = 15) had significantly decreased body weight ( P = .003), mid–upper-arm circumference ( P = .002), and body fat ( P = .002) by the end of intervention. A trend of body weight gain in the intervention group (n = 17; P = .08) and significant increase of body fat ( P = .002) was observed; moreover, patients reported a significant improvement in fatigue ( P = .002) and appetite scores ( P = .006) under quality-of-life domains at the end of intervention. Conclusions. Embedding a nutrition-sensitive intervention ( IAtta ) within Indian palliative care therapy may improve quality of life and stabilize body weight in cancer cachexia patients.

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