Involuntary weight loss and altered body image in patients with cancer anorexia–cachexia syndrome

2010 ◽  
pp. 499-508 ◽  
Author(s):  
Susan E. McClement
Keyword(s):  
Weight Loss ◽  
Body Image ◽  
Patients With Cancer ◽  
Cancer Anorexia ◽  
Involuntary Weight Loss ◽  
Cachexia Syndrome

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.

Metoclopramide in Anorexia Caused by Cancer-Associated Dyspepsia Syndrome (CADS)

1993 ◽  
Vol 9 (2) ◽  
pp. 14-18 ◽  
Author(s):  
◽  
Kristine A. Nelson ◽  
T. Declan Walsh
Keyword(s):  
Advanced Cancer ◽  
Prokinetic Agent ◽  
Patients With Cancer ◽  
Dyspeptic Symptoms ◽  
Cancer Anorexia ◽  
Cachexia Syndrome

Anorexia is a common problem in advanced cancer, part of the cancer anorexia-cachexia syndrome. Although the etiology is multifactorial, symptoms suggestive of gastroparesis are often present in patients with cancer anorexia. We have successfully used metoclopramide, a prokinetic agent, to stimulate appetite in advanced cancer and relieve other dyspeptic symptoms associated with anorexia.

Comparison of Orally Administered Cannabis Extract and Delta-9-Tetrahydrocannabinol in Treating Patients With Cancer-Related Anorexia-Cachexia Syndrome: A Multicenter, Phase III, Randomized, Double-Blind, Placebo-Controlled Clinical Trial From the Cannabis-In-Cachexia-Study-Group

2006 ◽  
Vol 24 (21) ◽  
pp. 3394-3400 ◽  
Author(s):  
Florian Strasser ◽  
Diana Luftner ◽  
Kurt Possinger ◽  
Gernot Ernst ◽  
Thomas Ruhstaller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Eastern Cooperative Oncology Group ◽  
Phase Iii ◽  
Controlled Clinical Trial ◽  
Life Questionnaire ◽  
Patients With Cancer ◽  
Cannabis Extract ◽  
Cachexia Syndrome

Purpose To compare the effects of cannabis extract (CE), delta-9-tetrahydrocannabinol (THC), and placebo (PL) on appetite and quality of life (QOL) in patients with cancer-related anorexia-cachexia syndrome (CACS). Patients and Methods Adult patients with advanced cancer, CACS, weight loss (≥ 5% over 6 months), and Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤ 2 were randomly assigned (2:2:1) to receive CE (standardized for 2.5 mg THC and 1 mg cannabidiol) or THC (2.5 mg) or PL orally, twice daily for 6 weeks. Appetite, mood, and nausea were monitored daily with a visual analog scale (VAS); QOL was assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (composite score: questions 29 and 30). Cannabinoid-related toxicity was assessed every 2 weeks. Results Of 289 patients screened, 243 were randomly assigned and 164 (CE, 66 of 95 patients; THC, 65 of 100 patients; and PL, 33 of 48 patients) completed treatment. At baseline, groups were comparable for age (mean, 61 years), sex (54% men), weight loss (32% ≥ 10%), PS (13% ECOG = 2), antineoplastic treatment (50%), appetite (mean VAS score, 31/100 mm), and QOL (mean score, 30/100). Intent-to-treat analysis showed no significant differences between the three arms for appetite, QOL, or cannabinoid-related toxicity. Increased appetite was reported by 73%, 58%, and 69% of patients receiving CE, THC, or PL, respectively. An independent data review board recommended termination of recruitment because of insufficient differences between study arms. Conclusion CE at the oral dose administered was well tolerated by these patients with CACS. No differences in patients' appetite or QOL were found either between CE, THC, and PL or between CE and THC at the dosages investigated.

Perceptions and consequences of cancer-related weight loss among patients with cancer and caregivers.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 224-224
Author(s):  
Joanne S Buzaglo ◽  
Alexandra K Zaleta ◽  
Kayla M Miller ◽  
Victoria Kennedy ◽  
Ellyn Specker Charap
Keyword(s):  
Weight Loss ◽  
Body Image ◽  
Physical Appearance ◽  
Healthcare Team ◽  
Family Impact ◽  
Patients With Cancer ◽  
Care Plans ◽  
Medical Visits ◽  
Taste Changes ◽  
Cancer Experience

224 Background: Cancer-related weight loss affects up to 50% of individuals with cancer, yet our understanding of psychosocial consequences of this weight loss is limited. This study examined patient and caregiver perceptions of symptoms and consequences of cancer-related weight loss. Methods: Patients with self-reported weight loss (n = 15; 26% non-mBC, 13% colorectal, 13% MM, 13% ovarian, 35% other; mean BMI = 22.9) and caregivers of people experiencing weight loss (n = 15) were recruited through the online Cancer Experience Registry. Participants completed a one-hour phone interview about views about weight loss; transcribed responses underwent content and thematic analysis by three coders (agreement = 89%). Results: Across participants, the most commonly reported weight loss-related symptoms included appetite changes (80% of participants), nausea (73%), and taste changes (60%). Most bothersome consequences of weight loss for patients included fear of disease progression (53%), loss of identity (47%), caregiver burden worries (40%), anxiety (27%), and body image concerns/embarrassment about physical appearance (27%). Most bothersome consequences for caregivers were burden of providing care (80%), distress about physical appearance of the patient (80%), changed sense of patient identity (60%), fear of illness progression (53%), and family impact (40%). Weight loss acceptance varied by BMI; obese/overweight patients reported greater acceptance, citing improvements in body image and better physical fitness as reasons for acceptance. Only 33% of patients and 22% of caregivers reported that their healthcare team addressed cancer-related weight loss during medical visits. Conclusions: With respect to cancer-related weight loss, patients and caregivers most often identified psychosocial concerns as bothersome; concerns about weight loss causing changes in physical appearance were more prevalent among caregivers. These results support development of a psychometric measure to evaluate cancer-related weight loss and suggest the need for better integration of cancer-related weight loss concerns into survivorship care plans.

The cancer anorexia-cachexia syndrome.

1994 ◽  
Vol 12 (1) ◽  
pp. 213-225 ◽  
Author(s):  
K A Nelson ◽  
D Walsh ◽  
F A Sheehan
Keyword(s):  
Literature Review ◽  
Advanced Cancer ◽  
Clinical Evaluation ◽  
Symptomatic Treatment ◽  
Patients With Cancer ◽  
Comprehensive Literature Review ◽  
Cancer Anorexia ◽  
Cachexia Syndrome

PURPOSE To review the research related to the anorexia-cachexia syndrome in patients with cancer, with attention to the etiology and symptomatic treatment. DESIGN A comprehensive literature review using MEDLINE. RESULTS AND CONCLUSION The anorexia-cachexia syndrome is a common problem in advanced cancer. Although many possible etiologies have been investigated, the cause has not been determined. Appropriate clinical evaluation is necessary to identify those patients who may respond to available, symptomatic treatments.

Weighing Ourselves Down

2015 ◽  
Vol 4 (3) ◽  
pp. 51-69 ◽  
Author(s):  
Nathan Hodges
Keyword(s):  
Weight Loss ◽  
Body Image ◽  
Physical Health ◽  
Lived Experiences ◽  
Objective Measure ◽  
Subjective Experiences ◽  
Cultural Meanings ◽  
Canonical Narratives

Bodyweight—the number on the scale—has been constructed as an objective measure of health, and weight loss as synonymous with healthier. Weight has been used as a way of classifying and controlling people, ignoring the embodied, relational, and cultural meanings attached to health and weight. Instead, these subjective experiences are lumped into a numerical category. Our society's obsession with weight is weighing us down and most of us should toss out our scales. Scale stories offer a departure from canonical narratives about physical health and body image by emphasizing emotions and lived experiences instead of bodyweight and numerical categories.

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