Journal article
Early recognition of malnutrition and cachexia in the cancer patient: a position paper of a European School of Oncology Task Force.
- Aapro M Clinique de Genolier, Genolier, Switzerland.
- Arends J Tumor Biology Center, Albert Ludwig's University, Freiburg, Germany.
- Bozzetti F Department of Medicine and Surgery, University of Milan, Milan, Italy.
- Fearon K School of Clinical Sciences and Community Health, University of Edinburgh, Royal Infirmary, Edinburgh, UK k.fearon@ed.ac.uk.
- Grunberg SM Hematology/Oncology Division, University of Vermont College of Medicine, Burlington, VT, USA.
- Herrstedt J Department of Oncology, Odense University Hospital, Odense, Denmark.
- Hopkinson J School of Healthcare Sciences, Cardiff University, Cardiff, UK.
- Jacquelin-Ravel N Clinique de Genolier, Genolier, Switzerland.
- Jatoi A Department of Oncology, Mayo Clinic, Rochester, MN, USA.
- Kaasa S Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
- Strasser F Department of Internal Medicine, Kantonsspital, St Gallen, Switzerland.
- 2014-02-27
Published in:
- Annals of oncology : official journal of the European Society for Medical Oncology. - 2014
cancer cachexia
malnutrition
nutritional support
review
systemic inflammation
Body Composition
Cachexia
Early Diagnosis
Humans
Malnutrition
Molecular Targeted Therapy
Neoplasms
Pharmaceutical Preparations
Practice Patterns, Physicians'
Prognosis
Weight Loss
English
BACKGROUND
Weight loss and cachexia are common, reduce tolerance of cancer treatment and the likelihood of response, and independently predict poor outcome.
METHODS
A group of experts met under the auspices of the European School of Oncology to review the literature and-on the basis of the limited evidence at present-make recommendations for malnutrition and cachexia management and future research.
CONCLUSIONS
Our focus should move from end-stage wasting to supporting patients' nutritional and functional state throughout the increasingly complex and prolonged course of anti-cancer treatment. When inadequate nutrient intake predominates (malnutrition), this can be managed by conventional nutritional support. In the presence of systemic inflammation/altered metabolism (cachexia), a multi-modal approach including novel therapeutic agents is required. For all patients, oncologists should consider three supportive care issues: ensuring sufficient energy and protein intake, maintaining physical activity to maintain muscle mass and (if present) reducing systemic inflammation. The results of phase II/III trials based on novel drug targets (e.g. cytokines, ghrelin receptor, androgen receptor, myostatin) are expected in the next 2 years. If effective therapies emerge, early detection of malnutrition and cachexia will be increasingly important in the hope that timely intervention can improve both patient-centered and oncology outcomes.
Weight loss and cachexia are common, reduce tolerance of cancer treatment and the likelihood of response, and independently predict poor outcome.
METHODS
A group of experts met under the auspices of the European School of Oncology to review the literature and-on the basis of the limited evidence at present-make recommendations for malnutrition and cachexia management and future research.
CONCLUSIONS
Our focus should move from end-stage wasting to supporting patients' nutritional and functional state throughout the increasingly complex and prolonged course of anti-cancer treatment. When inadequate nutrient intake predominates (malnutrition), this can be managed by conventional nutritional support. In the presence of systemic inflammation/altered metabolism (cachexia), a multi-modal approach including novel therapeutic agents is required. For all patients, oncologists should consider three supportive care issues: ensuring sufficient energy and protein intake, maintaining physical activity to maintain muscle mass and (if present) reducing systemic inflammation. The results of phase II/III trials based on novel drug targets (e.g. cytokines, ghrelin receptor, androgen receptor, myostatin) are expected in the next 2 years. If effective therapies emerge, early detection of malnutrition and cachexia will be increasingly important in the hope that timely intervention can improve both patient-centered and oncology outcomes.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1093/annonc/mdu085
- PMID 24569913
- Persistent URL
- https://sonar.ch/global/documents/608
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