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Cancer Prevention and Treatment
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
An International Consensus Conference defined cachexia as a multifactorial syndrome of ongoing loss of skeletal muscle mass with or without loss of fat mass that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. The diagnostic criteria for cachexia is weight loss of >5% or weight loss from baseline weight of >2% in individuals showing depletion of body weight of <20 kg/m2. Cachexia is marked by loss of appetite, impaired glucose tolerance, and involuntary weight loss. Cachexia may ultimately be manifested by loss of subcutaneous fat, muscle mass, and an inability to maintain weight. Significant muscle loss has also been called sarcopenia and may be difficult to determine in previously overweight or obese individuals.
Symptom Control in Hospice-State of the Art
Published in Inge B. Corless, Zelda Foster, The Hospice Heritage: Celebrating Our Future, 2020
J. Cameron Muir, Lisa M. Krammer, Jacqueline R. Cameron, Charles F. von Gunten
Anorexia (the loss of appetite) and cachexia (involuntary weight loss, weakness, lean body wasting and poor performance status) accompany many advanced diseases.59 Cachexia is a prevalent (> 80%) and disturbing symptom occurring in most patients with advanced cancer and AIDS, and is the primary cause of death in up to 22% of patients with advanced cancer.60 Cachexia is also more common in older patients and becomes more prevalent as disease progresses.61 The diagnosis of cachexia is straightforward, based upon a positive clinical history, the presence of substantial weight loss and the physical examination. Plasma albumin concentration is usually decreased, though its measurement (or that of any other laboratory parameters) is not necessary.61
Introduction to energy aspects of nutrition
Published in Geoffrey P. Webb, Nutrition, 2019
The term cachexia is derived from the Greek words kakos (bad) and hexis (condition). It describes the weight loss experienced by many people with chronic diseases like cancer, AIDS, chronic renal failure and chronic obstructive pulmonary disease. Patients experience anorexia and often eat little and there is hypermetabolism. Cachexia often signals the final terminal stage of the disease and in many cases is a major contributory factor in their death. Unlike in simple weight loss, there is loss of lean muscle tissue as well as fat, and the loss of lean and fat tissue cannot be arrested by increased calorie input.
Evaluation of the relationship of the T and M stage with the erector spinae muscle area in male lung cancer patients
Published in The Aging Male, 2023
Cachexia is a complex medical syndrome and is usually develops due to an underlying disease and is characterized by muscle wasting. Fat mass loss may or may not be accompanied [8]. Sarcopenia is a progressive syndrome characterized by falls, fractures, physical disability, and mortality, usually as a result of muscle disease [9]. Sarcopenia is a prognostic factor that can be seen in patients with cancer due to cachexia and presents with a decrease in skeletal muscle mass [10,11]. Measurements made from the psoas muscles in the section taken from the L3 vertebra level in CT are one of the most commonly used methods for sarcopenia [12,13]. In cases where the skeletal muscle index is <55 cm2/m2 in men and <39 cm2/m2 in women at the L3 vertebra level, sarcopenia is considered [14]. In addition, relative sarcopenia has been previously calculated using muscle and subcutaneous fat tissue measurements made in the axial section at the T12 vertebra level and compared with clinical data [15]. The erector spinae muscle area (ESMa) measured at the T12 vertebra level has been found to be a determining factor in the prognosis in patients with idiopathic pulmonary fibrosis [16].
Pharmacotherapeutic options for cancer cachexia: emerging drugs and recent approvals
Published in Expert Opinion on Pharmacotherapy, 2023
Lorena Garcia-Castillo, Giacomo Rubini, Paola Costelli
Three progressive stages can be recognized in cancer cachexia: pre-cachexia, cachexia, and refractory cachexia [3]. Early diagnosis is fundamental in the management of cancer patients and consists of the identification of a weight loss of at least 5% in 12 months or less, accompanied by other symptoms, such as decreased muscle strength, fatigue, anorexia, and abnormal biochemistry [4]. As patients advance from pre-cachexia to refractory cachexia, treatments become ineffective and the expected survival drastically drops below three months [3]. Regardless of early diagnosis, the management of cachexia in a clinical setting is hampered by the lack of effective treatments. Its multi-etiological nature renders cachexia a disease that requires a multimodal intervention consisting of nutritional therapy, pharmacological agents, and exercise (Figure 1). Moreover, treatments for cachexia should be finely combined with the treatments for the underlying illness [1]. Current therapeutic approaches have not proven to be effective, unfortunately depicting cachexia as a still unmet medical need. Thus, efforts in the identification of novel pharmacological agents, as well as their integration into a multimodal therapeutic protocol, are needed.
Body Composition and Response and Outcome of Neoadjuvant Treatment for Pancreatic Cancer
Published in Nutrition and Cancer, 2022
Kaizhou Jin, Yuan Tang, Anqi Wang, Zhiqian Hu, Chen Liu, Haiyang Zhou, Xianjun Yu
The main prognostic factor was cachexia phenotype. However, age, sex, disease extent, chemotherapy response, presence of sarcopenia, obesity, sarcopenic obesity, and myosteatosis before and after NAT, and tumor characteristics were also examined. Age as well other parameters was dichotomized at the mean for Kaplan–Meier and Cox proportional analysis. Results of Kaplan–Meier survival analyses are reported as median survival with log rank test P values. Results of Cox proportional analysis are reported as hazard ratios with 95% confidence intervals. A multivariate cox regression analysis based on the results of the univariate analyses was performed to calculate the HRs and 95% confidence intervals (CIs) of the independent variables. Candidate variables with a P < 0.2 on univariate analysis were included in multivariable model.