Addressing unmet needs for people with cancer cachexia: recommendations from a multistakeholder workshop

García, José Manuel Pérez; Dunne, Richard F.; Santiago, Kristen; Martin, Lisa W.; Birnbaum, Morris J.; Crawford, Jeffrey; Hendifar, Andrew Eugene; Kochanczyk, Martin; Moravek, Cassadie; Piccinin, Doris; Picozzi, Vincent J.; Roeland, Eric; Selig, Wendy; Zimmers, Teresa A.

doi:10.1002/jcsm.12910

Cited by 25 publications

(25 citation statements)

References 37 publications

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“…Although, there is growing data on basic science level of therapeutic targets including antibodies, muscle stem cells and mesenchymal stromal cell transplantation, 10 there are still few evidence‐based interventions for the treatment of cachexia, and a clear definition of cachexia and effective screening tools are urgently needed. 10 , 11 , 12 Leading organizations have published guidelines for the management of cachexia including the European Society of Medical Oncology, 13 the American Society of Clinical Oncology 14 and the Japanese Society for Palliative Medicine. 15 Organizations have also published oncology nutrition guidelines, for example, the European Society for Clinical Nutrition and Metabolism (ESPEN).…”

Section: Introductionmentioning

confidence: 99%

Identification and management of cancer cachexia in patients: Assessment of healthcare providers' knowledge and practice gaps

Baracos

Coats

Anker

et al. 2022

J cachexia sarcopenia muscle

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Background Cancer cachexia negatively impacts patient outcomes, quality of life and survival. Identification and management of cancer cachexia remains challenging to healthcare professionals (HCPs). The aim of this assessment was to identify current gaps in HCPs' knowledge and practice for identifying and managing adults with cancer‐related cachexia. Results may guide development of new educational programmes to close identified gaps and improve outcomes of cancer patients. Methods An international assessment was conducted using a mixed‐methods approach including focus group interviews with subject matter experts and an electronic survey of practising HCP. The assessment was led by the Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD) and was supported by in‐country collaborating organizations. Results A quantitative survey of 58 multiple‐choice questions was completed by physicians, nurses dietitians and other oncology HCP (N = 2375). Of all respondents, 23.7% lacked confidence in their ability to provide care for patients with cancer cachexia. Patients with gastrointestinal, head and neck, pulmonary cancers and leukaemia/lymphoma were reported as those at highest risk for cachexia. Only 29.1% of respondents recognized a key criterion of cancer cachexia as >5% weight loss from baseline, but many (14.4%) did not utilize a standardized definition of cancer cachexia. Despite this, most clinicians (>84%) were able to identify causes of weight loss—reduced oral intake, progressive disease, side effects of therapy and disease‐related inflammation. Of all respondents, 52.7% indicated newly diagnosed patients with cancer should be screened for weight loss. In practice, 61.9% reported that patient weight was systematically tracked over time, but only 1125 (47.4%) reported they weigh their cancer patients at each visit. Treatment of cachexia focused on increasing the patient's nutritional intake by oral nutritional supplements (64.2%), energy and protein fortified foods (60.3%) and counselling by a dietitian (57.1%). Whereas many respondents (37.3%) considered cachexia inevitable, most (79.2%) believed that an interprofessional team approach could improve care and that use of standardized tools is critical. Conclusions Findings from this international assessment highlight the challenges associated with the care of patients with cancer cachexia, opportunities for interventions to improve patient outcomes and areas of variance in care that would benefit from further analysis.

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Section: Introductionmentioning

confidence: 99%

Identification and management of cancer cachexia in patients: Assessment of healthcare providers' knowledge and practice gaps

Baracos

Coats

Anker

et al. 2022

J cachexia sarcopenia muscle

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“…In conclusion, many actions are needed to better understand cancer cachexia ( Garcia et al, 2022 ). Clinicians should better take into consideration, beside tumor fighting, also lean and fat body mass, nutritional and psychological status of their patients, and multimodal therapeutic approaches should be considered to counteract this syndrome.…”

Section: Discussionmentioning

confidence: 99%

Cancer cachexia as a multiorgan failure: Reconstruction of the crime scene

Ferrara

Samaden

Ruggieri

et al. 2022

Front. Cell Dev. Biol.

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Cachexia is a devastating syndrome associated with the end-stage of several diseases, including cancer, and characterized by body weight loss and severe muscle and adipose tissue wasting. Although different cancer types are affected to diverse extents by cachexia, about 80% of all cancer patients experience this comorbidity, which highly reduces quality of life and response to therapy, and worsens prognosis, accounting for more than 25% of all cancer deaths. Cachexia represents an urgent medical need because, despite several molecular mechanisms have been identified, no effective therapy is currently available for this devastating syndrome. Most studies focus on skeletal muscle, which is indeed the main affected and clinically relevant organ, but cancer cachexia is characterized by a multiorgan failure. In this review, we focus on the current knowledge on the multiple tissues affected by cachexia and on the biomarkers with the attempt to define a chronological pathway, which might be useful for the early identification of patients who will undergo cachexia. Indeed, it is likely that the inefficiency of current therapies might be attributed, at least in part, to their administration in patients at the late stages of cachexia.

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“…Patient education into what cachexia is, its common symptoms and its associated problems can mitigate distress [18 ▪ ]. There is growing international consensus that education provided by a multidisciplinary team is important if patients are to successfully self-manage cachexia-related problems [19 ▪ ].…”

Section: The Need For Education In Cancer Cachexia: Health Care Profe...mentioning

confidence: 99%

Educational needs of self-care in cachectic cancer patients and caregivers

Hopkinson

2023

Current Opinion in Oncology

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Purpose of reviewTo give an overview of what is known about the educational component of supportive care for people with cancer cachexia and their family caregivers.Recent findingsThe educational needs for self-care by people with cancer cachexia are largely unmet. There is potential for education to enable self-care that mitigates cachexia-related distress with benefit to quality of life and mitigates malnutrition/malnutrition risk with implications for treatment tolerance and outcomes. Theoretically informed approaches to cancer cachexia education for patients and their family members are needed if optimal methods for support of self-care are to be identified. The cancer workforce also needs education to have the confidence and knowledge to play a role in the cancer cachexia education of their patients.SummaryTo address the educational needs of self-care in cachectic cancer patients and their caregivers, there is much work to do. Healthcare professionals need to know the best educational process and methods for cachexia for supporting quality of life and to facilitate improving cancer treatment outcomes including survival.

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Addressing unmet needs for people with cancer cachexia: recommendations from a multistakeholder workshop

Cited by 25 publications

References 37 publications

Identification and management of cancer cachexia in patients: Assessment of healthcare providers' knowledge and practice gaps

Identification and management of cancer cachexia in patients: Assessment of healthcare providers' knowledge and practice gaps

Cancer cachexia as a multiorgan failure: Reconstruction of the crime scene

Educational needs of self-care in cachectic cancer patients and caregivers

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