Cancer cachexia: an orphan with a future

Lainščak, Mitja; Rosano, Giuseppe

doi:10.1002/jcsm.12401

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…However, the cause of death in advanced cancer is notoriously difficult to ascertain (particularly because of the multi‐morbid problems of many patients including infections and multi‐organ failure) and consensus on appropriate event definitions in cancer is not established yet. The symptoms of patients with advanced cancer — suggested here to be heart failure‐like — may indeed be due to mimics of heart failure such as major frailty and cachexia 19 . Clinical investigations on this are called for.…”

Section: Hypothesismentioning

confidence: 93%

Advanced cancer is also a heart failure syndrome: a hypothesis

Anker

Sanz

Zamorano

et al. 2021

European J of Heart Fail

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We present the hypothesis that advanced stage cancer is also a heart failure syndrome. It can develop independently of or in addition to cardiotoxic effects of anti‐cancer therapies. This includes an increased risk of ventricular arrhythmias. We suggest the pathophysiologic link for these developments includes generalized muscle wasting (i.e. sarcopenia) due to tissue homeostasis changes leading to cardiac wasting associated cardiomyopathy. Cardiac wasting with thinning of the ventricular wall increases ventricular wall stress, even in the absence of ventricular dilatation. In addition, arrhythmias may be facilitated by cellular wasting processes affecting structure and function of electrical cells and conduction pathways. We submit that in some patients with advanced cancer (but not terminal cancer), heart failure therapy or defibrillators may be relevant treatment options. The key points in selecting patients for such therapies may be the predicted life expectancy, quality of life at intervention time, symptomatic burden, and consequences for further anti‐cancer therapies. The cause of death in advanced cancer is difficult to ascertain and consensus on event definitions in cancer is not established yet. Clinical investigations on this are called for. Broader ethical considerations must be taken into account when aiming to target cardiovascular problems in cancer patients. We suggest that focused attention to evaluating cardiac wasting and arrhythmias in cancer will herald a further evolution in the rapidly expanding field of cardio‐oncology.

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Section: Hypothesismentioning

confidence: 93%

Advanced cancer is also a heart failure syndrome: a hypothesis

Anker

Sanz

Zamorano

et al. 2021

European J of Heart Fail

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“…About 1.5–2 million deaths are occurring in patients with cachexia per year. Recent studies showed that a total of 800,300 patients (15.8 per 10,000 of the total population of the EU) and 527,100 patients (16.5 per 10,000 of the total US population) suffer from cancer-related cachexia ( Lainscak & Rosano, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Regardless of the causes, the lack of awareness and knowledge about cachexia can also be a contributing factor to the exacerbation of the ACS. Furthermore, Lainscak (2019) has identified the lack of financial resources allocated to the coding of cachexia as a contributing factor (Lainscak & Rosano, 2019). Mattox (2017) presented the latest criteria for the diagnosis of the ACS which include: (1) assessing quality of life and anorexia, (2) measuring caloric intake (3) determine nutrition impact risk factors and symptoms (4) measure weight and body composition and (5) check biological markers.…”

Section: Introductionmentioning

confidence: 99%

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Nurses’ Knowledge in Relation to the Anorexia–Cachexia Syndrome in Cancer Patients: A Cross-National Comparison in Two European Countries

et al. 2021

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Introduction The Anorexia–Cachexia Syndrome (ACS) is a severe complication of cancer and is considered to be a significant cause of morbidity and mortality affecting up to two-thirds of cancer patients and one that needs specialized nursing care. Studies showed that the ACS has been relatively under-researched and under-resourced whist the nurses’ knowledge has not been systematically explored. Objective Τo explores nurses’ knowledge, understanding, and management of ACS in clinical practice in two European countries. Methods Descriptive-comparative study with 197 cancer nurses recruited during two National Conferences in Greece and Cyprus. Data were retrieved with the “Investigation of anorexia–cachexia syndrome in Practice” questionnaire. Results In terms of nurses’ perceptions on ACS, the prevailing characteristic reported in both countries was anorexia ( p = .65) followed by weight loss ( p = .04). 189 nurses (95.9%, p = .176) do not currently use a tool to assess patients’ nutritional status as part of their standard clinical practice. Statistically significant differences were found in relation to the routine assessment of nutritional-related symptoms including early satiety (Cyprus 64% vs. Greece 37%, p = .001), hiccough (66% vs. 36%, p < .001), alteration of the taste/odor sensation (77% vs. 45%, p < .001), problems in the oral cavity (84% vs. 68%, p = .032) and daily activities (85% vs. 69%, p = .032). The priority level for the ACS management differed significantly in the two countries ( p = .006), with higher priority being reported in Cyprus. Conclusion The study showed that more education is needed for cancer nurses to better understand the ACS which can facilitate the better management of the syndrome in clinical practice.

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“…Cachexia prevalence in advanced cancer might be as high as 60%-80%. 18 Nutritional issues in patients with cancer are so important that the European Cancer Patient Coalition (ECPC) published a Cancer Patient's Nutritional Bill of Rights, which was presented in the European Parliament in Brussels in November 2017. 19 But, … has the scale of this issue been acknowledged or reflected in provision of adequate support?…”

mentioning

confidence: 99%