Estimation of Cachexia among Cancer Patients Based on Four Definitions

Abstract

Objectives. Estimate and compare the proportion of cancer patients with cachexia using different definitions from available clinical data. Methods. Electronic medical records were examined to estimate the proportion of cancer patients with cachexia using 4 definitions: (1) ICD-9 diagnostic code of 799.4 (cachexia), (2) ICD-9 diagnosis of cachexia, anorexia, abnormal weight loss, or feeding difficulties, (3) prescription for megestrol acetate, oxandrolone, somatropin, or dronabinol, and (4) ≥5% weight loss. Patients with cancer of the stomach, pancreas, lung, colon/rectum, head/neck, esophagus, prostate, breast, or liver diagnosed between 1999 and 2004 were followed for cachexia. Results. Of 8541 cancer patients (60% men and 55% Caucasian), cachexia was observed in 2.4% of patients using the cachexia diagnostic code, 5.5% expanded diagnoses, 6.4% prescription medication definition, and 14.7% with ≥5% weight loss. Conclusions. The proportion of patients with cachexia varied considerably depending upon the definition employed, indicating that a standard operational definition is needed.

Fasting vs dietary restriction in cellular protection and cancer treatment: from model organisms to patients

“…Among the problems associated with the translation of DR into clinical applications is that chronic DR delays but does not stop the progression of the disease (Mukherjee et al, 2004;Bonorden et al, 2009;Shelton et al, 2010), and that this delay will occur for only a subset of malignancies (Kalaany and Sabatini, 2009). Although weight loss and cachexia in the early stages of cancer progression are not as common as thought (Tisdale, 2002;Fearon et al, 2003;Fox et al, 2009), the B15% loss of body mass index caused by a moderate (20%) calorie restriction (Racette et al, 2006) would prevent its use in the great majority of cancer treatment scenarios. In addition, the effect of long-term restriction in delaying wound healing and impairing immune function Kristan, 2008;Reed et al, 1996) may impose a significant risk to cancer patients receiving chemotherapy, surgery or immunity-based treatments (Kim and Demetri, 1996).…”

PROVENGE (Sipuleucel-T) in Prostate Cancer: The First FDA-Approved Therapeutic Cancer Vaccine

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The role of physical activity in counteracting age-related sarcopenia and cancer cachexia: A brief literature review

“…Interestingly, the incidence of weight loss vary greatly according to the tumor site: the greatest weight loss was seen among patients with solid tumors (e.g. gastric, pancreatic, lung, colorectal, head and neck) (16). In particular, those patients with upper gastrointestinal and lung cancer are more predisposed to this condition with a prevalence of cachexia up to 80% and 60% respectively (17).…”