Managing Nutrition Impact Symptoms in Cancer Cachexia: A Case Series and Mini Review

Khorasanchi, Adam; Nemani, Srinidhi; Pandey, Sudeep; Fabbro, Egidio Del

doi:10.3389/fnut.2022.831934

Cited by 21 publications

(12 citation statements)

References 58 publications

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“…19,20 Now, cancer cachexia is still treated with measures. 3,37,38 The present results indicate that the Warburg effect is a target in the fight against cancer cachexia.…”

Section: Discussionsupporting

confidence: 56%

The Warburg effect drives cachectic states in patients with pancreatobiliary adenocarcinoma

Zhang

Sui

et al. 2023

The FASEB Journal

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We have studied whether the Warburg effect (uncontrolled glycolysis) in pancreatobiliary adenocarcinoma triggers cachexia in the patient. After 74 pancreatobiliary adenocarcinomas were removed by surgery, their glucose transporter‐1 and four glycolytic enzymes were quantified using Western blotting. Based on the resulting data, the adenocarcinomas were equally divided into a group of low glycolysis (LG) and a group of high glycolysis (HG). Energy homeostasis was assessed in these cancer patients and in 74 non‐cancer controls, using serum albumin and C‐reactive protein and morphometrical analysis of abdominal skeletal muscle and fat on computed tomography scans. Some removed adenocarcinomas were transplanted in nude mice to see their impacts on host energy homeostasis. Separately, nude mice carrying tumor grafts of MiaPaCa‐2 pancreatic adenocarcinoma cells were treated with the glycolytic inhibitor 3‐bromopyruvate and with emodin that inhibited glycolysis by decreasing hypoxia‐inducible factor‐1α. Adenocarcinomas in both group LG and group HG impaired energy homeostasis in the cancer patients, compared to the non‐cancer reference. The impaired energy homeostasis induced by the adenocarcinomas in group HG was more pronounced than that by the adenocarcinomas in group LG. When original adenocarcinomas were grown in nude mice, their glycolytic abilities determined the levels of hepatic gluconeogenesis, skeletal muscle proteolysis, adipose‐tissue lipolysis, and weight loss in the mice. When MiaPaCa‐2 cells were grown as tumors in nude mice, 3‐bromopyruvate and emodin decreased tumor‐induced glycolysis and cachexia, with the best effects being seen when the drugs were administered in combination. In conclusion, the Warburg effect in pancreatobiliary adenocarcinoma triggers cancer cachexia.

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“…19,20 Now, cancer cachexia is still treated with measures. 3,37,38 The present results indicate that the Warburg effect is a target in the fight against cancer cachexia.…”

Section: Discussionsupporting

confidence: 56%

The Warburg effect drives cachectic states in patients with pancreatobiliary adenocarcinoma

Zhang

Sui

et al. 2023

The FASEB Journal

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“…Management should appropriately address treatable factors associated with cancer. Symptoms that produce secondary hunger are termed nutrition impact symptoms and are thought to be caused by complications such as chemotherapy-related oral mucosal damage, diarrhea, nausea, and vomiting, as well as cancer-related depression ( 60 ). These complications for most cases are manageable by therapeutic intervention.…”

Section: Methodsmentioning

confidence: 99%

The landscape of cancer cachexia in advanced non-small cell lung cancer: a narrative review

Yamada¹,

Takayama²

2023

Transl Lung Cancer Res

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Background and Objective Cancer cachexia presents with weight loss, anorexia, and fatigue and worsens the prognosis and quality of life of cancer patients. We aimed to summarize the current relevant discourse in the literature about cancer cachexia in the setting of non-small cell lung carcinoma and the possible current and future treatments. Methods We conduct a narrative review of the literature on the landscape of cancer cachexia in the context of non-small cell lung cancer, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances. Key Content and Findings The need for appropriate intervention for cancer cachexia is increasing as the prognosis of patients with advanced non-small cell lung cancer is improving with advances in treatment. Tumor cells play a role in the pathogenesis of cachexia, where they release factors that elicit the production of inflammatory cytokines by the immune system resulting in decreased appetite, abnormal energy metabolism, and skeletal muscle degeneration. Comorbid chronic lung diseases are associated with pulmonary cachexia and sarcopenia and commonly occur in the context of lung cancer, further contributing to the increased incidence of cachexia in patients with lung cancer. Currently, a ghrelin-like agonist, anamorelin, is approved for the treatment of cancer cachexia and is used in clinical practice in Japan. The role that nutritional and exercise therapies can play as added treatments must be further explored. Conclusions Cancer cachexia remains a poorly understood phenomenon, and awareness must be raised through educational activities for health care providers and patient family members. In addition, new therapeutics targeting cancer cachexia, such as GDF-15 antibodies, are in development, and further progress is expected.

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“…In addition to increased energy expenditure, many patients with cancer cachexia also have significantly reduced energy intake caused by a variety of Nutritional Impact Symptoms (NIS), any of a broad range of symptoms impeding nutrient intake ( 33 ) ( Figure 1 ). The tumor stage and location, and the type of anti-cancer therapy prescribed can influence the type and amount of food consumed.…”

Section: Cancer Cachexia Pathophysiologymentioning

confidence: 99%

“…It seems plausible then, that pain management may improve cachexia and vice versa , but there is a scarcity of literature to examine this question. Pain is considered a nutrition impact symptom (NIS) ( 33 ), and multidisciplinary clinics designed to address NIS have reported both increased rates of symptom management ( 34 ) and decreased severity of pain, fatigue, and anorexia ( 71 ). However, in these studies, cachexia-related outcomes such as energy intake and body mass and composition were not measured.…”

Section: A Role For Pain In Cachexia Development and Progressionmentioning

confidence: 99%

Cancer cachexia: Pathophysiology and association with cancer-related pain

Law

2022

Front. Pain Res.

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Cachexia is a syndrome of unintentional body weight loss and muscle wasting occurring in 30% of all cancer patients. Patients with cancers most commonly leading to brain metastases have a risk for cachexia development between 20 and 80%. Cachexia causes severe weakness and fatigue and negatively impacts quality and length of life. The negative energy balance in cachectic patients is most often caused by a combination of increased energy expenditure and decreased energy intake. Basal metabolic rate may be elevated due to tumor secreted factors and a systemic inflammatory response leading to inefficiency in energy production pathways and increased energy demand by the tumor and host tissues. A growing body of research explores physiological and molecular mechanisms of metabolic dysregulation in cachexia. However, decreased energy intake and physical functioning also remain important contributors to cachexia pathogenesis. Pain associated with metastatic malignancy is significantly associated with inflammation, thus making inflammation a common link between cancer pain and cachexia. Pain may also influence appetite and food intake and exacerbate fatigue and functional decline, potentially contributing to cachexia severity. Cancer pain and cachexia often occur simultaneously; however, causal relationships remain to be established. Appropriate assessment and treatment of pain in advanced cancer patients may positively impact nutrition status and physical functioning, slowing the progression of cachexia and improving quality and length of life for patients.

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Managing Nutrition Impact Symptoms in Cancer Cachexia: A Case Series and Mini Review

Cited by 21 publications

References 58 publications

The Warburg effect drives cachectic states in patients with pancreatobiliary adenocarcinoma

The Warburg effect drives cachectic states in patients with pancreatobiliary adenocarcinoma

The landscape of cancer cachexia in advanced non-small cell lung cancer: a narrative review

Cancer cachexia: Pathophysiology and association with cancer-related pain

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