Quality of Life and Symptom Burden Improve in Patients Attending a Multidisciplinary Clinical Service for Cancer Cachexia: A Retrospective Observational Review

Bland, Kelcey A.; Harrison, Meg; Zopf, Eva M.; Sousa, Mariana S.; Currow, David C.; Ely, Matthew; Agar, Meera; Butcher, Belinda; Vaughan, Vanessa; Dowd, A. Justine; Martin, Peter

doi:10.1016/j.jpainsymman.2021.02.034

Cited by 33 publications

(37 citation statements)

References 66 publications

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“…Optimizing the medical management of symptoms and educating patients on the direct role exercise might play in improved symptom management, may stimulate patients’ interest in exercise. Palliative patients with cancer cachexia who receive multidisciplinary care, including consultation with a palliative care physician, nurse practitioner, dietitian, and physical therapist, report improvements in cancer symptoms, including fatigue, pain, anorexia, and nausea [ 54 ]. Such multimodal treatment approaches may be an important first step to manage symptoms prior to prescribing structured exercise, particularly among inactive patients or those with lower exercise motivation.…”

Section: Discussionmentioning

confidence: 99%

“I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study

et al. 2022

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Cachexia is a prevalent muscle wasting syndrome among people with advanced cancer that profoundly impacts patient quality of life (QoL) and physical function. Exercise can improve QoL, physical function, and overall health in people with cancer and may be an important addition to treatment approaches for cancer cachexia. Greater understanding of patients’ perception of exercise can help elucidate the feasibility of implementing exercise interventions for cancer cachexia and facilitate the design of patient-centered interventions. We aimed to describe the perception of exercise in patients with advanced cancer and cachexia, and capture exercise motivators, barriers, and preferences, to inform the feasibility of exercise interventions. Individual interviews (n = 20) with patients with locally advanced or metastatic cancer with cachexia were conducted and analyzed using reflexive thematic analysis. Main themes from interviews were: 1) Life is disrupted by cancer and cachexia; 2) Exercise offers hope; 3) Exercise barriers are multifaceted; and 4) Exercise access and support are important. Participants reported that their cancer and cachexia had intensely altered their lives, including ability to exercise. Exercise was perceived as important and participants described a hope for exercise to improve their health and wellbeing. Yet, several complex exercise barriers, such as burdensome cancer symptoms and the overwhelming impact of the COVID-19 pandemic, hindered exercise participation and prevented participants from fully realizing the perceived benefits of exercise. Factors believed to improve exercise engagement and overcome exercise barriers included increased exercise support (e.g., professional supervision) and accessibility (e.g., convenient locations). Patient-reported exercise barriers and preferences can inform the design of exercise interventions, particularly within future research studies aiming to establish exercise feasibility and efficacy in people with advanced cancer and cachexia.

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Section: Discussionmentioning

confidence: 99%

“I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study

et al. 2022

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“…In addition, as mentioned earlier, multiple factors are involved in cancer cachexia, including anorexia, skeletal muscle loss, and metabolic changes in the liver and adipose tissue against a background of systemic inflammation. Therefore, the treatment of cancer cachexia requires not only pharmacological therapies but also multidisciplinary interventions including nutrition therapy, exercise, and psychosocial interventions [26,[67][68][69]. However, clinical trials of pharmacological therapies and exercise interventions in patients with cancer cachexia have reported high dropout rates and low compliance, and the treatment itself can be a burden for patients [70,71].…”

Section: Clinical Evidence For the Treatment Of Cancer Cachexiamentioning

confidence: 99%

Cancer Cachexia: Its Mechanism and Clinical Significance

Nishikawa

Goto

Fukunishi

et al. 2021

IJMS

140

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The term “cachexia” is derived from the Greek words kakos (bad) and hexis (habit). Cachexia is a malnutrition associated with chronic diseases such as cancer, chronic heart failure, chronic renal failure, and autoimmune diseases, and is characterized by decreased skeletal muscle mass. Cancer cachexia is quite common in patients with advanced cancer. Weight loss is also a characteristic symptom of cancer cachexia, along with decreased skeletal muscle mass. As nutritional supplementation alone cannot improve cachexia, cytokines and tumor-derived substances have been attracting attention as its relevant factors. Cancer cachexia can be also associated with reduced chemotherapeutic effects, increased side effects and treatment interruptions, and even poorer survival. In 2011, a consensus definition of cachexia has been proposed, and the number of relevant research reports has increased significantly. However, the pathogenesis of cachexia is not fully understood, and there are currently few regulatory-approved standard treatments for cachexia. The main reason for this is that multiple etiologies are involved in the development of cachexia. In this review, we will outline the current status of cachexia, the mechanisms of which have been elucidated in recent years, especially from the perspective of advanced cancer.

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“…, 2. , 3. Cachexia is characterized by the ongoing loss of skeletal muscle mass (with or without the loss of fat mass) that leads to progressive functional impairment.…”

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confidence: 99%

“…In practical terms, this care has mostly fallen to dieticians 8 , 9 who have much to offer but may struggle to maximize their impact without other colleagues addressing symptom control issues, providing psychosocial support, and prescribing targeted exercise. 3 More recently, the importance of exercise in cancer rehabilitation has grown particularly in the cancer survivorship sector. 10 Intensive treatment regimens for some cancer cohorts, such as head and neck cancers, have included prevention and treatment of CC in a much more proactive structured way.…”

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confidence: 99%

Cancer cachexia syndrome: Reflecting on 20 years of providing cancer cachexia care as the leader of an interdisciplinary team in an Australian cancer center

Quality of Life and Symptom Burden Improve in Patients Attending a Multidisciplinary Clinical Service for Cancer Cachexia: A Retrospective Observational Review

Cited by 33 publications

References 66 publications

“I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study

“I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study

Cancer Cachexia: Its Mechanism and Clinical Significance

Cancer cachexia syndrome: Reflecting on 20 years of providing cancer cachexia care as the leader of an interdisciplinary team in an Australian cancer center

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