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HERO ID
7391109
Reference Type
Journal Article
Subtype
Review
Title
Understanding the mechanisms and treatment options in cancer cachexia
Author(s)
Fearon, K; Arends, J; Baracos, V
Year
2013
Is Peer Reviewed?
1
Journal
Nature Reviews. Clinical Oncology
ISSN:
1759-4774
EISSN:
1759-4782
Volume
10
Issue
2
Page Numbers
90-99
Language
English
PMID
23207794
DOI
10.1038/nrclinonc.2012.209
Web of Science Id
WOS:000314859300008
Abstract
Cancer cachexia is a metabolic syndrome that can be present even in the absence of weight loss ('precachexia'). Cachexia is often compounded by pre-existing muscle loss, and is exacerbated by cancer therapy. Furthermore, cachexia is frequently obscured by obesity, leading to under-diagnosis and excess mortality. Muscle wasting (the signal event in cachexia) is associated not only with reduced quality of life, but also markedly increased toxicity from chemotherapy. Many of the primary events driving cachexia are likely mediated via the central nervous system and include inflammation-related anorexia and hypoanabolism or hypercatabolism. Treatment of cachexia should be initiated early. In addition to active management of secondary causes of anorexia (such as pain and nausea), therapy should target reduced food intake (nutritional support), inflammation-related metabolic change (anti-inflammatory drugs or nutrients) and reduced physical activity (resistance exercise). Advances in the understanding of the molecular biology of the brain, immune system and skeletal muscle have provided novel targets for the treatment of cachexia. The combination of therapies into a standard multimodal package coupled with the development of novel therapeutics promises a new era in supportive oncology whereby quality of life and tolerance to cancer therapy could be improved considerably.
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