A multimodal approach to cancer-related cachexia: from theory to practice

Expert Rev Anticancer Ther. 2021 Aug;21(8):819-826. doi: 10.1080/14737140.2021.1927720. Epub 2021 May 27.

Abstract

Introduction: Cachexia represents a relevant issue in oncological care, which is still lacking effective therapies. Although the incidence of cancer cachexia varies across cancer types, it is responsible for approximately a quarter of cancer-related deaths. The pathophysiology of this syndrome is multifactorial, including weight loss, muscle atrophy and impairment of the pro-/anti-inflammatory balance.Areas covered: Diagnostic criteria and optimal endpoints for cachexia-dedicated trials are still debated, slowing the identification of interventions counteracting cachexia sequaele. The multifaceted features of this syndrome support the rationale for personalized therapy. A multimodal approach is likely to offer the best option to address key cachexia-related issues. Pharmacologic agents, physical exercise, nutritional and psycho-social interventions may have a synergistic effect, and improve quality of life.Expert opinion: A personalized multimodal intervention could be the best strategy to effectively manage cancer cachexia. To offer such a comprehensive approach, a specialized staff, including health professionals with different expertise, is necessary. Each specialist plays a specific role inside the multimodal intervention, with the aim of delivering the best cancer care and access to the most effective therapeutic options for each patient.

Keywords: Cancer; cachexia; exercise; multimodal intervention; nutrition; psychological support.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cachexia* / etiology
  • Cachexia* / therapy
  • Exercise
  • Humans
  • Neoplasms* / drug therapy
  • Neoplasms* / therapy
  • Quality of Life
  • Weight Loss