Assessment Of Cachexia In Cancer Patients With Advanced Disease

Cachexia is one of the major symptoms of cancer patients in the advanced stage of the disease, being present in 40-80% of patients. Characterized by disturbance of the body's energy and protein metabolism, cachexia affects the patient's quality of life and it is also a negative prognostic factor of disease therapeutic response to chemotherapy and a predictive factor of survival. Accurate diagnosis and staging of cancer cachexia in advanced stages of cancer requires at least evaluation of appetite and gastrointestinal symptoms, history of weight change and BMI, CRP and performance status and a physical examination focusing on loss of subcutaneous fat, muscle wasting (temporal region, deltoids, and quadriceps with loss of bulk and tone by palpation), edema (sacral or ankle) or ascites. The causes of cachexia in cancer patients are complex and, most often confounding, with either reversible causes (e.g. insufficient nutritional intake) or irreversible. In the last years, the development of cachexia treatment guidelines requires active intervention in the management of patients with cachexia to improve their life quality. Management of people with cachexia requires a team approach that should also include oncologic, nutritional, physiotherapeutic and mental health care services, as well as general practice and nursing care service for the patient.