Cancer-associated malnutrition, cachexia and sarcopenia: The skeleton in the hospital closet 40 years later

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dc.contributor.authorRyan, Aoife M.
dc.contributor.authorPower, Derek G.
dc.contributor.authorDaly, Louise
dc.contributor.authorCushen, Samantha J.
dc.contributor.authorNí­ Bhuachalla, Éadaoin
dc.contributor.authorPrado, Carla M.
dc.date.accessioned2021-11-23T09:55:32Z
dc.date.available2021-11-23T09:55:32Z
dc.date.issued2016-01-20
dc.date.updated2021-11-23T09:31:55Z
dc.description.abstractAn awareness of the importance of nutritional status in hospital settings began more than 40 years ago. Much has been learned since and has altered care. For the past 40 years several large studies have shown that cancer patients are amongst the most malnourished of all patient groups. Recently, the use of gold-standard methods of body composition assessment, including computed tomography, has facilitated the understanding of the true prevalence of cancer cachexia (CC). CC remains a devastating syndrome affecting 50â 80 % of cancer patients and it is responsible for the death of at least 20 %. The aetiology is multifactorial and complex; driven by pro-inflammatory cytokines and specific tumour-derived factors, which initiate an energy-intensive acute phase protein response and drive the loss of skeletal muscle even in the presence of adequate food intake and insulin. The most clinically relevant phenotypic feature of CC is muscle loss (sarcopenia), as this relates to asthenia, fatigue, impaired physical function, reduced tolerance to treatments, impaired quality of life and reduced survival. Sarcopenia is present in 20â 70 % depending on the tumour type. There is mounting evidence that sarcopenia increases the risk of toxicity to many chemotherapy drugs. However, identification of patients with muscle loss has become increasingly difficult as 40â 60 % of cancer patients are overweight or obese, even in the setting of metastatic disease. Further challenges exist in trying to reverse CC and sarcopenia. Future clinical trials investigating dose reductions in sarcopenic patients and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationRyan, A. M., Power, D. G., Daly, L., Cushen, S. J., Ní Bhuachalla, É and Prado, C. M. (2016) 'Cancer-associated malnutrition, cachexia and sarcopenia: The skeleton in the hospital closet 40 years later', Proceedings of the Nutrition Society, 75(2), pp.199-211. doi: 10.1017/S002966511500419Xen
dc.identifier.doi10.1017/S002966511500419Xen
dc.identifier.endpage211en
dc.identifier.issn0029-6651
dc.identifier.issn1475-2719
dc.identifier.issued2en
dc.identifier.journaltitleProceedings of the Nutrition Societyen
dc.identifier.startpage199en
dc.identifier.urihttps://hdl.handle.net/10468/12246
dc.identifier.volume75en
dc.language.isoenen
dc.publisherCambridge University Press on behalf of The Nutrition Societyen
dc.relation.ispartofThe Nutrition Society Irish Section Meeting, University College Cork, Cork, 16–19 June 2015
dc.relation.isversionofConference on ‘Nutrition at key life stages: new findings, new approaches’ Julie Wallace lecture
dc.rights© 2016, the Authors. Published by Cambridge University Press on behalf of The Nutrition Society. This material is free to view and download for personal use only. Not for re-distribution, re-sale or use in derivative works.en
dc.subjectCanceren
dc.subjectCachexiaen
dc.subjectSarcopeniaen
dc.subjectQuality of lifeen
dc.subjectMalnutritionen
dc.subjectSurvivalen
dc.titleCancer-associated malnutrition, cachexia and sarcopenia: The skeleton in the hospital closet 40 years lateren
dc.typeArticle (peer-reviewed)en
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