Impact of musculoskeletal degradation on cancer outcomes and strategies for management in clinical practice

dc.contributor.authorRyan, Aoife M.
dc.contributor.authorSullivan, Erin S.
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2021-12-02T15:44:16Z
dc.date.available2021-12-02T15:44:16Z
dc.date.issued2020-11-03
dc.description.abstractThe prevalence of malnutrition in patients with cancer is one of the highest of all patient groups. Weight loss (WL) is a frequent manifestation of malnutrition in cancer and several large-scale studies have reported that involuntary WL affects 50–80% of patients with cancer, with the degree of WL dependent on tumour site, type and stage of disease. The study of body composition in oncology using computed tomography has unearthed the importance of both low muscle mass (sarcopenia) and low muscle attenuation as important prognostic indications of unfavourable outcomes including poorer tolerance to chemotherapy; significant deterioration in performance status and quality of life (QoL), poorer post-operative outcomes and shortened survival. While often hidden by excess fat and high BMI, muscle abnormalities are highly prevalent in patients with cancer (ranging from 10 to 90%). Early screening to identify individuals with sarcopenia and decreased muscle quality would allow for earlier multimodal interventions to attenuate adverse body compositional changes. Multimodal therapies (combining nutritional counselling, exercise and anti-inflammatory drugs) are currently the focus of randomised trials to examine if this approach can provide a sufficient stimulus to prevent or slow the cascade of tissue wasting and if this then impacts on outcomes in a positive manner. This review will focus on the aetiology of musculoskeletal degradation in cancer; the impact of sarcopenia on chemotherapy tolerance, post-operative complications, QoL and survival; and outline current strategies for attenuation of muscle loss in clinical practice.en
dc.description.sponsorshipHealth Research Board (Clinical Research Facility at Mercy University Hospital Cork)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationRyan, A. M. and Sullivan, E. S. (2021) 'Impact of musculoskeletal degradation on cancer outcomes and strategies for management in clinical practice', Proceedings of the Nutrition Society, 80(1), pp. 73-91. doi: 10.1017/S0029665120007855en
dc.identifier.doi10.1017/S0029665120007855en
dc.identifier.eissn475-2719
dc.identifier.endpage91en
dc.identifier.issn0029-6651
dc.identifier.issued1en
dc.identifier.journaltitleProceedings of the Nutrition Societyen
dc.identifier.startpage73en
dc.identifier.urihttps://hdl.handle.net/10468/12304
dc.identifier.volume80en
dc.language.isoenen
dc.publisherCambridge University Press on behalf of The Nutrition Societyen
dc.rights© 2020, 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.subjectSurvivalen
dc.subjectNutritionen
dc.subjectSarcopeniaen
dc.titleImpact of musculoskeletal degradation on cancer outcomes and strategies for management in clinical practiceen
dc.typeArticle (peer-reviewed)en
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