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A cross-sectional study examining the prevalence of cachexia and areas of unmet need in patients with cancer

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Abstract

Purpose

The semantics of defining cancer cachexia over the last decade has resulted in uncertainty as to the prevalence. This has further hindered the recognition and subsequent treatment of this condition. Following the consensus definition for cancer cachexia in 2011, there is now a need to establish estimates of prevalence. Therefore, the primary aim of the present study was to assess the prevalence of cachexia in an unselected cancer population. A secondary aim was to assess patient-perceived need of attention to cachexia.

Methods

A cross-sectional study in hospital patients was undertaken. Key inclusion criteria were the following: age > 18 years, cancer diagnosis, and no surgery the preceding 24 h. Data on demographics, disease, performance status, symptoms, cachexia, and patients’ perceived need of attention to weight loss and nutrition were registered.

Results

Data were available on 386 of 426 eligible patients. Median age (IQR) was 65 years (56–72), 214 (55%) were male and 302 (78%) had a performance status of 0–1 (Eastern Cooperative Oncology Group). Prevalence of cachexia (inpatients/outpatients) was 51/22%. Prevalence was highest in patients with gastrointestinal cancer (62/42%) and lung cancer (83/36%). There was no major difference in prevalence between patients with metastatic (55/24%) and localized disease (47/19%). Twenty percent of inpatients and 15% of outpatients wanted more attention to weight loss and nutrition. Cachexia (p < 0.001), symptoms of mood disorder (p < 0.001), and male gender (p < 0.01) were independently associated with increased need of attention.

Conclusion

Cachexia is a prevalent condition, affecting both patients with localized and metastatic cancer. Clinical attention to the condition is a sizeable unmet need.

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Funding

This study has received funding from the Cancer Fund at St. Olav’s Hospital—Trondheim University Hospital and The Liaison Committee for education, research, and innovation in Central Norway. Additionally, the European Palliative Care Research Centre has received unrestricted grants from The Norwegian Cancer Society.

Author information

Authors and Affiliations

  1. European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU—Norwegian University of Science and Technology, Postbox 8905, NO-7491, Trondheim, Norway

    Ola Magne Vagnildhaug, Trude Rakel Balstad, Sigrun Saur Almberg, Cinzia Brunelli, Anne Kari Knudsen, Stein Kaasa, Morten Thronæs & Tora Skeidsvoll Solheim

  2. Cancer Clinic, St. Olav’s Hospital—Trondheim University Hospital, Postboks 3250 Sluppen, NO-7006, Trondheim, Norway

    Ola Magne Vagnildhaug, Trude Rakel Balstad, Sigrun Saur Almberg, Stein Kaasa, Morten Thronæs & Tora Skeidsvoll Solheim

  3. Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Giacomo Venezian 1, 20133, Milan, Italy

    Cinzia Brunelli

  4. Department of Oncology, Oslo University Hospital and University of Oslo, Postboks 4956 Nydalen, NO-0424, Oslo, Norway

    Anne Kari Knudsen & Stein Kaasa

  5. Edinburgh Cancer Research UK Centre, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh, EH4 2XR, UK

    Barry Laird

Authors
  1. Ola Magne Vagnildhaug
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  2. Trude Rakel Balstad
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  6. Stein Kaasa
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  9. Tora Skeidsvoll Solheim
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Corresponding author

Correspondence to Ola Magne Vagnildhaug.

Ethics declarations

All procedures performed in this study were in accordance with the ethical standards of the regional ethics committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Stein Kaasa reports stock ownership in Eir Soloutions AS. Barry Laird reports personal fees from Chugai, outside the submitted work. Ola Magne Vagnildhaug, Trude Rakel Balstad, Sigrun Saur Almberg, Cinzia Brunelli, Anne Kari Knudsen, Morten Thronæs, and Tora Skeidsvoll Solheim have nothing to disclose.

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Vagnildhaug, O.M., Balstad, T.R., Almberg, S.S. et al. A cross-sectional study examining the prevalence of cachexia and areas of unmet need in patients with cancer. Support Care Cancer 26, 1871–1880 (2018). https://doi.org/10.1007/s00520-017-4022-z

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  • DOI: https://doi.org/10.1007/s00520-017-4022-z

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