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Components of the anorexia–cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia

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Abstract

Introduction

Cancer-related anorexia is traditionally considered part of a complex but ill-defined anorexia–cachexia syndrome in which anorexia is intimately associated with other gastrointestinal (GI) symptoms and weight loss. We surveyed cancer patients with anorexia to learn more about the relationship between anorexia and these symptoms.

Materials and methods

A 22-item GI questionnaire assessed the severity of anorexia and the prevalence of concurrent GI symptoms, including taste changes, food aversions, altered sense of smell, and diurnal food intake changes. The relationship between anorexia severity and anticancer therapy and prior menstrual or pregnancy-related appetite changes was also assessed.

Results

Ninety-five of 101 patients with anorexia surveyed had complete data. Seventy-eight percent of them had moderate or severe anorexia. Abnormal diurnal appetite variation, taste changes, and food aversions were present in over 50% of all those with anorexia. Judged by the numerical rating scale, the worse the anorexia, the more prevalent were early satiety, constipation, vomiting, and food aversions. Those with more severe anorexia had greater weight loss, and worse performance status. Anorexia severity did not correlate with that during prior menses/pregnancy or antitumor therapy.

Conclusions

Evaluation of multiple other GI symptoms is important in understanding the total experience of cancer anorexia. Early satiety, taste changes, food aversions, and altered sense of smell are important accompanying GI symptoms. Most validated anorexia tools do not assess these commonly associated GI symptoms. Future research should develop a comprehensive anorexia symptom questionnaire.

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Authors and Affiliations

  1. Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, M-76, Cleveland, OH, 44195, USA

    Tugba Yavuzsen, Declan Walsh, Mellar P. Davis, Jordanka Kirkova, Susan LeGrand, Ruth Lagman, Lesley Bicanovsky, Bassam Estfan, Bushra Cheema & Abdo Haddad

  2. Department of Biostatistics and Epidemiology, The Cleveland Clinic Taussig Cancer Center, Cleveland, OH, USA

    Tao Jin

Authors
  1. Tugba Yavuzsen
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  2. Declan Walsh
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Corresponding author

Correspondence to Declan Walsh.

Additional information

A World Health Organization Demonstration Project in Palliative Medicine.

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Yavuzsen, T., Walsh, D., Davis, M.P. et al. Components of the anorexia–cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia. Support Care Cancer 17, 1531–1541 (2009). https://doi.org/10.1007/s00520-009-0623-5

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  • DOI: https://doi.org/10.1007/s00520-009-0623-5

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