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Cancer Cachexia

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Practical Medical Oncology Textbook

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Abstract

Cachexia is one of the most devastating conditions associated to cancer. Severe wasting produces both a high symptomatic burden and secondary psychological distress, and it is estimated to directly cause 20% of cancer deaths. Its pathophysiology is characterized by tumor-host interactions that, mediated mainly by tumor- and host-derived molecules, lead to profound metabolic changes that predominantly affect the central nervous system, the gastrointestinal tract, the adipose and the skeletal muscle tissue, and the immune system. Due to its clinical variability, consensus definitions were established, which defined cancer cachexia as the consequence of a variable combination of decreased oral intake and impaired metabolism that is refractory to conventional nutritional support. The establishment of clinical stages in which lean body mass evaluations were progressively incorporated to improve tissue wasting detection has increasingly stressed the early detection of the syndrome. Although cancer cachexia treatment has been an active research field in the last decades, no single drug has clinically demonstrated a robust benefit, and progestogens remain the only drugs specifically approved for this condition. Ongoing research is being conducted to elucidate whether intervening earlier in the natural history of the syndrome or combining drugs, nutritional interventions, and/or physical activity programs is able to improve outcomes. Additionally, the bottleneck-shaped pathophysiology of cancer cachexia, which begins within tumor cells, raises hope that better oncologic treatments will decisively contribute to decrease the dramatic impact of this condition.

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Authors and Affiliations

  1. Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain

    Iñaki Eguren-Santamaría & Ignacio Gil-Bazo

  2. Department of Palliative Medicine and Symptom Control, Clínica Universidad de Navarra, Pamplona, Spain

    Carlos Centeno

  3. ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain

    Carlos Centeno

  4. IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, España

    Carlos Centeno

  5. Program of Solid Tumors, Center for Applied Medical Research, Pamplona, Spain

    Ignacio Gil-Bazo

  6. Navarra Health Research Institute (IDISNA), Pamplona, Spain

    Ignacio Gil-Bazo

  7. Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain

    Ignacio Gil-Bazo

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  1. Iñaki Eguren-Santamaría
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  2. Carlos Centeno
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  3. Ignacio Gil-Bazo
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Correspondence to Ignacio Gil-Bazo .

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Editors and Affiliations

  1. Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy

    Antonio Russo

  2. Oncology Department, University of Antwerp, Edegem, Belgium

    Marc Peeters

  3. Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy

    Lorena Incorvaia

  4. Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai System & Icahn School of Medicine, Mount Sinai, NY, USA

    Christian Rolfo

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Eguren-Santamaría, I., Centeno, C., Gil-Bazo, I. (2021). Cancer Cachexia. In: Russo, A., Peeters, M., Incorvaia, L., Rolfo, C. (eds) Practical Medical Oncology Textbook. UNIPA Springer Series. Springer, Cham. https://doi.org/10.1007/978-3-030-56051-5_21

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