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A longitudinal study of muscle strength and function in patients with cancer cachexia

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Abstract

Purpose

Patients with cancer frequently experience an involuntary loss of weight (in particular loss of muscle mass), defined as cachexia, with profound implications for independence and quality of life. The rate at which such patients’ physical performance declines has not been well established. The aim of this study was to determine the change in muscle strength and function over 8 weeks in patients with already established cancer cachexia, to help inform the design and duration of physical activity interventions applicable to this patient group.

Methods

Patients with thoracic and gastrointestinal cancer and with unintentional weight loss of > 5% in 6 months or BMI < 20 plus 2% weight loss were included. Physical and functional assessments (baseline, 4 weeks, 8 weeks) included isometric quadriceps and hamstring strength, handgrip, standing balance, 10-m walk time and timed up and go.

Results

Fifty patients (32 male), mean ± SD age 65 ± 10 years and BMI 24.9 ± 4.3 kg/m2, were recruited. Thoracic cancer patients had lower muscle strength and function (p < 0.05). Despite notable attrition, in patients who completed all assessments (8 thoracic and 12 gastrointestinal), there was little change in performance over 8 weeks (p > 0.05). Baseline variables did not differentiate between completers and non-completers (p > 0.05).

Conclusions

More than a third of patients with established cancer cachexia in our study were stable over 8 weeks, suggesting a subgroup who may benefit from targeted interventions of reasonable duration. Better understanding the physical performance parameters which characterise and differentiate these patients has important clinical implications for cancer multidisciplinary team practice.

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Acknowledgements

The authors would like to thank all patients who participated and NISCHR for supporting Research Nurses across Wales.

Funding

This study was funded by Tenovus Cancer Care. AN’s and AB’s posts are fully and partially, respectively, supported by Marie Curie core grant funding: MCCC-FCO-14-C.

Author information

Authors and Affiliations

  1. School of Healthcare Sciences, College of Biomedical and Life Sciences, Heath Park, Cardiff University, Cardiff, CF14 4XN, UK

    Nichola Gale & Robert van Deursen

  2. Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, CF23 6XD, UK

    David Wasley & Karianne Backx

  3. Velindre Cancer Centre, Whitchurch, Cardiff, CF14 2TL, UK

    Sioned Roberts & Annemarie Nelson

  4. Marie Curie Research Centre (MCPCRC), School of Medicine, Heath Park, Cardiff University, Cardiff, CF14 4XN, UK

    Anthony Byrne

Authors
  1. Nichola Gale
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  2. David Wasley
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  3. Sioned Roberts
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  4. Karianne Backx
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  7. Anthony Byrne
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Corresponding author

Correspondence to Nichola Gale.

Ethics declarations

The study was approved by the South East Wales Ethics committee, Cardiff and Vale University Health Board.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

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

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Gale, N., Wasley, D., Roberts, S. et al. A longitudinal study of muscle strength and function in patients with cancer cachexia. Support Care Cancer 27, 131–137 (2019). https://doi.org/10.1007/s00520-018-4297-8

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