Anorexia-cachexia syndrome in cancer patients

Abstract

The cancer anorexia-cachexia syndrome (CACS) is a common complication in advanced cancer patients. It is characterized by massive wasting of skeletal muscle and adipose tissue with involuntary weight loss, anemia, asthenia, and negative nitrogen balance due to immunological, physiological and metabolic changes. CACS is intensified by alterations in nutrient metabolism (carbohydrates, proteins, and lipids), hormonal changes (leptin, neuropeptide-Y, melanocortin, ghrelin), and increased serum cytokine levels (TNFa, IL-1, IL-6, IFN-g). Tumors produce factors that alter the patient's perception of food, particularly taste and smell, and cancer treatment contributes to CACS. Nutritional treatment uses special nutrients such as polyunsaturated fatty acids (EPA and DHA), the amino acids glutamine and arginine, and nucleotides. Nutritional and pharmacological treatment with appetite-stimulating drugs has yielded more positive results in patients with CACS.