Cancer-associated cachexia
Abstract
Cancer-associated cachexia is a disorder characterized by loss of body weight with specific losses of skeletal muscle and adipose tissue. Cachexia is driven by a variable combination of reduced food intake and metabolic changes, including elevated energy expenditure, excess catabolism and inflammation. Cachexia is highly associated with cancers of the pancreas, oesophagus, stomach, lung, liver and bowel; this group of malignancies is responsible for half of all cancer deaths worldwide. Cachexia involves diverse mediators derived from the cancer cells and cells within the tumour microenvironment, including inflammatory and immune cells. In addition, endocrine, metabolic and central nervous system perturbations combine with these mediators to elicit catabolic changes in skeletal and cardiac muscle and adipose tissue. At the tissue level, mechanisms include activation of inflammation, proteolysis, autophagy and lipolysis. Cachexia associates with a multitude of morbidities encompassing functional, metabolic and immune disorders as well as aggravated toxicity and complications of cancer therapy. Patients experience impaired quality of life, reduced physical, emotional and social well-being and increased use of healthcare resources. To date, no effective medical intervention completely reverses cachexia and there are no approved drug therapies. Adequate nutritional support remains a mainstay of cachexia therapy, whereas drugs that target overactivation of catabolic processes, cell injury and inflammation are currently under investigation.
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Maintenance of body weight can be difficult during treatment for some cancers (advanced colon, lung, pancreatic) where weight and lean mass loss is common; weight gain is a common side effect of chemotherapy and anti-estrogen therapy for breast cancer or anti-androgen therapy for prostate cancer.
“maintenance of body weight can be difficult during treatment for some cancers, where loss of weight and lean body mass is a common concern, such as advanced colon, lung cancer and pancreatic cancer(98); whereas weight gain can be a common side effect of chemotherapy and anti-estrogen therapy for breast cancer or anti-androgen therapy for prostate cancer(99).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [98]
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- Authors
- Baracos, V. E., Martin, L., Korc, M., Guttridge, D. C., & Fearon, K. C. H.
- Affiliations
- University of Alberta (CA)
- Indiana University Indianapolis (US)
- Edinburgh Royal Infirmary (GB)
- Corresponding author
- Baracos, Vickie E.
- Venue
- Nature Reviews Disease Primers
- Published
- 2018-01-18
- Volume
- 4
- Issue
- 1
- Pages
- 17105-17105
- ISSN
- 2056-676X (ISSN-L)
- OpenAlex
- W2784374589
- Cited by
- 1,738
- References
- 339
- Citations by year
- 2026: 268 · 2025: 253 · 2024: 274 · 2023: 233 · 2022: 234 · 2021: 209 · 2020: 140 · 2019: 84 · 2018: 40 · 2017: 1 · 2014: 1
- FWCI
- 15.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature Reviews Disease Primers (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R13CA210548)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- cancer cachexia, skeletal muscle atrophy, adipose tissue loss, energy expenditure, inflammation, tumor microenvironment, catabolism, proteolysis, autophagy, lipolysis, nutritional support, cancer therapy toxicity, quality of life
- MeSH terms
- Cachexia, Humans, Mass Screening, Neoplasms, Obesity, Quality of Life, Body Mass Index, Translational Research, Biomedical
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