Quality of Life and Symptom Burden Improve in Patients Attending a Multidisciplinary Clinical Service for Cancer Cachexia: A Retrospective Observational Review

Background. Cancer cachexia negatively affects quality of life (QoL) and increases symptom burden. A multimodal treatment approach may optimize cachexia outcomes, including QoL. We evaluated QoL and symptoms over time among patients attending a multidisciplinary clinical service for cancer cachexia. Methods. Adults with cancer who attended the clinical service three times between 2017 and 2020 were included. Quality of life and symptoms were assessed using the European Organization for Research and Treatment of Cancer Quality of life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL) and the Functional Assessment Anorexia/Cachexia Therapy (FAACT) questionnaires. Physical function was assessed using the 30s sit-to-stand test and handgrip strength. Results. Overall, 162 patients (age = 67.2 +/- 12.0 years) were included. Mean six-month weight loss at baseline was 10.4% +/- 9.4%. Mean body weight was stable between clinic visits (P = 0.904) and no change in sit-to-stand repetitions (P = 0.133) or handgrip strength (P = 0.734) occurred over time. Improvements in EORTC QLQ-C15-PAL overall QoL (Delta 10.7 +/- 2.5, P < 0.001), physical function (Delta 8.0 +/- 2.4, P= 0.003) and emotional function (Delta 11.4 +/- 2.9, P < 0.001) occurred by the second visit. EORTC QLQ-C15-PAL fatigue (Delta 13.8 +/- 2.9, P < 0.001), pain (Delta 10.3 +/- 3.3, P = 0.007), nausea/vomiting (Delta 16.1 +/- 3.0, P < 0.001) and appetite symptoms (Delta 25.9 +/- 3.8, P < 0.001) also improved by the second visit. FAACT total score (Delta 14.6 +/- 2.7, P < 0.001), anorexia-cachexia symptoms (Delta 6.6 +/- 1.1, P < 0.001), and physical (Delta 3.7 +/- 0.70, P < 0.001), emotional (Delta 1.9 +/- 0.60, P= 0.005) and functional wellbeing (Delta 2.7 +/- 0.71, P= 0.001) improved by the second visit. All improvements in EORTC QLQ-C15-PAL and FAACT outcomes were maintained at the third visit. Conclusion. Significant improvements in QoL and symptoms were associated with attending a cancer cachexia clinical service. Our findings support using multidisciplinary, multimodal cancer cachexia treatment approaches to improve patient wellbeing. (C) 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.