Principles of cachexia in tumor patients

Background. The cancer cachexia syndrome is the most common paraneoplastic syndrome affecting approximately half of the patients with a malignant tumor. Objective. Presentation of the pathophysiological processes in cancer cachexia and the clinical consequences. Material and methods. Selective literature search in PubMed with inclusion of the current guidelines. Results. Characteristic of cancer cachexia is a systemic inflammation syndrome. Tumor-specific and proinflammatory mediators lead to loss of appetite, systemic inflammation, metabolic and hormonal changes. Systemic inflammation has effects on protein, carbohydrate and lipid metabolism of the liver and peripheral organs. Frequently, insulin resistance and impaired glucose tolerance are also present. The consequences are a diminished food intake, lower nutrient utilization and loss of muscle tissue, with or without loss of fat mass. In addition, cancer therapy even with newer targeted anticancer agents, may speed up muscle breakdown and promote the development of cancer cachexia. Conclusion. Cancer cachexia leads to a progressive reduction of performance, to fatigue and a loss of independence. In the multimodal therapy of cancer cachexia syndrome in cancer patients nutritional therapeutic measures represent an important component in order to improve the clinical course of patients.