Quality of Life, Diet, and Behavior in Cancer
Most patients with advanced, incurable cancer find themselves contending with the Cancer-related Anorexia Cachexia Syndrome (CACS) at some point during their disease course. This syndrome predicts a poor prognosis; is associated with a reduced appetite that interferes with patients’ social interactions during meal time, results in progressive weakness that in turn impairs patients’ ability to function, markedly detracts from patients’ quality of life, and overall carries negative psychosocial consequences. The anorexia, or loss of appetite, and weight loss that occur in these patients is due in part to decreased caloric intake, but it is also the result of a derangement in pathophysiology that patients and their family members have little control over. Thus, an important aspect of helping patients and their families cope with this syndrome rests in frankly discussing its pathophysiology, emphasizing that much of what is occurring is “not their fault.” Although a variety of interventions, including further cancer treatment, invasive procedures, appetite stimulants, and parenteral nutrition have been tried and sometimes are effective in treating some aspects of this syndrome, none provides a real solution for most patients. This void in therapeutic options further underscores the importance of providing education to patients and families about this complex problem and providing them with the psychosocial support needed to help them cope the best they can under these circumstances.
KeywordsParenteral Nutrition Lean Body Mass Short Bowel Syndrome Rest Energy Expenditure Advanced Cancer Patient
Cancer-related anorexia cachexia syndrome
Tumor necrosis factor alpha
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