Issue
Date Log
Copyright (c) 2025 Mohsen Dughaylib Ghazai Alotaibi, Hamad Hadi Saeed Al-Dughman, Nourah Abdurouf Turki, Abdullah Ateeq Oudah Alsubhi, Abdullah Mohammed Hassan Mindil, Abdulkarim Hadi Othman Hakmi, Mihaf Kamal Alrajhi

This work is licensed under a Creative Commons Attribution 4.0 International License.
Anorexia and Cachexia: Multidisciplinary Assessment, Diagnosis, Prevention, and Management Across Nursing, Clinical Nutrition, Physical Therapy, Diagnostic Radiology, Public Health, and Epidemiology
Corresponding Author(s) : Mohsen Dughaylib Ghazai Alotaibi
Saudi Journal of Medicine and Public Health, Vol. 2 No. 2 (2025)
Abstract
Background: Cachexia is a multifactorial metabolic syndrome associated with chronic diseases, particularly advanced malignancies, chronic obstructive pulmonary disease, heart failure, chronic kidney disease, and chronic infections. It is characterized by progressive skeletal muscle wasting, adipose tissue loss, systemic inflammation, and metabolic dysregulation that cannot be fully reversed by conventional nutritional support. When accompanied by severe appetite loss, it manifests as anorexia-cachexia syndrome, resulting in substantial functional decline and increased mortality.
Aim: This review aimed to provide a comprehensive overview of the etiology, epidemiology, pathophysiology, clinical assessment, diagnostic evaluation, prevention, and multidisciplinary management of anorexia and cachexia while highlighting evidence-based strategies that improve patient outcomes across multiple healthcare disciplines.
Methods: A narrative educational review was conducted by synthesizing current evidence, international clinical guidelines, and published literature regarding the mechanisms, diagnosis, nutritional assessment, functional evaluation, and therapeutic management of cachexia in patients with chronic diseases.
Results: Cachexia develops through complex interactions among chronic inflammation, neuroendocrine dysfunction, metabolic abnormalities, and impaired protein synthesis, resulting in progressive muscle wasting and functional deterioration. Early diagnosis requires comprehensive clinical, nutritional, anthropometric, laboratory, and functional assessments. Management is most effective when multidisciplinary, integrating nutritional optimization, individualized exercise programs, pharmacological therapies, psychosocial support, and treatment of the underlying disease. Emerging therapies targeting inflammatory and metabolic pathways show promising potential, although further clinical evidence is needed.
Conclusion: Early recognition and multidisciplinary intervention are essential for slowing disease progression, preserving muscle mass, improving functional capacity, enhancing quality of life, and optimizing clinical outcomes. Comprehensive patient-centered management remains the cornerstone of effective cachexia care.
Keywords
Download Citation
Endnote/Zotero/Mendeley (RIS)BibTeX
- Tisdale MJ. Mechanisms of cancer cachexia. Physiol Rev. 2009 Apr;89(2):381-410.
- Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018 Jan 18;4:17105.
- Roeland EJ, Bohlke K, Baracos VE, Bruera E, Del Fabbro E, Dixon S, Fallon M, Herrstedt J, Lau H, Platek M, Rugo HS, Schnipper HH, Smith TJ, Tan W, Loprinzi CL. Management of Cancer Cachexia: ASCO Guideline. J Clin Oncol. 2020 Jul 20;38(21):2438-2453.
- Arai H, Maeda K, Wakabayashi H, Naito T, Konishi M, Assantachai P, Auyeung WT, Chalermsri C, Chen W, Chew J, Chou MY, Hsu CC, Hum A, Hwang IG, Kaido T, Kang L, Kamaruzzaman SB, Kim M, Lee JSW, Lee WJ, Liang CK, Lim WS, Lim JY, Lim YP, Lo RS, Ong T, Pan WH, Peng LN, Pramyothin P, Razalli NH, Saitoh M, Shahar S, Shi HP, Tung HH, Uezono Y, von Haehling S, Won CW, Woo J, Chen LK. Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia. J Cachexia Sarcopenia Muscle. 2023 Oct;14(5):1949-1958.
- Setiawan T, Sari IN, Wijaya YT, Julianto NM, Muhammad JA, Lee H, Chae JH, Kwon HY. Cancer cachexia: molecular mechanisms and treatment strategies. J Hematol Oncol. 2023 May 22;16(1):54.
- Webster JM, Kempen LJAP, Hardy RS, Langen RCJ. Inflammation and Skeletal Muscle Wasting During Cachexia. Front Physiol. 2020;11:597675.
- Li Q, Zhang D, Sui X, Song T, Hu L, Xu X, Wang X, Wang F. The Warburg effect drives cachectic states in patients with pancreatobiliary adenocarcinoma. FASEB J. 2023 Sep;37(9):e23144.
- von Haehling S, Anker SD. Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle. 2010 Sep;1(1):1-5.
- von Haehling S, Anker MS, Anker SD. Prevalence and clinical impact of cachexia in chronic illness in Europe, USA, and Japan: facts and numbers update 2016. J Cachexia Sarcopenia Muscle. 2016 Dec;7(5):507-509.
- Cederholm T, Bosaeus I. Malnutrition in Adults. N Engl J Med. 2024 Jul 11;391(2):155-165.
- von Haehling S, Anker SD. Prevalence, incidence and clinical impact of cachexia: facts and numbers-update 2014. J Cachexia Sarcopenia Muscle. 2014 Dec;5(4):261-3.
- Andrade CS, Jesus RP, Andrade TB, Oliveira NS, Nabity SA, Ribeiro GS. Prevalence and characteristics associated with malnutrition at hospitalization among patients with acquired immunodeficiency syndrome in Brazil. PLoS One. 2012;7(11):e48717.
- Xu Y, Wang D, Chen P, Qi B, Li X, Xie C, Wu J, Li L, Gao G, Geng S, Yang D. Factors associated with skeletal muscle mass in middle-aged men living with HIV. J Cachexia Sarcopenia Muscle. 2024 Oct;15(5):1965-1975.
- Li F, Ruan X, Min L. Targeting both sides of the GDF15-GFRAL-RET receptor complex: A new approach to achieve body weight homeostasis. Genes Dis. 2017 Dec;4(4):183-184.
- Tsai VWW, Husaini Y, Sainsbury A, Brown DA, Breit SN. The MIC-1/GDF15-GFRAL Pathway in Energy Homeostasis: Implications for Obesity, Cachexia, and Other Associated Diseases. Cell Metab. 2018 Sep 04;28(3):353-368.
- van Norren K, Dwarkasing JT, Witkamp RF. The role of hypothalamic inflammation, the hypothalamic-pituitary-adrenal axis and serotonin in the cancer anorexia-cachexia syndrome. Curr Opin Clin Nutr Metab Care. 2017 Sep;20(5):396-401.
- Martín AI, Priego T, Moreno-Ruperez Á, González-Hedström D, Granado M, López-Calderón A. IGF-1 and IGFBP-3 in Inflammatory Cachexia. Int J Mol Sci. 2021 Aug 31;22(17)
- VanderVeen BN, Cardaci TD, Bullard BM, Madden M, Li J, Velazquez KT, Kubinak JL, Fan D, Murphy EA. Involvement of the gut microbiota in cancer cachexia. Am J Physiol Cell Physiol. 2024 Sep 01;327(3):C661-C670.
- Tamayo-Torres E, Garrido A, de Cabo R, Carretero J, Gómez-Cabrera MC. Molecular mechanisms of cancer cachexia. Role of exercise training. Mol Aspects Med. 2024 Oct;99:101293.
- Zhang F, Shen A, Jin Y, Qiang W. The management strategies of cancer-associated anorexia: a critical appraisal of systematic reviews. BMC Complement Altern Med. 2018 Aug 09;18(1):236.
- Rassy EE, Ghosn M, Rassy NA, Assi T, Robert C. Do immune checkpoint inhibitors perform identically in patients with weight extremes? Immunotherapy. 2018 Jul;10(9):733-736.
- Arrieta O, Luvián-Morales J, Turcott JG, Oñate-Ocaña LF. Quality of life and anorexia/cachexia in lung cancer: validation of the Spanish version of the FAACT instrument. Qual Life Res. 2018 Oct;27(10):2709-2718.
- Schwarz S, Prokopchuk O, Esefeld K, Gröschel S, Bachmann J, Lorenzen S, Friess H, Halle M, Martignoni ME. The clinical picture of cachexia: a mosaic of different parameters (experience of 503 patients). BMC Cancer. 2017 Feb 14;17(1):130.
- Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011 May;12(5):489-95.
- Song M, Zhang Q, Tang M, Zhang X, Ruan G, Zhang X, Zhang K, Ge Y, Yang M, Li Q, Li X, Liu X, Li W, Cong M, Wang K, Song C, Shi H. Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study. J Cachexia Sarcopenia Muscle. 2021 Dec;12(6):1489-1500.
- Anderson LJ, Chong N, Migula D, Sauer A, Garrison M, Wu P, Dash A, Garcia JM. Muscle mass, not radiodensity, predicts physical function in cancer patients with or without cachexia. Oncotarget. 2020 May 19;11(20):1911-1921.
- Ozorio GA, Barão K, Forones NM. Cachexia Stage, Patient-Generated Subjective Global Assessment, Phase Angle, and Handgrip Strength in Patients with Gastrointestinal Cancer. Nutr Cancer. 2017 Jul;69(5):772-779.
- Hagmann C, Cramer A, Kestenbaum A, Durazo C, Downey A, Russell M, Geluz J, Ma JD, Roeland EJ. Evidence-based Palliative Care Approaches to Non-pain Physical Symptom Management in Cancer Patients. Semin Oncol Nurs. 2018 Aug;34(3):227-240.
- Mattox TW. Cancer Cachexia: Cause, Diagnosis, and Treatment. Nutr Clin Pract. 2017 Oct;32(5):599-606.
- Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, Erickson N, Laviano A, Lisanti MP, Lobo DN, McMillan DC, Muscaritoli M, Ockenga J, Pirlich M, Strasser F, de van der Schueren M, Van Gossum A, Vaupel P, Weimann A. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017 Oct;36(5):1187-1196.
- Brown RO, Compher C., American Society for Parenteral and Enteral Nutrition Board of Directors. A.S.P.E.N. clinical guidelines: nutrition support in adult acute and chronic renal failure. JPEN J Parenter Enteral Nutr. 2010 Jul-Aug;34(4):366-77.
- Morley JE. Calories and cachexia. Curr Opin Clin Nutr Metab Care. 2009 Nov;12(6):607-10.
- Aprile G, Basile D, Giaretta R, Schiavo G, La Verde N, Corradi E, Monge T, Agustoni F, Stragliotto S. The Clinical Value of Nutritional Care before and during Active Cancer Treatment. Nutrients. 2021 Apr 05;13(4)
- Nakamura K, Tonouchi H, Sasayama A, Ashida K. A Ketogenic Formula Prevents Tumor Progression and Cancer Cachexia by Attenuating Systemic Inflammation in Colon 26 Tumor-Bearing Mice. Nutrients. 2018 Feb 14;10(2)
- Wongwan P, Keskool P, Ongard S, Metheetrairut C. Physical Properties of Meals that are Suitable for Patients after Surgery to Treat Oral Cavity Cancers. Asian Pac J Cancer Prev. 2023 Mar 01;24(3):841-847.
- Bouleuc C, Anota A, Cornet C, Grodard G, Thiery-Vuillemin A, Dubroeucq O, Crétineau N, Frasie V, Gamblin V, Chvetzoff G, Favier L, Tournigand C, Grach MC, Raynard B, Salas S, Capodano G, Pazart L, Aubry R. Impact on Health-Related Quality of Life of Parenteral Nutrition for Patients with Advanced Cancer Cachexia: Results from a Randomized Controlled Trial. Oncologist. 2020 May;25(5):e843-e851.
- Feng Y, Feng X, Wan R, Luo Z, Qu L, Wang Q. Impact of exercise on cancer: mechanistic perspectives and new insights. Front Immunol. 2024;15:1474770.
- Arends J, Strasser F, Gonella S, Solheim TS, Madeddu C, Ravasco P, Buonaccorso L, de van der Schueren MAE, Baldwin C, Chasen M, Ripamonti CI., ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines☆. ESMO Open. 2021 Jun;6(3):100092.
- Ligibel JA, Bohlke K, May AM, Clinton SK, Demark-Wahnefried W, Gilchrist SC, Irwin ML, Late M, Mansfield S, Marshall TF, Meyerhardt JA, Thomson CA, Wood WA, Alfano CM. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol. 2022 Aug 01;40(22):2491-2507.
- Zhu C, Ma H, He A, Li Y, He C, Xia Y. Exercise in cancer prevention and anticancer therapy: Efficacy, molecular mechanisms and clinical information. Cancer Lett. 2022 Sep 28;544:215814.
- Ribeiro C, Santos R, Correia P, Maddocks M, Gomes B. Resistance training in advanced cancer: a phase II safety and feasibility trial-home versus hospital. BMJ Support Palliat Care. 2022 Sep;12(3):287-291.
- Travier N, Velthuis MJ, Steins Bisschop CN, van den Buijs B, Monninkhof EM, Backx F, Los M, Erdkamp F, Bloemendal HJ, Rodenhuis C, de Roos MA, Verhaar M, ten Bokkel Huinink D, van der Wall E, Peeters PH, May AM. Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial. BMC Med. 2015 Jun 08;13:121.
- Courneya KS, Segal RJ, McKenzie DC, Dong H, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Crawford JJ, Mackey JR. Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Med Sci Sports Exerc. 2014 Sep;46(9):1744-51.
- Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act. 2021 Apr 06;18(1):50.
- Fairman CM, Lønbro S, Cardaci TD, VanderVeen BN, Nilsen TS, Murphy AE. Muscle wasting in cancer: opportunities and challenges for exercise in clinical cancer trials. JCSM Rapid Commun. 2022 Jan-Jun;5(1):52-67.
- Youssef J, Novosad SA, Winthrop KL. Infection Risk and Safety of Corticosteroid Use. Rheum Dis Clin North Am. 2016 Feb;42(1):157-76, ix-x.
- Haan BJ, Blackmon SN, Cobb AM, Cohen HE, DeVier MT, Perez MM, Winslow SF. Corticosteroids in critically ill patients: A narrative review. Pharmacotherapy. 2024 Jul;44(7):581-602.
- Garcia JM, Boccia RV, Graham CD, Yan Y, Duus EM, Allen S, Friend J. Anamorelin for patients with cancer cachexia: an integrated analysis of two phase 2, randomised, placebo-controlled, double-blind trials. Lancet Oncol. 2015 Jan;16(1):108-16.
- Dev R, Amano K, Naito T, Del Fabbro E. Anamorelin for the Treatment of Cancer Anorexia-Cachexia Syndrome. Curr Oncol Rep. 2024 Jul;26(7):762-772.
- Andrade C. Therapeutic Effects, Side Effects, and Adverse Effects of Neuropsychiatric Drugs in the Context of Treating Cancer-Related Anorexia With Olanzapine and Mirtazapine. J Clin Psychiatry. 2024 Aug 21;85(3)
- Kast RE, Foley KF. Cancer chemotherapy and cachexia: mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects. Eur J Cancer Care (Engl). 2007 Jul;16(4):351-4.
- Arrieta O, Cárdenas-Fernández D, Rodriguez-Mayoral O, Gutierrez-Torres S, Castañares D, Flores-Estrada D, Reyes E, López D, Barragán P, Soberanis Pina P, Cardona AF, Turcott JG. Mirtazapine as Appetite Stimulant in Patients With Non-Small Cell Lung Cancer and Anorexia: A Randomized Clinical Trial. JAMA Oncol. 2024 Mar 01;10(3):305-314.
- Advani SM, Advani PG, VonVille HM, Jafri SH. Pharmacological management of cachexia in adult cancer patients: a systematic review of clinical trials. BMC Cancer. 2018 Nov 27;18(1):1174.
- Gelato M, McNurlan M, Freedland E. Role of recombinant human growth hormone in HIV-associated wasting and cachexia: pathophysiology and rationale for treatment. Clin Ther. 2007 Nov;29(11):2269-88.
- Mak RH, Gunta S, Oliveira EA, Cheung WW. Growth Hormone Improves Adipose Tissue Browning and Muscle Wasting in Mice with Chronic Kidney Disease-Associated Cachexia. Int J Mol Sci. 2022 Dec 04;23(23)
- Gordon JN, Trebble TM, Ellis RD, Duncan HD, Johns T, Goggin PM. Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial. Gut. 2005 Apr;54(4):540-5.
- Hong DS, Janku F, Naing A, Falchook GS, Piha-Paul S, Wheler JJ, Fu S, Tsimberidou AM, Stecher M, Mohanty P, Simard J, Kurzrock R. Xilonix, a novel true human antibody targeting the inflammatory cytokine interleukin-1 alpha, in non-small cell lung cancer. Invest New Drugs. 2015 Jun;33(3):621-31.
- Kang EA, Park JM, Jin W, Tchahc H, Kwon KA, Hahm KB. Amelioration of cancer cachexia with preemptive administration of tumor necrosis factor-α blocker. J Clin Biochem Nutr. 2022 Mar;70(2):117-128.
- Reid J, Hughes CM, Murray LJ, Parsons C, Cantwell MM. Non-steroidal anti-inflammatory drugs for the treatment of cancer cachexia: a systematic review. Palliat Med. 2013 Apr;27(4):295-303.
References
Tisdale MJ. Mechanisms of cancer cachexia. Physiol Rev. 2009 Apr;89(2):381-410.
Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018 Jan 18;4:17105.
Roeland EJ, Bohlke K, Baracos VE, Bruera E, Del Fabbro E, Dixon S, Fallon M, Herrstedt J, Lau H, Platek M, Rugo HS, Schnipper HH, Smith TJ, Tan W, Loprinzi CL. Management of Cancer Cachexia: ASCO Guideline. J Clin Oncol. 2020 Jul 20;38(21):2438-2453.
Arai H, Maeda K, Wakabayashi H, Naito T, Konishi M, Assantachai P, Auyeung WT, Chalermsri C, Chen W, Chew J, Chou MY, Hsu CC, Hum A, Hwang IG, Kaido T, Kang L, Kamaruzzaman SB, Kim M, Lee JSW, Lee WJ, Liang CK, Lim WS, Lim JY, Lim YP, Lo RS, Ong T, Pan WH, Peng LN, Pramyothin P, Razalli NH, Saitoh M, Shahar S, Shi HP, Tung HH, Uezono Y, von Haehling S, Won CW, Woo J, Chen LK. Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia. J Cachexia Sarcopenia Muscle. 2023 Oct;14(5):1949-1958.
Setiawan T, Sari IN, Wijaya YT, Julianto NM, Muhammad JA, Lee H, Chae JH, Kwon HY. Cancer cachexia: molecular mechanisms and treatment strategies. J Hematol Oncol. 2023 May 22;16(1):54.
Webster JM, Kempen LJAP, Hardy RS, Langen RCJ. Inflammation and Skeletal Muscle Wasting During Cachexia. Front Physiol. 2020;11:597675.
Li Q, Zhang D, Sui X, Song T, Hu L, Xu X, Wang X, Wang F. The Warburg effect drives cachectic states in patients with pancreatobiliary adenocarcinoma. FASEB J. 2023 Sep;37(9):e23144.
von Haehling S, Anker SD. Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle. 2010 Sep;1(1):1-5.
von Haehling S, Anker MS, Anker SD. Prevalence and clinical impact of cachexia in chronic illness in Europe, USA, and Japan: facts and numbers update 2016. J Cachexia Sarcopenia Muscle. 2016 Dec;7(5):507-509.
Cederholm T, Bosaeus I. Malnutrition in Adults. N Engl J Med. 2024 Jul 11;391(2):155-165.
von Haehling S, Anker SD. Prevalence, incidence and clinical impact of cachexia: facts and numbers-update 2014. J Cachexia Sarcopenia Muscle. 2014 Dec;5(4):261-3.
Andrade CS, Jesus RP, Andrade TB, Oliveira NS, Nabity SA, Ribeiro GS. Prevalence and characteristics associated with malnutrition at hospitalization among patients with acquired immunodeficiency syndrome in Brazil. PLoS One. 2012;7(11):e48717.
Xu Y, Wang D, Chen P, Qi B, Li X, Xie C, Wu J, Li L, Gao G, Geng S, Yang D. Factors associated with skeletal muscle mass in middle-aged men living with HIV. J Cachexia Sarcopenia Muscle. 2024 Oct;15(5):1965-1975.
Li F, Ruan X, Min L. Targeting both sides of the GDF15-GFRAL-RET receptor complex: A new approach to achieve body weight homeostasis. Genes Dis. 2017 Dec;4(4):183-184.
Tsai VWW, Husaini Y, Sainsbury A, Brown DA, Breit SN. The MIC-1/GDF15-GFRAL Pathway in Energy Homeostasis: Implications for Obesity, Cachexia, and Other Associated Diseases. Cell Metab. 2018 Sep 04;28(3):353-368.
van Norren K, Dwarkasing JT, Witkamp RF. The role of hypothalamic inflammation, the hypothalamic-pituitary-adrenal axis and serotonin in the cancer anorexia-cachexia syndrome. Curr Opin Clin Nutr Metab Care. 2017 Sep;20(5):396-401.
Martín AI, Priego T, Moreno-Ruperez Á, González-Hedström D, Granado M, López-Calderón A. IGF-1 and IGFBP-3 in Inflammatory Cachexia. Int J Mol Sci. 2021 Aug 31;22(17)
VanderVeen BN, Cardaci TD, Bullard BM, Madden M, Li J, Velazquez KT, Kubinak JL, Fan D, Murphy EA. Involvement of the gut microbiota in cancer cachexia. Am J Physiol Cell Physiol. 2024 Sep 01;327(3):C661-C670.
Tamayo-Torres E, Garrido A, de Cabo R, Carretero J, Gómez-Cabrera MC. Molecular mechanisms of cancer cachexia. Role of exercise training. Mol Aspects Med. 2024 Oct;99:101293.
Zhang F, Shen A, Jin Y, Qiang W. The management strategies of cancer-associated anorexia: a critical appraisal of systematic reviews. BMC Complement Altern Med. 2018 Aug 09;18(1):236.
Rassy EE, Ghosn M, Rassy NA, Assi T, Robert C. Do immune checkpoint inhibitors perform identically in patients with weight extremes? Immunotherapy. 2018 Jul;10(9):733-736.
Arrieta O, Luvián-Morales J, Turcott JG, Oñate-Ocaña LF. Quality of life and anorexia/cachexia in lung cancer: validation of the Spanish version of the FAACT instrument. Qual Life Res. 2018 Oct;27(10):2709-2718.
Schwarz S, Prokopchuk O, Esefeld K, Gröschel S, Bachmann J, Lorenzen S, Friess H, Halle M, Martignoni ME. The clinical picture of cachexia: a mosaic of different parameters (experience of 503 patients). BMC Cancer. 2017 Feb 14;17(1):130.
Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011 May;12(5):489-95.
Song M, Zhang Q, Tang M, Zhang X, Ruan G, Zhang X, Zhang K, Ge Y, Yang M, Li Q, Li X, Liu X, Li W, Cong M, Wang K, Song C, Shi H. Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study. J Cachexia Sarcopenia Muscle. 2021 Dec;12(6):1489-1500.
Anderson LJ, Chong N, Migula D, Sauer A, Garrison M, Wu P, Dash A, Garcia JM. Muscle mass, not radiodensity, predicts physical function in cancer patients with or without cachexia. Oncotarget. 2020 May 19;11(20):1911-1921.
Ozorio GA, Barão K, Forones NM. Cachexia Stage, Patient-Generated Subjective Global Assessment, Phase Angle, and Handgrip Strength in Patients with Gastrointestinal Cancer. Nutr Cancer. 2017 Jul;69(5):772-779.
Hagmann C, Cramer A, Kestenbaum A, Durazo C, Downey A, Russell M, Geluz J, Ma JD, Roeland EJ. Evidence-based Palliative Care Approaches to Non-pain Physical Symptom Management in Cancer Patients. Semin Oncol Nurs. 2018 Aug;34(3):227-240.
Mattox TW. Cancer Cachexia: Cause, Diagnosis, and Treatment. Nutr Clin Pract. 2017 Oct;32(5):599-606.
Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, Erickson N, Laviano A, Lisanti MP, Lobo DN, McMillan DC, Muscaritoli M, Ockenga J, Pirlich M, Strasser F, de van der Schueren M, Van Gossum A, Vaupel P, Weimann A. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017 Oct;36(5):1187-1196.
Brown RO, Compher C., American Society for Parenteral and Enteral Nutrition Board of Directors. A.S.P.E.N. clinical guidelines: nutrition support in adult acute and chronic renal failure. JPEN J Parenter Enteral Nutr. 2010 Jul-Aug;34(4):366-77.
Morley JE. Calories and cachexia. Curr Opin Clin Nutr Metab Care. 2009 Nov;12(6):607-10.
Aprile G, Basile D, Giaretta R, Schiavo G, La Verde N, Corradi E, Monge T, Agustoni F, Stragliotto S. The Clinical Value of Nutritional Care before and during Active Cancer Treatment. Nutrients. 2021 Apr 05;13(4)
Nakamura K, Tonouchi H, Sasayama A, Ashida K. A Ketogenic Formula Prevents Tumor Progression and Cancer Cachexia by Attenuating Systemic Inflammation in Colon 26 Tumor-Bearing Mice. Nutrients. 2018 Feb 14;10(2)
Wongwan P, Keskool P, Ongard S, Metheetrairut C. Physical Properties of Meals that are Suitable for Patients after Surgery to Treat Oral Cavity Cancers. Asian Pac J Cancer Prev. 2023 Mar 01;24(3):841-847.
Bouleuc C, Anota A, Cornet C, Grodard G, Thiery-Vuillemin A, Dubroeucq O, Crétineau N, Frasie V, Gamblin V, Chvetzoff G, Favier L, Tournigand C, Grach MC, Raynard B, Salas S, Capodano G, Pazart L, Aubry R. Impact on Health-Related Quality of Life of Parenteral Nutrition for Patients with Advanced Cancer Cachexia: Results from a Randomized Controlled Trial. Oncologist. 2020 May;25(5):e843-e851.
Feng Y, Feng X, Wan R, Luo Z, Qu L, Wang Q. Impact of exercise on cancer: mechanistic perspectives and new insights. Front Immunol. 2024;15:1474770.
Arends J, Strasser F, Gonella S, Solheim TS, Madeddu C, Ravasco P, Buonaccorso L, de van der Schueren MAE, Baldwin C, Chasen M, Ripamonti CI., ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines☆. ESMO Open. 2021 Jun;6(3):100092.
Ligibel JA, Bohlke K, May AM, Clinton SK, Demark-Wahnefried W, Gilchrist SC, Irwin ML, Late M, Mansfield S, Marshall TF, Meyerhardt JA, Thomson CA, Wood WA, Alfano CM. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol. 2022 Aug 01;40(22):2491-2507.
Zhu C, Ma H, He A, Li Y, He C, Xia Y. Exercise in cancer prevention and anticancer therapy: Efficacy, molecular mechanisms and clinical information. Cancer Lett. 2022 Sep 28;544:215814.
Ribeiro C, Santos R, Correia P, Maddocks M, Gomes B. Resistance training in advanced cancer: a phase II safety and feasibility trial-home versus hospital. BMJ Support Palliat Care. 2022 Sep;12(3):287-291.
Travier N, Velthuis MJ, Steins Bisschop CN, van den Buijs B, Monninkhof EM, Backx F, Los M, Erdkamp F, Bloemendal HJ, Rodenhuis C, de Roos MA, Verhaar M, ten Bokkel Huinink D, van der Wall E, Peeters PH, May AM. Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial. BMC Med. 2015 Jun 08;13:121.
Courneya KS, Segal RJ, McKenzie DC, Dong H, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Crawford JJ, Mackey JR. Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Med Sci Sports Exerc. 2014 Sep;46(9):1744-51.
Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act. 2021 Apr 06;18(1):50.
Fairman CM, Lønbro S, Cardaci TD, VanderVeen BN, Nilsen TS, Murphy AE. Muscle wasting in cancer: opportunities and challenges for exercise in clinical cancer trials. JCSM Rapid Commun. 2022 Jan-Jun;5(1):52-67.
Youssef J, Novosad SA, Winthrop KL. Infection Risk and Safety of Corticosteroid Use. Rheum Dis Clin North Am. 2016 Feb;42(1):157-76, ix-x.
Haan BJ, Blackmon SN, Cobb AM, Cohen HE, DeVier MT, Perez MM, Winslow SF. Corticosteroids in critically ill patients: A narrative review. Pharmacotherapy. 2024 Jul;44(7):581-602.
Garcia JM, Boccia RV, Graham CD, Yan Y, Duus EM, Allen S, Friend J. Anamorelin for patients with cancer cachexia: an integrated analysis of two phase 2, randomised, placebo-controlled, double-blind trials. Lancet Oncol. 2015 Jan;16(1):108-16.
Dev R, Amano K, Naito T, Del Fabbro E. Anamorelin for the Treatment of Cancer Anorexia-Cachexia Syndrome. Curr Oncol Rep. 2024 Jul;26(7):762-772.
Andrade C. Therapeutic Effects, Side Effects, and Adverse Effects of Neuropsychiatric Drugs in the Context of Treating Cancer-Related Anorexia With Olanzapine and Mirtazapine. J Clin Psychiatry. 2024 Aug 21;85(3)
Kast RE, Foley KF. Cancer chemotherapy and cachexia: mirtazapine and olanzapine are 5-HT3 antagonists with good antinausea effects. Eur J Cancer Care (Engl). 2007 Jul;16(4):351-4.
Arrieta O, Cárdenas-Fernández D, Rodriguez-Mayoral O, Gutierrez-Torres S, Castañares D, Flores-Estrada D, Reyes E, López D, Barragán P, Soberanis Pina P, Cardona AF, Turcott JG. Mirtazapine as Appetite Stimulant in Patients With Non-Small Cell Lung Cancer and Anorexia: A Randomized Clinical Trial. JAMA Oncol. 2024 Mar 01;10(3):305-314.
Advani SM, Advani PG, VonVille HM, Jafri SH. Pharmacological management of cachexia in adult cancer patients: a systematic review of clinical trials. BMC Cancer. 2018 Nov 27;18(1):1174.
Gelato M, McNurlan M, Freedland E. Role of recombinant human growth hormone in HIV-associated wasting and cachexia: pathophysiology and rationale for treatment. Clin Ther. 2007 Nov;29(11):2269-88.
Mak RH, Gunta S, Oliveira EA, Cheung WW. Growth Hormone Improves Adipose Tissue Browning and Muscle Wasting in Mice with Chronic Kidney Disease-Associated Cachexia. Int J Mol Sci. 2022 Dec 04;23(23)
Gordon JN, Trebble TM, Ellis RD, Duncan HD, Johns T, Goggin PM. Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial. Gut. 2005 Apr;54(4):540-5.
Hong DS, Janku F, Naing A, Falchook GS, Piha-Paul S, Wheler JJ, Fu S, Tsimberidou AM, Stecher M, Mohanty P, Simard J, Kurzrock R. Xilonix, a novel true human antibody targeting the inflammatory cytokine interleukin-1 alpha, in non-small cell lung cancer. Invest New Drugs. 2015 Jun;33(3):621-31.
Kang EA, Park JM, Jin W, Tchahc H, Kwon KA, Hahm KB. Amelioration of cancer cachexia with preemptive administration of tumor necrosis factor-α blocker. J Clin Biochem Nutr. 2022 Mar;70(2):117-128.
Reid J, Hughes CM, Murray LJ, Parsons C, Cantwell MM. Non-steroidal anti-inflammatory drugs for the treatment of cancer cachexia: a systematic review. Palliat Med. 2013 Apr;27(4):295-303.