Cancer Cachexia: Why Nutritional Support Alone Does Not Reverse It, and What That Means for Counselling
DOI:
https://doi.org/10.5281/zenodo.22278479Keywords:
Cancer cachexia, Nutritional support, Multimodal therapy, Anabolic resistance, CounsellingAbstract
That nutritional support does not reverse cancer cachexia is partly a finding and partly a definition: the consensus definition
specifies loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. The mechanism explains
why. Where reduced intake is accompanied by systemic inflammation and metabolic dysregulation, feeding addresses one of three
drivers and the other two persist. The clinical evidence follows. A randomised trial of nutritional therapy alone in advanced
cancer found no consistent effect on body weight or survival, and a phase III multimodal trial combining nutrition, exercise, an
anti-inflammatory drug and anticancer therapy achieved modest weight stabilisation without significant improvement in muscle
mass or physical activity. The syndrome is associated with around 20 per cent of cancer deaths. What counselling can address is
distress in patient and family, which is measurable where weight gain is not.
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