Page 18 - Diagnosis and clinical consequences of cachexia in patients with advanced cancer Susanne Blauwhoff-Buskermolen

Chapter 1
Aims and outline of this thesis
Cancer cachexia is a major issue for patients with advanced cancer due to its high prevalence and signi cant impact on patients’ physical performance. Despite the fact that cancer cachexia has since long been recognized as negative consequence of cancer, active assessment or management has not become standard of supportive care due to lack of validated diagnostic criteria. Furthermore, although we know that weight loss and low muscle mass are associated with worse outcome, unknown is how muscle mass develops during anticancer treatment for advanced cancer.The major aim of this thesis is to contribute to the knowledge of diagnosis and clinical consequences of cachexia in patients with advanced cancer.
Chapter 2 describes the relevance of diagnostic criteria of ‘pre-cachexia’. Chapter 3 describes a pilot study on the association between the cut-off value of >5% weight loss in the past year on changes in body composition during palliative chemotherapy for advanced cancer.
Chapter 4 describes cut-off values for the FAACT – A/CS and the VAS for appetite in the diagnosis of cancer anorexia.
In chapter 5 we studied associations between ghrelin levels and anorexia and cachexia in patients with non-small cell lung cancer (NSCLC).
Chapter 6 describes the in uence of different types of muscle mass measurements on the diagnosis of low muscle mass and cancer cachexia.
Chapter 7 shows the association between muscle measures, toxicity and sur vival in older patients with advanced cancer.
In chapter 8 we studied changes in muscle mass during palliative chemotherapy in patients with metastatic colorectal cancer and the consequences for treatment toxicity and survival.
Chapter 9 describes the design of a randomized controlled trial on the effect of individualized nutritional counseling on muscle mass and treatment outcome in patients with metastatic colorectal cancer undergoing chemotherapy.
In chapter 10 the main ndings of the studies are summarized and discussed in context of clinical implications. Also, recommendations for further research are provided.
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