Practical approaches to managing cancer patients with weight loss.

PURPOSE OF REVIEW: Poor appetite and weight loss are a source of family conflict, psychological distress, and associated with poor tolerance to chemotherapy, impaired quality of life, and decreased survival. Despite clinicians' concern about the effect of cachexia on their patients, few oncological professional organizations provide guidelines for the treatment of cancer-related weight loss.

RECENT FINDINGS: Recent publications indicate there is an unmet need for addressing cachexia in patients with cancer. Studies also reveal that patients are often consuming inadequate calories and protein. Inadequate oral intake may be mitigated by a multimodal interdisciplinary approach that uses pharmacological and nonpharmacological measures such as exercise and counseling. Other positive clinical outcomes include decreased symptom burden, improved quality of life, and enhanced physical performance.

SUMMARY: Experience from specialist cachexia clinics and published literature indicates that simple assessments and interventions can be applied more broadly in clinical practice and that the interdisciplinary multimodal approach is important for achieving successful outcomes. The positive influence of this approach on clinical outcomes also has to be considered in clinical trial design.