Multidisciplinary approaches to cancer cachexia: current service models and future perspectives

ABSTRACT

Introduction

Cancer cachexia remains a complex unmet need in oncology, despite its high prevalence and high impact. Patients with cachexia experience numerous complications, including reduced tolerance and effectiveness of anti-cancer therapy, reduced mobility, and reduced functional status, leading to decreased quality of life and survival.

Areas covered

As the field moves toward greater consensus of definitions and measurements, we highlight tools currently available for identification and staging of cachexia, and the barriers that people with cancer face in timely identification and management of cachexia. Multidisciplinary cachexia service models have emerged to address practice gaps and needs identified by patients and clinicians. Person-centred approaches to cachexia care demonstrate promising improvements in patient outcomes, but controlled trials of service models are lacking.

Expert opinion

While significant advances have been made in the understanding of cachexia, future trials of clinical service models require standardisation of definitions and outcome measures, with more robust controlled studies to establish the efficacy of proposed best practice. We remain excited with the potential benefit of these innovative models and continue to advocate for implementation of dedicated multidisciplinary cachexia teams to ensure patients and their families receive the right support, in the right place, at the right time.

KEYWORDS:

• Cancer cachexia
• multidisciplinary care
• supportive cancer care
• clinical service models
• palliative rehabilitation

Article highlights

• Cancer cachexia remains a complex unmet need in oncology care, despite its high prevalence and high impact.

• Barriers to early and effective cachexia intervention include clinician awareness, inconsistent application of definitions, tools, or measurements, and complex underlying pathology.

• It remains unlikely that a single pharmacological approach will be effective unless combined with individualised nutritional counselling, structured exercise and scrupulous symptom control.

• Multidisciplinary service models have emerged to support the complex care needs of people affected by cancer cachexia, with variations tailored to their local context.

• Controlled trials are required to confirm efficacy of multidisciplinary service models, though preliminary studies are promising.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper received no funding.