Routine Lab Tests May Help Diagnose Cachexia in Cancer Patients

Researchers are developing a 5-point diagnostic tool for cachexia – an involuntary weight loss, characterized primarily by muscle wasting and metabolic changes, often associated with cancer and many chronic diseases.

Cachexia cannot be treated solely with increased food intake or nutritional supplements. It is often associated with poor responses to oncological treatments, increased hospitalizations, and has been shown to be a major burden to family caregivers. It is still largely overlooked and untreated.

A study by researchers at the McGill University Health Centre (MUHC; Montreal, Québec, Canada) aims to save patient lives by providing a practical tool to diagnose cachexia before it becomes irreversible.

"We are losing many cancer patients, not because of their cancer, but because their bodies have undergone important metabolic changes. In other words, they have simply stopped functioning correctly. In severe stages of cachexia, weight loss becomes very important and nutrients can no longer be absorbed or used properly by cancer patients," said paper lead author Dr. Antonio Vigano, MUHC, "Cachexia gets worse with time and the longer we wait to address it, the harder it is to treat. Effectively diagnosing cachexia when still in its early stages can make an enormous difference for a cancer patient’s prognosis and quality of life. In order to save more lives, we need practical and accessible tools that can be effectively used by clinicians in their routine practice to identify patients with cachexia."

The tool is composed of 5 routinely available clinical measures and laboratory tests, and could be available to doctors within the next few years pending additional studies and validation. Beginning with the 4-stage classification system proposed for cachexia (non-cachexia, pre-cachexia, cachexia, and refractory cachexia), cancer patients were assigned to these cachexia stages according to 5 classification criteria: (1) biochemistry (high C-reactive protein or leukocytes, or hypoalbuminemia, or anemia); (2) food intake (normal/decreased); weight loss: (3) moderate (≤5%) or (4) significant (>5%/past six months); and (5) performance status (Eastern Cooperative Oncology Group Performance Status ≥3).

The researchers also hope the tool can be applied to other patients who are losing weight from chronic diseases, such as acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease, multiple sclerosis, chronic heart failure, tuberculosis, and others.

Dr. Vigano’s team is participating in studies aiming at developing treatments for cachexia, but these treatments will only be useful if doctors can diagnose cachexia and understand the severity of each case.

The study, by Vigano AAL et al, was published online September 19, 2016 in the journal Clinical Nutrition.

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