Malignant diseases, as all chronic diseases, follow a distinct and specific trajectory that can lead to development of cachexia. When cachexia develops, patients will often have a stage of the disease with limited life expectancy. There are no proven and clinically effective interventions to improve quality of life and/or life expectancy in patients with cachexia. Despite implications for daily practice, the epidemiology data remain scarce, and several features still are largely estimates rather than robust information retrieved from cross-sectional or prospective observational studies. Simultaneous step would be to promote (epidemiological) studies in cancer cachexia, with particular emphasis on pathophysiology and patient-related outcomes.
COBISS.SI-ID: 3372923
Cancer cachexia is a complex multifactorial syndrome marked by a continuous depletion of skeletal muscle mass associated, in some cases, with a reduction in fat mass. It is irreversible by nutritional support alone and affects up to 74% of patients with cancer-dependent on the underlying type of cancer-and is associated with physical function impairment, reduced response to cancer-related therapy, and higher mortality. Organs, like muscle, adipose tissue, and liver, play an important role in the progression of cancer cachexia by exacerbating the pro- and anti-inflammatory response initially activated by the tumor and the immune system of the host. Moreover, this metabolic dysfunction is produced by alterations in glucose, lipids, and protein metabolism that, when maintained chronically, may lead to the loss of skeletal muscle and adipose tissue. Although a couple of drugs have yielded positive results in increasing lean body mass with limited impact on physical function, a single therapy has not lead to effective treatment of this condition. Therefore, a multimodal intervention, including pharmacological agents, nutritional support, and physical exercise, may be a reasonable approach for future studies to better understand and prevent the wasting of body compartments in patients with cancer cachexia.
COBISS.SI-ID: 4737765
There is an increasing interest in osteoporosis and reduced bone mineral density affecting not only post%menopausal women but also men, particularly with coexisting chronic diseases. Bone status in patients with stable chronic heart failure (HF) has been rarely studied so far. HF and osteoporosis are highly prevalent aging%related syndromes that exact a huge impact on society. Both disorders are common causes of loss of function and independence, and of prolonged hospitalizations, presenting a heavy burden on the health care system. The most devastating complication of osteoporosis is hip fracture, which is associated with high mortality risk and among those who survive, leads to a loss of function and independence often necessitating admission to long%term care. Current HF guidelines do not suggest screening methods or patient education in terms of osteoporosis or osteoporotic fracture. This review may serve as a solid base to discuss the need for bone health evaluation in HF patients.
COBISS.SI-ID: 15204867