Practical multimodal care for cancer cachexia. Issue 4 (December 2016)

• Record Type: Journal Article
• Authors: Maddocks, Matthew; Hopkinson, Jane; Conibear, John; Reeves, Annie; Shaw, Clare; Fearon, Ken C.H.
• Is Part Of: Current opinion in supportive and palliative care. Volume 10:Issue 4(2016:Dec.)
• Publication Date: 2016-12
• Subjects: cancer cachexia -- clinical education -- multimodal care -- supportive care; Palliative treatment -- Periodicals; Pain -- Periodicals; Palliative Care -- Periodicals; Pain Management -- Periodicals; 616.02905
• DOI: 10.1097/SPC.0000000000000241
• Languages: English
• ISSNs: 1751-4266

Abstract

Abstract : Purpose of review: Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. Recent findings: Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented. We propose multimodal care approaches that incorporate nutritional support, exercise, and anti-inflammatory agents, on a background of personalized oncology care and family-centred education. Collectively, the cases reveal that multimodal care is part of everyone's remit, often focuses on supported self-management, and demands buy-in from the patient and their family. Once operationalized, multimodal care approaches can be tested pragmatically, including alongside emerging pharmacological cachexia treatments. Summary: We demonstrate that multimodal care for cancer cachexia can be achieved using simple treatments and without a dedicated team of specialists. The sharing of advice between health professionals can help build collective confidence and expertise, moving towards a position in which every team member feels they can contribute towards multimodal care.