Cachexia and bladder cancer: clinical impact and management. Issue 4 (25th December 2021)

• Record Type: Journal Article
• Authors: Lokeshwar, Soum D.; Press, Benjamin H.; Nie, James; Klaassen, Zachary; Kenney, Patrick A.; Leapman, Michael S.
• Is Part Of: Current opinion in supportive and palliative care. Volume 15:Issue 4(2021)
• Page Start: 260
• Page End: 265
• Publication Date: 2021-12-25
• Subjects: bladder cancer -- cachexia -- radical cystectomy -- sarcopenia; Palliative treatment -- Periodicals; Pain -- Periodicals; Palliative Care -- Periodicals; Pain Management -- Periodicals; 616.02905
• DOI: 10.1097/SPC.0000000000000580
• Languages: English
• ISSNs: 1751-4266

Abstract

Abstract : Purpose of review: The purpose of this review is to describe the causes, management, and clinical outcomes associated with cachexia and related components including sarcopenia, among patients with bladder cancer (BCa). Recent findings: Cachexia in patients with BCa is associated with poorer outcomes after radical cystectomy (RC), radiation, and chemotherapy. Nutritional supplements and novel pharmaceutical agents including magnolol, flucoidan and Anamorelin are currently undergoing investigation for their potential use in BCa patients with cachexia. Summary: Cachexia is a hypercatabolic state thought to be caused by an immune-regulated release of cytokines and disruptions of molecular pathways within the tumor microenvironment and systemically. Nutritional deficiencies in patients with BCa also contribute to cachexia and sarcopenia. Patients with BCa -related cachexia and sarcopenia experience worse survival and therapeutic outcomes after RC, chemotherapy, and radiation therapy. Patients with cachexia also experience more postoperative complications after RC. The management of cachexia in patients with BCa remains challenging and requires timely identification, and multidisciplinary management including nutritional supplementation, physical therapy, palliative care, and pharmacological agents. Clinical trials and human studies are still required to determine which pharmacological agents are optimal for BCa cachexia.