Review
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Kanserde Kaşeksi ve Beslenme

Year 2023, Volume: 32 Issue: 1, 26 - 32, 31.03.2023
https://doi.org/10.17827/aktd.1213292

Abstract

ABSTRACT
Cachexia results from different combinations of metabolic variables and decreased food intake, including increased energy expenditure, excessive catabolism, and inflammations. Anorexia, asthenia, sarcopenia and anemia are clinical features of cachexia, and are effective in reducing the quality of life. The prevalence of cachexia in cancer patients is estimated to be 35%. There are 2 factors that cause the development of cachexia in cancer. The first is the disruption of the anabolic process. All types of cachexia are associated with anorexia, decreased oral intake, lack of movement, and accompanying endocrine changes. Factors such as early satiety, taste and tissue disorders, pain, psychological reasons, gastrointestinal system disorders, dry mouth are factors that contribute to weight loss by reducing oral intake. Secondly, it is the catabolic process caused by the tumor-derived factors and metabolic changes. Enteral and parenteral nutrition support improves the patient's nutritional status by increasing appetite and energy intake. A multidisciplinary team effort is required in prevention of cancer cachexia. The purpose of this review is to interpret the role of nutrition in cancer cachexia.
Keywords: Cancer, cachexia, nutrition

ÖZET
Kaşeksi, artan enerji harcaması, aşırı katabolizma ve inflamasyonlar dahil olmak üzere, metabolik değişkenler ve azalan gıda alımının farklı kombinasyonları sonucu olarak ortaya çıkmaktadır. Anoreksiya, asteni, sarkopeni ve anemi kaşeksinin klinik özelliklerinden olup yaşam kalitesinin azalmasında etkili olmaktadır. Kanser hastalarında kaşeksi prevalansının %35 olduğu tahmin edilmektir. Kanserde kaşeksi gelişimine sebep olan 2 faktör bulunmaktadır; Birincisi anabolik sürecin bozulmasıdır. Bütün kaşeksi türlerinde anoreksiyle oral alımda azalma, hareket eksikliği ve eşlik eden endokrin değişimler mevcuttur. Erken doyma, tat ve doku rahatsızlıkları, ağrı, psikolojik sebepler, gastrointestinal sistem bozukluları, ağız kuruluğu gibi etmenler oral alımı azaltarak kilo kaybına katkı sağlayan faktörlerdir. İkinci olarak da tümör kaynaklı faktörler ve metabolik değişimlerin sebep olduğu katabolik süreçtir. Enteral ve parenteral beslenme desteği, iştah ve enerji alımında artış sağlayarak hastanın beslenme durumunda gelişme sağlamaktadır. Kanser kaşeksisinin önlenmesinde multidisipliner bir ekip çalışması gereklidir. Bu derlemenin amacı kanser kaşeksisinde beslenmenin rolünü yorumlamaktır.
Anahtar kelimeler: Kanser, kaşeksi, beslenme

References

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  • 2- Baracos VE Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018;4:17105.
  • 3- Argilés JM, Busquets S, Stemmler B, López-Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer. 2014;14:754-62. 4- Warren S. The ımmedıate causes of death ın cancer. Am J Med Sci. Available from: https://www.scienceopen.com/document?vid=b7e1c45c-4d97-43ea-b27d-:48025cb89923 Accesses: 10 Nov 2022.
  • 5- Dolly A, Dumas J, Servais S. Cancer cachexia and skeletal muscle atrophy in clinical studies: what do we really know? JCSM. 2020;11:1413-28.
  • 6- von Haehling S, Anker SD. Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle. 2010;1:1-5.
  • 7- Fonseca GWP da, Farkas J, Dora E, von Haehling S, Lainscak M. Cancer cachexia and related metabolic dysfunction. Int J Mol Sci. 2020;21:E2321.
  • 8- Hatice Duygu Tosun, Gülden Köksal. Kanserde kaşeksi ve beslenme. Bes Diy Derg. 2012;40:59-68.
  • 9- Daou HN. Exercise as an anti-inflammatory therapy for cancer cachexia: a focus on interleukin-6 regulation. Am J Physiol Regul Integr Comp Physiol. 2020;318:296-310.
  • 10- Patel HJ, Patel BM. TNF-α and cancer cachexia: Molecular insights and clinical implications. Life Sciences. 2017;170:56-63.
  • 11- MacDonald N, Easson AM, Mazurak VC, Dunn GP, Baracos VE. Understanding and managing cancer cachexia. J Am Coll of Surg. 2003;197:143-61.
  • 12- Argilés JM, Busquets S, Toledo M, López-Soriano FJ. The role of cytokines in cancer cachexia. Curr Opin Support Palliat Care. 2009;3:263-8.
  • 13- Di̇nler G. Çocuk kanser hastalarında beslenme. Güncel Pediatri. 2009;7:31-6.
  • 14- Pham-Huy LA, He H, Pham-Huy C. Free radicals, antioxidants in disease and health. Int J Biomed Sci. 2008;4:89-96.
  • 15- Serna-Thomé G, Castro-Eguiluz D, Fuchs-Tarlovsky V, Sánchez-López M, Delgado-Olivares L, Coronel-Martínez J, et al. Use of Functional foods and oral supplements as adjuvants in cancer treatment. Rev Invest Clin. 2018;70:136-46.
  • 16- Fracaro L, Frez FC, Silva BC, Vicentini GE, de Souza SR, Martins HA, et al. Walker 256 tumor-bearing rats demonstrate altered interstitial cells of Cajal Effects on ICC in the Walker 256 tumor model. Neurogastroenterol Motil.2016;28:101-115.
  • 17- Azman M, Mohd Yunus MR, Sulaiman S, Syed Omar SN. Enteral glutamine supplementation in surgical patients with head and neck malignancy: a randomized controlled trial. Head Neck. 2015;37:1799-807.
  • 18- Vicentini GE, Fracaro L, de Souza SRG, Martins HA, Guarnier FA, Zanoni JN. Experimental cancer cachexia changes neuron numbers and peptide levels in the intestine: partial protective effects after dietary supplementation with l-glutamine. PLoS One. 2016;11:e0162998.
  • 19- Vicentini GE, Martins HA, Fracaro L, de Souza SRG, da Silva Zanoni KP, Silva TNX, et al. Does l-glutamine-supplemented diet extenuate NO-mediated damage on myenteric plexus of Walker 256 tumor-bearing rats? Food Res Int. 2017;101:24-34.
  • 20- Martins HA, Bazotte RB, Vicentini GE, Lima MM, Guarnier FA, Hermes-Uliana C, et al. L-Glutamine supplementation promotes an improved energetic balance in Walker-256 tumor-bearing rats. Tumour Biol. 2017;39:1010428317695960.
  • 21- Martins HA, Sehaber CC, Hermes-Uliana C, Mariani FA, Guarnier FA, Vicentini GE, et al. Supplementation with l-glutamine prevents tumor growth and cancer-induced cachexia as well as restores cell proliferation of intestinal mucosa of Walker-256 tumor-bearing rats. Amino Acids. 2016;48:2773-84.
  • 22- Holeček M. Branched-chain amino acids in health and disease: metabolism, alterations in blood plasma, and as supplements. Nutr Metab. 2018;15:33
  • 23- Eley HL, Russell ST, Tisdale MJ. Effect of branched-chain amino acids on muscle atrophy in cancer cachexia. Biochemical Journal. 2007;407:113-20.
  • 24- Bonhomme S, Belabed L, Blanc MC, Neveux N, Cynober L, Darquy S. Arginine-supplemented enteral nutrition in critically ill diabetic and obese rats: a dose-ranging study evaluating nutritional status and macrophage function. Nutrition. 2013;29:305–12.
  • 25- ESPEN guidelines on nutrition in cancer patients - ScienceDirect: Available from https://www.sciencedirect.com/science/article/pii/S0261561416301819?casa_token
  • 26- van de Worp WRPH, Schols AMWJ, Theys J, van Helvoort A, Langen RCJ. Nutritional interventions in cancer cachexia: evidence and perspectives from experimental models. Front Nutr. 2020;7:601329.
  • 27- Tayek JA. A review of cancer cachexia and abnormal glucose metabolism in humans with cancer. J Am Coll Nutr. 1992;11:445-56.
  • 28- Nicolini A, Ferrari P, Masoni MC, Fini M, Pagani S, Giampietro O et al. Malnutrition, anorexia and cachexia in cancer patients: a mini-review on pathogenesis and treatment. Biomed Pharmacother. 2013;67:807-17. 29- Benoist S, Brouquet A. Nutritional assessment and screening for malnutrition. J Visc Surg. 2015;152 Suppl 1:S3-7.
  • 30- Cao J, Xu H, Li W, Guo Z, Lin Y, Shi Y. Investigation on nutrition status and clinical outcome of common cancers (INSCOC) group, Chinese Society of Nutritional Oncology nutritional assessment and risk factors associated to malnutrition in patients with esophageal cancer. Curr Probl Cancer. 2021;45:100638.
  • 31- Karpuzoğlu D, Batar N.Onkolojide tercih edilen beslenme durumu tarama ve değerlendirme yöntemleri. J Health Sci Life. 2019;1:37-46.
  • 32- Sadeghi M, Keshavarz-Fathi M, Baracos V, Arends J, Mahmoudi M, Rezaei N. Cancer cachexia: diagnosis, assessment, and treatment. Crit Rev Oncol Hematol. 2018;127:91-104.
  • 33- Kantar M, Ataseven E, Önen Göktepe Ş. Kanserli çocuklarda beslenme uygulamaları. Çocuk Hematoloji ve Onkolojide Nutrisyon Bülteni. 1. Baskı. (Ed: MK.): 55-61. İstanbul, Clinic Pediatri, 2021;55-61.
  • 34- Aarnivala H, Pokka T, Soininen R, Möttönen M, Harila-Saari A, Niinimäki R. Trends in age- and sex-adjusted body mass index and the prevalence of malnutrition in children with cancer over 42 months after diagnosis: a single-center cohort study. Eur J Pediatr. 2020;179:91-8.
  • 35- Chow R, Bruera E, Chiu L, Chow S, Chiu N, Lam H. Enteral and parenteral nutrition in cancer patients: a systematic review and meta-analysis. Ann Palliat Med. 2016;5:30-41.
  • 36- Cheng Y, Zhang J, Zhang L, Wu J, Zhan Z. Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis. BMC Gastroenterol. 2018;181:11.
Year 2023, Volume: 32 Issue: 1, 26 - 32, 31.03.2023
https://doi.org/10.17827/aktd.1213292

Abstract

References

  • 1- Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12:489-95.
  • 2- Baracos VE Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018;4:17105.
  • 3- Argilés JM, Busquets S, Stemmler B, López-Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer. 2014;14:754-62. 4- Warren S. The ımmedıate causes of death ın cancer. Am J Med Sci. Available from: https://www.scienceopen.com/document?vid=b7e1c45c-4d97-43ea-b27d-:48025cb89923 Accesses: 10 Nov 2022.
  • 5- Dolly A, Dumas J, Servais S. Cancer cachexia and skeletal muscle atrophy in clinical studies: what do we really know? JCSM. 2020;11:1413-28.
  • 6- von Haehling S, Anker SD. Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle. 2010;1:1-5.
  • 7- Fonseca GWP da, Farkas J, Dora E, von Haehling S, Lainscak M. Cancer cachexia and related metabolic dysfunction. Int J Mol Sci. 2020;21:E2321.
  • 8- Hatice Duygu Tosun, Gülden Köksal. Kanserde kaşeksi ve beslenme. Bes Diy Derg. 2012;40:59-68.
  • 9- Daou HN. Exercise as an anti-inflammatory therapy for cancer cachexia: a focus on interleukin-6 regulation. Am J Physiol Regul Integr Comp Physiol. 2020;318:296-310.
  • 10- Patel HJ, Patel BM. TNF-α and cancer cachexia: Molecular insights and clinical implications. Life Sciences. 2017;170:56-63.
  • 11- MacDonald N, Easson AM, Mazurak VC, Dunn GP, Baracos VE. Understanding and managing cancer cachexia. J Am Coll of Surg. 2003;197:143-61.
  • 12- Argilés JM, Busquets S, Toledo M, López-Soriano FJ. The role of cytokines in cancer cachexia. Curr Opin Support Palliat Care. 2009;3:263-8.
  • 13- Di̇nler G. Çocuk kanser hastalarında beslenme. Güncel Pediatri. 2009;7:31-6.
  • 14- Pham-Huy LA, He H, Pham-Huy C. Free radicals, antioxidants in disease and health. Int J Biomed Sci. 2008;4:89-96.
  • 15- Serna-Thomé G, Castro-Eguiluz D, Fuchs-Tarlovsky V, Sánchez-López M, Delgado-Olivares L, Coronel-Martínez J, et al. Use of Functional foods and oral supplements as adjuvants in cancer treatment. Rev Invest Clin. 2018;70:136-46.
  • 16- Fracaro L, Frez FC, Silva BC, Vicentini GE, de Souza SR, Martins HA, et al. Walker 256 tumor-bearing rats demonstrate altered interstitial cells of Cajal Effects on ICC in the Walker 256 tumor model. Neurogastroenterol Motil.2016;28:101-115.
  • 17- Azman M, Mohd Yunus MR, Sulaiman S, Syed Omar SN. Enteral glutamine supplementation in surgical patients with head and neck malignancy: a randomized controlled trial. Head Neck. 2015;37:1799-807.
  • 18- Vicentini GE, Fracaro L, de Souza SRG, Martins HA, Guarnier FA, Zanoni JN. Experimental cancer cachexia changes neuron numbers and peptide levels in the intestine: partial protective effects after dietary supplementation with l-glutamine. PLoS One. 2016;11:e0162998.
  • 19- Vicentini GE, Martins HA, Fracaro L, de Souza SRG, da Silva Zanoni KP, Silva TNX, et al. Does l-glutamine-supplemented diet extenuate NO-mediated damage on myenteric plexus of Walker 256 tumor-bearing rats? Food Res Int. 2017;101:24-34.
  • 20- Martins HA, Bazotte RB, Vicentini GE, Lima MM, Guarnier FA, Hermes-Uliana C, et al. L-Glutamine supplementation promotes an improved energetic balance in Walker-256 tumor-bearing rats. Tumour Biol. 2017;39:1010428317695960.
  • 21- Martins HA, Sehaber CC, Hermes-Uliana C, Mariani FA, Guarnier FA, Vicentini GE, et al. Supplementation with l-glutamine prevents tumor growth and cancer-induced cachexia as well as restores cell proliferation of intestinal mucosa of Walker-256 tumor-bearing rats. Amino Acids. 2016;48:2773-84.
  • 22- Holeček M. Branched-chain amino acids in health and disease: metabolism, alterations in blood plasma, and as supplements. Nutr Metab. 2018;15:33
  • 23- Eley HL, Russell ST, Tisdale MJ. Effect of branched-chain amino acids on muscle atrophy in cancer cachexia. Biochemical Journal. 2007;407:113-20.
  • 24- Bonhomme S, Belabed L, Blanc MC, Neveux N, Cynober L, Darquy S. Arginine-supplemented enteral nutrition in critically ill diabetic and obese rats: a dose-ranging study evaluating nutritional status and macrophage function. Nutrition. 2013;29:305–12.
  • 25- ESPEN guidelines on nutrition in cancer patients - ScienceDirect: Available from https://www.sciencedirect.com/science/article/pii/S0261561416301819?casa_token
  • 26- van de Worp WRPH, Schols AMWJ, Theys J, van Helvoort A, Langen RCJ. Nutritional interventions in cancer cachexia: evidence and perspectives from experimental models. Front Nutr. 2020;7:601329.
  • 27- Tayek JA. A review of cancer cachexia and abnormal glucose metabolism in humans with cancer. J Am Coll Nutr. 1992;11:445-56.
  • 28- Nicolini A, Ferrari P, Masoni MC, Fini M, Pagani S, Giampietro O et al. Malnutrition, anorexia and cachexia in cancer patients: a mini-review on pathogenesis and treatment. Biomed Pharmacother. 2013;67:807-17. 29- Benoist S, Brouquet A. Nutritional assessment and screening for malnutrition. J Visc Surg. 2015;152 Suppl 1:S3-7.
  • 30- Cao J, Xu H, Li W, Guo Z, Lin Y, Shi Y. Investigation on nutrition status and clinical outcome of common cancers (INSCOC) group, Chinese Society of Nutritional Oncology nutritional assessment and risk factors associated to malnutrition in patients with esophageal cancer. Curr Probl Cancer. 2021;45:100638.
  • 31- Karpuzoğlu D, Batar N.Onkolojide tercih edilen beslenme durumu tarama ve değerlendirme yöntemleri. J Health Sci Life. 2019;1:37-46.
  • 32- Sadeghi M, Keshavarz-Fathi M, Baracos V, Arends J, Mahmoudi M, Rezaei N. Cancer cachexia: diagnosis, assessment, and treatment. Crit Rev Oncol Hematol. 2018;127:91-104.
  • 33- Kantar M, Ataseven E, Önen Göktepe Ş. Kanserli çocuklarda beslenme uygulamaları. Çocuk Hematoloji ve Onkolojide Nutrisyon Bülteni. 1. Baskı. (Ed: MK.): 55-61. İstanbul, Clinic Pediatri, 2021;55-61.
  • 34- Aarnivala H, Pokka T, Soininen R, Möttönen M, Harila-Saari A, Niinimäki R. Trends in age- and sex-adjusted body mass index and the prevalence of malnutrition in children with cancer over 42 months after diagnosis: a single-center cohort study. Eur J Pediatr. 2020;179:91-8.
  • 35- Chow R, Bruera E, Chiu L, Chow S, Chiu N, Lam H. Enteral and parenteral nutrition in cancer patients: a systematic review and meta-analysis. Ann Palliat Med. 2016;5:30-41.
  • 36- Cheng Y, Zhang J, Zhang L, Wu J, Zhan Z. Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis. BMC Gastroenterol. 2018;181:11.
There are 34 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Review
Authors

Penbe Ecem Mısırlıoğlu 0000-0003-0944-4831

Beril Köse 0000-0002-5173-2389

Publication Date March 31, 2023
Acceptance Date March 10, 2023
Published in Issue Year 2023 Volume: 32 Issue: 1

Cite

AMA Mısırlıoğlu PE, Köse B. Kanserde Kaşeksi ve Beslenme. aktd. March 2023;32(1):26-32. doi:10.17827/aktd.1213292