Proposal of a tool for screening the risk of cachexia in cancer patients

Background and Objectives

Cancer cachexia is a multifaceted syndrome comprised of fatigue; progressive loss of functional capacity; increased risks of chemotherapeutic drug toxicity, postoperative complications, and hospitalization; decreased quality of life; and reduced survival. The objective of this study was to develop a screening tool to identify the risk of cachexia in outpatients with cancer.

Methods

The tool was developed to detect the risk of cachexia in outpatients treated at an oncology center. The proposed screening tool was based on diagnostic criteria for cachexia; functionality; and symptoms that may reduce alimentation. The self-administered tool was also posted on the hospital website to enable access by health professionals from other hospitals and clinics, as well as by patients.

Results

Data were collected from 275 patients receiving outpatient care. The most prevalent diagnosis was breast cancer (26.2%). The prevalence of metastatic cancer in the total sample was 25.1%. Risk of cachexia was identified in 37.8% of patients. Death within 30 days occurred in 47.1% (41 of 87) patients treated in the emergency room and was significantly associated with the risk of cachexia (n=39; 57.4%) (P<0.001). Age, female sex, and metastatic disease were associated with the risk of cachexia (P<0.001, P=0.014, P<0.001, respectively).

Conclusion

Cachexia is a prevalent and underdiagnosed condition among cancer patients. The development of screening tools is extremely important to facilitate the early detection of patients at risk, with the aim of initiating proactive interventions.