Cachexia is one of the most common manifestations in advanced
cancer patients, but too often it remains under- recognized and under-treated.
Starvation is not the same of
cachexia.
Cachexia is defined by "
weight loss >5% over past 6 months in absence of simple
starvation or the combination of ongoing
weight loss>2% with BMI <20 or
sarcopenia". The pathogenesis of
cancer cachexia is not fully understood, but
inflammation and an increased catabolic response to a number of
cancer-related factors seem to represent the basis of any assumption. Early diagnosis of a pre-cachectic or cachectic state is a key moment for the treatment of this complex syndrome, in order to guarantee an adequate food intake and suitable exercise and to interfere with the inflammatory processes that are typical of
cachexia. Therefore, one of the main aims is to identify those patients most likely to develop the syndrome early. A multimodality baseline approach to
cancer cachexia addresses reversible clinical contributory factors. There are currently no medicinal products that have a proven efficacy in the medical approach to
cancer cachexia. Recently,
anamorelin, a synthetic orally active
ghrelin receptor agonist, showed promising results, but the best approach to
cancer cachexia probably remains an early multimodal interventions consisting in nutritional intervention, exercise and rehabilitation program, and multi-target
drug therapies. This review summarizes what we know and what still need to know about
cancer cachexia syndrome.