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Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers
Considerable advances in the investigation and management of oesophagogastric cancer have occurred over the last few decades. While the historically dismal prognosis associated with these diseases has improved, outcomes remain very poor. Cancer cachexia is an often neglected, yet critical, factor fo...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768000/ https://www.ncbi.nlm.nih.gov/pubmed/36269458 http://dx.doi.org/10.1007/s11864-022-01028-1 |
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author | Brown, Leo R. Laird, Barry J. A. Wigmore, Stephen J. Skipworth, Richard J. E. |
author_facet | Brown, Leo R. Laird, Barry J. A. Wigmore, Stephen J. Skipworth, Richard J. E. |
author_sort | Brown, Leo R. |
collection | PubMed |
description | Considerable advances in the investigation and management of oesophagogastric cancer have occurred over the last few decades. While the historically dismal prognosis associated with these diseases has improved, outcomes remain very poor. Cancer cachexia is an often neglected, yet critical, factor for this patient group. There is a persuasive argument that a lack of assessment and treatment of cachexia has limited progress in oesophagogastric cancer care. In the curative setting, the stage of the host (based on factors such as body composition, function, and inflammatory status), alongside tumour stage, has the potential to influence treatment efficacy. Phenotypical features of cachexia may decrease the survival benefit of (peri-operative) chemoradiotherapy, immunotherapy, or surgical resection in patients with potentially curative malignancy. Most patients with oesophagogastric cancer unfortunately present with disease which is not amenable, or is unlikely to respond, to these treatments. In the palliative setting, host factors can similarly impair results from systemic anti-cancer therapies, cause adverse symptoms, and reduce quality of life. To optimise treatment pathways and enhance patient outcomes, we must utilise this information during clinical decision-making. As our understanding of the genesis of cancer cachexia improves and more therapeutic options, ranging from basic (e.g. exercise and nutrition) to targeted (e.g. anti-IL1 α and anti-GDF-15), become available, there can be grounds for optimism. Cachexia can change from a hitherto neglected condition to an integral part of the oesophagogastric cancer treatment pathway. |
format | Online Article Text |
id | pubmed-9768000 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-97680002022-12-22 Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers Brown, Leo R. Laird, Barry J. A. Wigmore, Stephen J. Skipworth, Richard J. E. Curr Treat Options Oncol Upper Gastrointestinal Cancers (JD Berlin, Section Editor) Considerable advances in the investigation and management of oesophagogastric cancer have occurred over the last few decades. While the historically dismal prognosis associated with these diseases has improved, outcomes remain very poor. Cancer cachexia is an often neglected, yet critical, factor for this patient group. There is a persuasive argument that a lack of assessment and treatment of cachexia has limited progress in oesophagogastric cancer care. In the curative setting, the stage of the host (based on factors such as body composition, function, and inflammatory status), alongside tumour stage, has the potential to influence treatment efficacy. Phenotypical features of cachexia may decrease the survival benefit of (peri-operative) chemoradiotherapy, immunotherapy, or surgical resection in patients with potentially curative malignancy. Most patients with oesophagogastric cancer unfortunately present with disease which is not amenable, or is unlikely to respond, to these treatments. In the palliative setting, host factors can similarly impair results from systemic anti-cancer therapies, cause adverse symptoms, and reduce quality of life. To optimise treatment pathways and enhance patient outcomes, we must utilise this information during clinical decision-making. As our understanding of the genesis of cancer cachexia improves and more therapeutic options, ranging from basic (e.g. exercise and nutrition) to targeted (e.g. anti-IL1 α and anti-GDF-15), become available, there can be grounds for optimism. Cachexia can change from a hitherto neglected condition to an integral part of the oesophagogastric cancer treatment pathway. Springer US 2022-10-21 2022 /pmc/articles/PMC9768000/ /pubmed/36269458 http://dx.doi.org/10.1007/s11864-022-01028-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Upper Gastrointestinal Cancers (JD Berlin, Section Editor) Brown, Leo R. Laird, Barry J. A. Wigmore, Stephen J. Skipworth, Richard J. E. Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers |
title | Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers |
title_full | Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers |
title_fullStr | Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers |
title_full_unstemmed | Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers |
title_short | Understanding Cancer Cachexia and Its Implications in Upper Gastrointestinal Cancers |
title_sort | understanding cancer cachexia and its implications in upper gastrointestinal cancers |
topic | Upper Gastrointestinal Cancers (JD Berlin, Section Editor) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9768000/ https://www.ncbi.nlm.nih.gov/pubmed/36269458 http://dx.doi.org/10.1007/s11864-022-01028-1 |
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