The Path to Holistic Multimodal Care for Cancer Cachexia Patients

Cancer cachexia (CC) is a pathophysiologically complex and multifactorial wasting disorder prevalent in cancer patients. Physical symptoms include fever, hyperalgesia, nausea, and oral mucositis. Patients often also present with exhaustion, anxiety, depression, and disorientation. Despite its high prevalence and detrimental impact on the quality of life of affected patients and family caregivers, no established standard care for CC management yet exists. In response to this unmet need, emerging research has highlighted the potential of holistic multimodal care – a comprehensive approach integrating medical, pharmacological, nutritional, and rehabilitative interventions as well as psychological, emotional, and social well-being issues in line with the specific needs of patients and family caregivers.

This review aims to provide an overview of existing knowledge on holistic multimodal care for CC.

Key learnings:

Holistic interventions in CC involve promoting adherence to multimodal therapies, supporting emotional adaptation and coping, providing evidence-based information and education about pathophysiology and self-care, and initiating end-of-life discussions through effective communication among patients, family caregivers, and clinicians. In this vein, holistic multimodal care for CC patients should occur under the responsibility of a multidisciplinary team, with clinicians in both oncology and palliative care settings regularly communicating with CC patients and caregivers to address pain, manage symptoms, and alleviate emotional distress. A pivotal role is also assigned to the palliative care nurse, who, when necessary, facilitates connections with various professionals, including pharmacists, psychologists, medical care workers, dentists, and dieticians, as well as physical, occupational, and speech therapists.

To facilitate the implementation of these comprehensive care standards, future research should focus on establishing screening and assessment tools to evaluate their potential benefits for both patients and family caregivers. Moreover, developing professional education and training programs focused on CC management, specifically targeting clinicians in cancer care, is an urgent endeavour.

Reviewed by: S. Duarte