Quality of life and symptom burden improve in patients attending a multidisciplinary clinical service for cancer cachexia: a retrospective observational review.

Abstract

BACKGROUND\nCancer cachexia negatively affects quality of life (QoL) and increases symptom burden. A multimodal treatment approach may optimise cachexia outcomes, including QoL. We evaluated QoL and symptoms over time among patients attending a multidisciplinary clinical service for cancer cachexia.\n\n\nMETHODS\nAdults with cancer who attended the clinical service three times between 2017-2020 were included. Quality of life and symptoms were assessed using the European Organization for Research and Treatment of Cancer-Quality of life Questionnaire Core 15 Palliative (EORTC QLQ-C15-PAL) and Functional Assessment Anorexia/Cachexia Treatment (FAACT). Physical function was assessed using the 30s sit-to-stand (STS) test and handgrip strength (HGS).\n\n\nRESULTS\nOverall, 162 patients (age=67.2±12.0yrs) were included. Mean six-month weight loss at baseline was 10.4±9.4%. Mean body weight was stable between clinic visits (p=0.904) and no change in STS (p=0.133) or HGS (p=0.734) occurred over time. Improvements in EORTC QLQ-C15-PAL overall QoL (Δ10.7±2.5, p<0.001), physical function (Δ8.0±2.4, p=0.003) and emotional function (Δ11.4±2.9, p<0.001) occurred by the second visit. EORTC QLQ-C15-PAL fatigue (Δ13.8±2.9, p<0.001), pain (Δ10.3±3.3, p=0.007), nausea/vomiting (Δ16.1±3.0, p<0.001) and appetite symptoms (Δ25.9±3.8, p<0.001) also improved by the second visit. FAACT total score (Δ14.6±2.7, p<0.001), anorexia-cachexia symptoms (Δ6.6±1.1, p<0.001), and physical (Δ3.7±0.70, p<0.001), emotional (Δ1.9±0.60, p=0.005) and functional wellbeing (Δ2.7±0.71, p=0.001) improved by the second visit. All QoL improvements were maintained at the third visit.\n\n\nCONCLUSION\nSignificant improvements in QoL/symptoms were associated with attending a cachexia clinical service. Our findings support using multidisciplinary, multimodal cancer cachexia treatment approaches to improve patient wellbeing.