Tumor cachexia: Pathophysiology, diagnostics and therapy [Tumorkachexie: Pathophysiologie, diagnostik und therapie]

Anorexia-cachexia syndrome (ACS) represents a wasting state due to a chronic inflammatory status involving the loss of muscle and fat caused directly by the tumor and/or mediated indirectly by a number of secondary factors. Complex metabolic changes and reduced caloric intake result in a chronic negative energy and protein balance in combination with accelerated metabolism leading to changes in body composition, reduced physical activity, associated symptoms and psychosocial-existential distress. In order to identify potentially correctable causes of ACS, secondary factors such as mucositis, pain and constipation must be ruled out systematically and treated according to international guidelines. Therapeutic options for ACS include pharmacotherapy as one pillar in addition to nutritional interventions, psychosocial-existential counseling and an improvement in physical activity. Effective communication with patients and their families is a component of outstanding importance for the treatment of ACS. © 2007 Springer Medizin Verlag.