A systematic and interdisciplinary approach to the measurement of outcomes over the disease trajectory in a unique specialized cachexia clinic.

Abstract

25 Background: Cancer cachexia affects 60-80% of advanced cancer patients and leads to weight loss, worsening functional status, and increased mortality. Thus, specialized clinics are needed to measure nutritional and functional trajectories over time in this population. Recently, the McGill University Health Centre has developed a systematic, standardized and interdisciplinary approach for the profiling and management of cancer cachexia. Methods: Patients with advanced cancer were recruited and categorized as cachetic. The following information was collected at baseline and at three follow-up visits: hand grip strength measured by Jamar dynamometer, the Edmonton Symptom Assessment System (ESAS) and the abridged Patient Generated Subjective Global Assessment (aPG-SGA) questionnaires. Results: Fifty-nine patients were eligible for this study yet only 24 completed 3 follow-ups and were included. There were 15 men and 9 women, mean age 65.7 years. Five patients had locally advanced disease and 19 had metastatic disease. The table contains results for handgrip strength, ESAS and aPG-SGA scores. Conclusions: Following baseline assessment and treatment, patients were noted to have a significant improvement in the aPG-SGA total score. Handgrip strength was maintained throughout the follow up period. ESAS appetite and fatigue exhibited a positive trend but did not achieve significance over time. This work suggests the benefits of an interdisciplinary cachexia clinic for the maintenance of nutritional and functional status in patients with cancer cachexia as well as possible improvements in quality of life. [Table: see text]