Abstract

Simple SummaryCachexia is a syndrome that can be present in many patients diagnosed with cancer, especially in those with metastatic or very advanced tumors. The patient may present with weight loss, loss of muscle mass, and even cardiac dysfunction as a result of it. The aim of this review is to understand how cachexia manifests and whether physical exercise has any role in trying to prevent or reverse this syndrome in cancer patients.Cachexia is a multifactorial syndrome that presents with, among other characteristics, progressive loss of muscle mass and anti-cardiac remodeling effect that may lead to heart failure. This condition affects about 80% of patients with advanced cancer and contributes to worsening patients’ tolerance to anticancer treatments and to their premature death. Its pathogenesis involves an imbalance in metabolic homeostasis, with increased catabolism and inflammatory cytokines levels, leading to proteolysis and lipolysis, with insufficient food intake. A multimodal approach is indicated for patients with cachexia, with the aim of reducing the speed of muscle wasting and improving their quality of life, which may include nutritional, physical, pharmacologic, and psychological support. This review aims to outline the mechanisms of muscle loss, as well as to evaluate the current clinical evidence of the use of physical exercise in patients with cachexia.

Highlights

  • Cachexia is a debilitating multifactorial syndrome, involving several metabolic pathways in different tissues and organs

  • Cancer-induced cachexia can be a complication of cancer progression which negatively affects the quality of life and overall survival of patients

  • Numerous metabolic pathways are modified in this condition, with increased inflammatory response and oxidative stress, decreased synthesis of proteins, and deregulation of genetic factors, resulting in weight and muscle mass loss, besides damage to several organs

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Summary

Introduction

Cachexia is a debilitating multifactorial syndrome, involving several metabolic pathways in different tissues and organs. It is characterized by systemic inflammation with progressive weight loss, depletion of adipose tissue, and loss of muscle mass that cannot be reversed by conventional nutritional support [1]. This condition can negatively affect patients during cancer treatment, reducing their tolerance and response to anticancer therapies, worsening their quality of life, and increasing mortality in patients with advanced cancer. Cachexia is indirectly responsible for 20% of all cancer-related deaths [2]

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