Practical and theoretical implications of weight gain in advanced non-small cell lung cancer patients

Abstract

Involuntary weight loss occurs frequently in individuals with many types of cancers and was shown to be associated with inferior survival almost 40 years ago (1). More recently, there is evidence that weight loss prior to initiation of systemic anti-cancer therapies is associated with increased treatment related side effects (2,3). The majority of these patients are suffering from the cancer anorexia cachexia syndrome. In 2011, a panel of cancer cachexia experts published a consensus statement which defined and classified cancer cachexia (4). This group pointed out that the predominant feature of this syndrome includes loss of skeletal muscle mass which cannot be reversed by conventional nutritional support and which may or may not be accompanied by loss of body fat. Their consensus for diagnostic criteria for cancer cachexia are weight loss greater than 5% in individuals with body mass index (BMI) of ≥20 during the preceding 6 months and 2% weight loss in individuals with BMI <20. They also defined stages of cachexia as pre cachexia (<5% weight loss), cachexia as defined above, and refractory cachexia which is usually associated with progressive cancer and poor performance status.