title: Cachexia and pancreatic cancer: are there treatment options?
abstract: Cachexia is frequently described in patients with pancreatic ductal adenocarcinoma (PDAC) and is associated with reduced survival and quality of life. Unfortunately, the therapeutic options of this multi-factorial and complex syndrome are limited. This is due to the fact that, despite extensive preclinical and clinical research, the underlying pathological mechanisms leading to PDAC-associated cachexia are still not fully understood. Furthermore, there is still a lack of consensus on the definition of cachexia, which complicates the standardization of diagnosis and treatment as well as the analysis of the current literature. In order to provide an efficient therapy for cachexia, an early and reliable diagnosis and consistent monitoring is required, which can be challenging especially in obese patients. Although many substances have been tested in clinical and preclinical settings, so far none of them have been proven to have a long-term effect in ameliorating cancer-associated cachexia. However, recent studies have demonstrated that multidimensional therapeutic modalities are able to alleviate pancreatic cancer-associated cachexia and ultimately improve patients' outcome. In this current review, we propose a stepwise and pragmatic approach to facilitate and standardize the treatment of cachexia in pancreatic cancer patients. This strategy consists of nutritional, dietary, pharmacological, physical and psychological methods.
authors: Tara C Mueller, Jeannine Bachmann, Marc E Martignoni, Department of Surgery, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.
authors: Tara C
authors: TC
authors: Mueller
authors: Tara C Mueller, Jeannine Bachmann, Marc E Martignoni, Department of Surgery, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.
authors: Marc A
authors: MA
authors: Burmeister
authors: Tara C Mueller, Jeannine Bachmann, Marc E Martignoni, Department of Surgery, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.
authors: Jeannine
authors: J
authors: Bachmann
authors: Tara C Mueller, Jeannine Bachmann, Marc E Martignoni, Department of Surgery, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.
authors: Marc E
authors: ME
authors: Martignoni
mesh_terms: D019167:Appetite Stimulants / Q000627:therapeutic use; D002100:Cachexia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications*; D003131:Combined Modality Therapy; D019587:Dietary Supplements; D006801:Humans; D044623:Nutrition Therapy / Q000379:methods*; D009752:Nutritional Status; D018529:Nutritional Support; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D019167:Appetite Stimulants
keywords: Cachexia; Gastrointestinal neoplasms; Nutritional support; Pancreatic neoplasms