Cachexia in Clinical Practice: Experience from an Endocrine-Led Care Model

Area of Science:

• Endocrinology
• Oncology
• Geriatrics
• Metabolic Medicine

Background:

• Cachexia is a complex syndrome of involuntary weight loss and muscle wasting, often associated with advanced cancer and chronic diseases.
• Limited effective treatment strategies and standardized outpatient care models exist for cachexia in the US.
• This condition significantly impacts patient prognosis and quality of life.

Purpose of the Study:

• To describe the structure, patient characteristics, and outcomes of a specialized multidisciplinary cachexia clinic.
• To evaluate the effectiveness of an integrated approach to managing cancer cachexia in an outpatient academic endocrinology practice.

Main Methods:

• Retrospective analysis of 103 patients referred to a single-center cachexia clinic over five years.
• Comprehensive assessments included weight trajectory, nutritional status, and physical performance (5x sit-to-stand, handgrip strength).
• Individualized interventions comprised nutrition counseling, resistance training, and pharmacologic management.

Main Results:

• Median monthly weight loss significantly decreased from -0.5 kg to 0.0 kg post-enrollment (p < 0.0001).
• The 5x sit-to-stand test performance improved significantly (p = 0.022), while handgrip strength remained unchanged.
• Patients receiving exercise interventions showed a trend toward weight gain, whereas those on protein supplements trended toward weight loss, though not statistically significant.

Conclusions:

• A multimodal cachexia clinic effectively stabilizes weight loss and enhances physical function in medically complex patients.
• These findings support the integration of interdisciplinary strategies for cachexia management.
• The study provides a framework for evaluating future cachexia interventions in routine clinical practice.