Cachexia in Pancreatic Cancer: New Insights to Impact Quality of Life and Survival

Introduction: Cancer cachexia is associated with systemic inflammation and metabolic derangement, leading to muscle atrophy, which affects over 80% of pancreatic cancer patients, the highest rate among all malignancies, negatively impacting quality of life and significantly reducing survival rate. Malnutrition, skeletal muscle loss (sarcopenia), and imbalanced energy expenditure are indicators of cachexia. No established screening tools in clinical practice are specific and sensitive enough to detect pancreatic cancer in its early stages. Objective: This paper aims to provide new insights by examining contributing factors in the development of cachexia and exploring future directions for managing cachexia to improve quality of life and overall survival in patients with pancreatic cancer. Conclusions: It is clinically vital to identify nutritional risks and consider aggressive nutritional interventions as soon as pancreatic cancer is diagnosed to (1) stabilize body weight, (2) decrease the disease-associated burden, and (3) improve the quality of life. To support the clinical management of cachexia in this population, more research is needed. Specifically, research is needed to identify biomarkers, such as muscle fiber-related genes, optimize drug delivery tailored to the specific metabolic and molecular profile, combine chemotherapeutic agents with nutritional supplements, and consider non-pharmacological interventions such as acupuncture and exercise specifically for cancer-cachexia patients. A multifaceted approach will help achieve a better quality of life and prolonged overall survival in patients with pancreatic cancer.