ANAHEIM, CALIFORNIA—Although nurses are familiar with palliative care guidelines related to cancer anorexia-cachexia syndrome (CACS), an educational needs-assessment survey revealed they are less familiar with novel therapeutic interventions in development. Nurses need more education on pathophysiology of cancer cachexia, treatment options, clinical evidence, and emerging FDA-approved pharmacologic options, concluded Elizabeth Duus, PhD, of Helsinn Therapeutics (US), Inc, in Bridgewater, New Jersey, and colleagues. This study was presented at the Oncology Nursing Society (ONS) 39th Annual Congress.

Systemic inflammation, reduced food intake, and altered metabolism contribute to loss of muscle mass and body weight in CACS. It can lead to reduced tolerance for and response to treatment, shortened survival, and lower quality of life. More than half of cancer patients develop cancer anorexia-cachexia, which is often under-recognized, and the condition lacks safe and effective treatments.

This pilot educational needs-assessment survey sought to gain insight into the educational needs of health care professionals relative to CACS. Of 1,000 surveys faxed to practitioners, 47 physicians and 16 nurses responded to questions about cancer anorexia-cachexia in patients with advanced non-small cell lung cancer (NSCLC).

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The 16 nurse-respondents consider the following to achieve a diagnosis of cancer cachexia: muscle loss (100%), loss of appetite (87.5%), and fatigue (50%). Familiarity with the National Comprehensive Cancer Network (NCCN) Practice Guidelines in Oncology for Palliative Care was ranked as high by 19% of respondents, average by 56%, and low by 25%. Notably, the survey participants reported low familiarity with novel therapeutic interventions being developed. Understanding of the role of ghrelin and ghrelin receptor agonists in CACS was reported as low by 81% of the survey respondents, average by 13%, and high by 6%.


Duus E, Williams M, Matthews C, Friend J. Results from a pilot educational needs assessment survey on cancer anorexia-cachexia syndrome (CACS) in patients with advanced non-small cell lung cancer.

Prepared by Kathy Boltz, PhD, and Joyce Pagán