Oncological Palliative Medicine, Section Oncology, Department of Internal Medicine and Palliative Care Centre, Cantonal Hospital, St. Gallen, Switzerland.
J Pain Symptom Manage. 2013 Jul;46(1):77-95. doi: 10.1016/j.jpainsymman.2012.06.020. Epub 2012 Nov 15.
Cancer cachexia is debilitating and affects most patients with advanced cancer. Because treatment options are poor, the psychosocial effects of cancer cachexia always should be assessed and psychosocial support provided.
To review the existing evidence of psychosocial effects of cancer cachexia with the aim of identifying factors that might be modified to improve outcomes.
We carried out a systematic literature search in MEDLINE and Embase. The search string included key words for the topics "advanced cancer," "cancer cachexia," and "psychosocial effects." Publications were selected by two reviewers. The search was complemented by a hand search.
Nineteen studies were included. The available information revealed mechanisms leading to, various presentations of, and coping strategies for psychosocial effects of cancer cachexia in both patients and their carers. Not all those affected manage the effects of the condition constructively. A number of clinically important adverse reactions have been identified. The main causes for negative psychosocial effects are a lack of knowledge of the irreversible nature of cancer cachexia and unsuccessful attempts to increase body weight with altered patterns of nutritional intake. Depending on patients' and their carers' coping resources, psychosocial effects may escalate or decrease. Early identification of psychosocial effects creates the potential for psychosocial interventions that improve the quality of life of those affected. Our analysis engendered a broader conceptualization of the psychosocial effects of cancer cachexia, leading to a number of suggestions for psychosocial interventions with the potential for providing relief.
The concept of psychosocial effects in cancer cachexia has the potential to sensitize health care professionals to cachexia-related problems and inform their clinical management of the condition.
癌症恶病质使人虚弱，影响大多数晚期癌症患者。由于治疗选择有限，癌症恶病质的心理社会影响应始终进行评估并提供心理社会支持。
综述癌症恶病质的心理社会影响的现有证据，目的是确定可能改善结局的可改变因素。
我们在 MEDLINE 和 Embase 中进行了系统的文献检索。检索词包括“晚期癌症”、“癌症恶病质”和“心理社会影响”等主题的关键词。由两位审稿人选择出版物。通过手工搜索对检索进行补充。
共纳入 19 项研究。现有的信息揭示了导致癌症恶病质的心理社会影响的机制，以及患者及其照顾者的各种表现和应对策略。并非所有受影响的人都能建设性地应对这些影响。已经确定了一些具有临床重要意义的不良反应。导致负性心理社会影响的主要原因是对癌症恶病质的不可逆性质缺乏了解，以及试图通过改变营养摄入模式来增加体重而失败。根据患者及其照顾者的应对资源，心理社会影响可能会加剧或减轻。早期识别心理社会影响为改善受影响者的生活质量提供心理社会干预的潜力。我们的分析产生了对癌症恶病质的心理社会影响的更广泛概念化，从而为具有缓解潜力的心理社会干预提出了一些建议。
癌症恶病质的心理社会影响概念有可能使医疗保健专业人员对恶病质相关问题敏感，并为他们对该病症的临床管理提供信息。
