Inter-Organ Communication Research Team, Institute for Life and Medical Sciences, Kyoto, Japan.
Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Cancer Sci. 2024 Mar;115(3):715-722. doi: 10.1111/cas.16078. Epub 2024 Jan 22.
Cancer cachexia is a complex, multifaceted condition that negatively impacts the health, treatment efficacy, and economic status of cancer patients. The management of cancer cachexia is an essential clinical need. Cancer cachexia is currently defined mainly according to the severity of weight loss and sarcopenia (i.e., macrosymptoms). However, such macrosymptoms may be insufficient to give clinicians clues on how to manage this condition as these symptoms appear at the late stage of cancer. We need to understand earlier events during the progression of cancer cachexia so as not to miss a clinical opportunity to control this complex syndrome. Recent research indicates that cancer-induced changes in the host are much wider than previously recognized, including disruption of liver function and the immune system. Furthermore, such changes are observed before the occurrence of visible distant metastases (i.e., in early, localized cancers). In light of these findings, we propose to expand the definition of cancer cachexia to include all cancer-induced changes to host physiology, including changes caused by early, localized cancers. This new definition of cancer cachexia can provide a new perspective on this topic, which can stimulate the research and development of novel cancer cachexia therapies.
癌症恶病质是一种复杂的、多方面的疾病，会对癌症患者的健康、治疗效果和经济状况产生负面影响。癌症恶病质的管理是一种重要的临床需求。癌症恶病质目前主要根据体重减轻和肌肉减少症（即宏观症状）的严重程度来定义。然而，这些宏观症状可能不足以提示临床医生如何管理这种情况，因为这些症状出现在癌症的晚期。我们需要了解癌症恶病质进展过程中的早期事件，以免错过控制这种复杂综合征的临床机会。最近的研究表明，癌症对宿主的影响比以前认识的要广泛得多，包括肝功能和免疫系统的破坏。此外，这些变化在可见的远处转移发生之前就已经出现（即在早期的局部癌症中）。有鉴于此，我们建议将癌症恶病质的定义扩大到包括宿主生理学的所有由癌症引起的变化，包括早期局部癌症引起的变化。这种癌症恶病质的新定义可以为这一主题提供一个新的视角，从而激发对新型癌症恶病质治疗方法的研究和开发。
