CANCER CACHEXIA STAGES: DO THEY PREDICT QUALITY OF LIFE?

Popi Kasvis1,3, Robert D. Kilgour1,2, Antonio Vigano1,3

1 McGill Nutrition and Performance Laboratory, McGill University Health Centre, Montreal, Quebec, Canada
2 Department of Exercise Science, Concordia University, Montreal, Quebec, Canada
3 Supportive and Palliative Care Division, McGill University Health Centre, Montreal, Quebec, Canada

Introduction: Cancer cachexia is associated with decreased quality of life (QoL) in advanced cancer patients. It is unclear whether cancer cachexia stages (CCS) will predict differences in commonly used QoL measures.

Objectives: To determine the association between CCS and two commonly used measures of QoL: 1) “Wellbeing” on the Edmonton Symptom Assessment Scale and 2) the Distress Thermometer.

Methods: Five hundred and twelve cancer patients who took part in a Cancer Rehabilitation Program at the McGill University Health Centre (Montreal, Quebec) were classified into the following CCS stages: non-cachexia (NC=172), pre-cachexia (PC=115), cachexia (C=154), and refractory cachexia (RC=71). Mixed model ANOVA was used to determine differences in wellbeing and distress among the CCS stages. A score ≥ 4 indicates a level of distress or lack of wellbeing requiring intervention.

Results: Average wellbeing in all CCS was > 4. Only RC patients showed a significantly greater lack of wellbeing when compared to the other 3 groups (p<0.0001). Similarly, RC patients demonstrated significant increases in distress than the NC and C groups (p<0.0024). 

Conclusion: Patients in the most severe stage of cachexia (RC) exhibit significantly greater distress and less wellbeing than those in other cachexia stages. Thus, comfort care measures should be of primary importance in RC patients.

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