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Kachexie

Cachexia

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Zusammenfassung

Eine Mangelernährung (ME) entwickelt sich häufig bei fortgeschrittener Tumorerkrankung und ist primär als Gewichtsverlust erkennbar. Parallel lässt sich oft ein betonter Verlust an Muskelmasse nachweisen. Sowohl ein Gewichts- als auch ein Muskelverlust sind mit einer Verschlechterung der Prognose assoziiert. Wichtigste Auslöser des Gewichts- und Muskelverlusts sind Reduktionen der Nahrungsaufnahme und der körperlichen Aktivität. Neben einer Vielzahl von Faktoren, die direkt die Nahrungsaufnahme und die Mobilität vermindern, entwickelt sich häufig eine tumorassoziierte systemische Inflammation, die zusätzlich Appetit und Aktivität unterdrückt und die Kachexie als inflammatorische Form der ME charakterisiert. Ein regelmäßiges Screening aller Tumorpatienten auf ME soll diejenigen Patienten erkennen, denen eine differenziertere Ernährungsdiagnostik angeboten werden soll und die von einem multimodalen Therapiekonzept profitieren können, das eine Optimierung der Nahrungszufuhr, ein Bewegungstraining sowie antinflammatorische Ansätze einschließt. Organisatorisch erfordert dies verbindliche Strukturen und Zuständigkeiten.

Abstract

Malnutrition frequently develops in patients with advanced cancer. It is diagnosed as unintentional weight loss but is often accompanied by a pronounced loss of muscle mass. Both weight loss and loss of muscle mass are associated with an impaired prognosis. The most important causes are an insufficient food intake and a decrease in physical activity. Numerous different tumor and treatment-associated factors may inhibit appetite and mobility. In addition, a cancer-induced systemic inflammatory response frequently develops in these patients and this syndrome is termed cachexia or inflammatory malnutrition. Cachexia suppresses appetite and induces fatigue. All cancer patients should be regularly screened for markers of malnutrition and if there is a suspicion of malnutrition further diagnostic work-up and multimodal treatment of cachexia should be offered, including an adequate supply of energy and nutrients, exercise training and anti-inflammatory agents. Organizing efficient nutritional treatment requires the installation of dedicated structures and the binding delegation of the necessary responsibilities.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Arends gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Tumorbiologie Freiburg, Breisacher Str. 117, 79106, Freiburg, Deutschland

    J. Arends

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Arends, J. Kachexie. Forum 29, 392–399 (2014). https://doi.org/10.1007/s12312-014-1174-3

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  • DOI: https://doi.org/10.1007/s12312-014-1174-3

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