Psychosocial Effects of Cancer Cachexia: A Systematic Literature Search and Qualitative Analysis

Context. 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. Objectives. To review the existing evidence of psychosocial effects of cancer cachexia with the aim of identifying factors that might be modified to improve outcomes. Methods. 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. Results. 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. Conclusion. 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. Crown Copyright (c) 2013 Published by Elsevier Inc. on behalf of U.S. Cancer Pain Relief Committee. All rights reserved.