The Importance of Functional Assessment in Advanced Cancer and Cachexia

It goes without saying that the best way to treat cancer cachexia is to treat successfully the patient's cancer. For some patients oncological therapy may be influenced by chronological age [45,46]. However, it is often recognised that physiological age is perhaps more important. Functional assessment may provide one measure of this robustness and contribute to the shift in medical treatment delivery away from being unduly governed by chronological age and towards a greater use of markers of 'biological age' or risk. Understanding the relationship, therefore, between functional status and overall patient 'fitness' and 'reserve' is important.

Unfortunately, for many of patients with advanced solid malignancy, progression of disease occurs despite active oncological therapy. At this point patients have often been weakened by the catabolic side-effects of anti-cancer therapy and their low performance status requires that any anti-cachexia therapy is non-toxic and will improve function. Understanding the determinants of function (such as cachectic muscle performance or mood) may assist in developing such selective therapies in cachexia.

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