Sarcopenia in Cancer Patients
DOI : 10.33371/ijoc.v13i3.628
Introduction: Sarcopenia in cancer patients, especially in advanced stage, recently known as an emerging problem. Firstly, sarcopenia is found in elderly patients. The diagnosis of sarcopenia needs evaluation of muscle composition and function and physical activity. Sarcopenia will give negative impacts such as increased mortality, chemo-toxicity, and decreased quality of life. Here, we review the current evidence describing the definition, impact, risk factors, mechanisms, diagnosis and treatment of sarcopenia in cancer patients.
Method: We identified 48 studies and/or review articles evaluating sarcopenia in cancer patients by searching PubMed and EMBASE databases.
Results: Sarcopenia is reported across all stages and types of cancers. There is a new definition of sarcopenia that is reported in 2019 paper. The risk factors or causes of sarcopenia in cancer are complex depending on the clinical settings of each patient. SARC-F questionnaire can be used to screen cancer patients in clinical settings. The diagnostic evaluation and cut-off measurement of sarcopenia especially in cancer varied across studies. The loss of muscle mass that happens during chemotherapy will make a poor prognosis. Sarcopenia can worsen chemotherapy toxicity. Combination exercise with adequate dietary supplementation, adequate energy, and protein are important in the management of sarcopenia in cancer patients.
Conclusions: Patients with cancer belong to a population at risk of developing sarcopenia before and after chemotherapy. Sarcopenia diagnosis needs the evaluation of muscle mass and muscle strength or physical performance. Physical activity exercise is the best strategy to reduce sarcopenia in cancer patients.
- Rosenborg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127:9905-15.
- Rosenberg IH. Summary comments. Am J Clin Nutr. 1989;50:1231-3.
- Bozzetti F. Forcing the vicious circle: sarcopenia increases toxicity, decreases response to chemotherapy and worsens with chemotherapy. Annals of oncology. 2017;28:2107-18.
- Reed RL, Pearlmutter L, Yochum K, Meredith KE, Mooradian AD. The relationship between muscle mass and muscle strength in the elderly. J Am Geriatr Soc. 1991;39:555-61.
- Hugher VA, Frontera WR, Wood M. Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. J Gerontol A Biol Sci Med Sci. 2001;56:B209-17.
- Manini TM, Clark BC. Dynapenia and aging: an update. J Gerontol A Biol Sci Med Sci. 2012;67:28-40.
- Baumgartner RN, Koehler KM, Gallagher D. Epidemiology of sarcopenia among the elderly in the New Mexico. Am J Epidemiol. 1998;47(8):755-63.
- Harimoto N, Shirabe K, Yamashita YI. Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Br J Surg. 2013;100(11):1523-30.
- Mir O, Coriat R, Blanchet B. Sarcopenia predicts early dose limiting toxicities and pharmacokinetics of sorafenib in patients with hepatocellular carcinoma. PLoS One. 2012;7(5):e37563.
- Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age and Ageing. 2010;39:412-23.
- Goodpaster BH, park SW, Harris TB. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2006;61:1059-64.
- Cruz-jentoft AJ, Bahat G, Bauer J, Boire Y, Bauyere O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019;48:16-31.
- Morley JE, Anker SD, von Haehling S. Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014. J Cachexia Sarcopenia Muscle. 2014;5:253-9.
- Kim TN, Choi KM. Sarcopenia: definition, epidemiology, and pathophysiology. J Bone Metab. 2013;20:1-10.
- Marcell TJ. Sarcopenia: causes, consequences, and preventions. J Gerontol A boil Sci Med Sci. 2003;58:M911-6.
- Du Bois D, Du Bois EF. Clinical calorimetry: tenth paper. A Formula to estimate the approximate surface area if height and weight be known. Arch Intern Med (Chic). 2016;17:863-71.
- Morgan DJ, Bray KM. Lean body mass as a predictor of drug dosage. Implications for drug therapy. Clin Pharmacokinet. 1994;26(4):292-307.
- Prado CM, Baracos VE, McCargar LJ, Mourtzakis M, Mulder KE, Reiman T, et al. Body composition as an independent determinant of 5-flurouracil-based chemotherapy toxicity. Clinical cancer research: an official journal of the American Association for cancer research. 2007;13:3264-8.
- Prado CM, Lima IS, Baracos VE. An exploratory study of body composition as a determinant of epirubicin pharmacokinetics and toxicity. Cancer Chemother Pharmacol. 2011;67(1):93-101.
- Crosby V, D’Souza C, Bristow C. Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study. Support care cancer. 2017;25(4):1257-61.
- Prado CM, Baracos VE, McCargar LJ. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009;15:2920-6.
- Gusella M, Tosso S, Ferrazzi E, Ferrari M, Padrini R. Relationship between body composition parameters and flurouracil pharmacokinetics. Br J Clin Pharmacol. 2002;54:13-9.
- Aslani A, Smith RC, Allen BJ, Pavlakis N, Levi JA. The predictive value of body protein for chemotherapy-induced toxicity. Cancer. 2000;88:796-803.
- Yancik R. Population aging and cancer: cross-national concern. Cancer J. 2005;11:437-41.
- Andersen JL. Muscle fibre type adaptation in elderly human muscle. Scand J Med Sci Sports. 2003;13:40-7.
- Extermann M. Measurement and impact of comorbidity in older cancer patients. Crit Rev Oncol Hematol. 2000;35:181-300.
- Bozzetti F, mariani L, Lo VS. The nutritional risk in oncology: a study of 1453 cancer outpatients. Support care cancer. 2012;20:1919-28.
- Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr. 2006;84:475-82.
- Burden ST, Hill J, Shaffer JL. Nutritional status of preoperative colorectal cancer patients. J Hum Nutr Diet. 2010;23:402-7.
- Kortebein P, Ferrando A, Lombeida J. Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA. 2007;297:1772-4.
- Khal J, Wyke SM, Russel ST. Expression of the ubiquitin-proteasome pathway and muscle loss in experimental cancer cachexia. Br J Cancer. 2005;93:774-80.
- Bossola M, Muscaritoli M, Costelli P. Increased muscle proteasome activity correlates with disease severity in gastric cancer patients. Ann Surg. 2003;237:384-9.
- Koppenil WH, Bounds PL, Dang CV. Otto Warburg’s contribution to current concepts of cancer metabolism Nat Rev Cancer. 2011;11:325-37.
- Qing G, Li B, Vu A. ATF4 regulates MYC- mediated neuroblastoma cell death upon gluttamin deprivation. Cancer cell. 2012;22:531-44.
- Cederholm T, Barazzoni R, Austin P. ESPEN guidelines on definitions and terminology of clinical nutrtion. Clin Nutr. 2017;36:49-64.
- Cederholm T, Jensen GI, Correia M. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr. 2018; 1440.
- Morley JE, Abbatecola AM, Argiles JM. Sarcopenia with limited mobilty: an international consensus. J Am Med Dir Assoc. 2011;12:403-9.
- Malmstrom TK, Miler DK, Simonsick EM. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7:28-36.
- Woo J, Leung J, Morley JE. Defining sarcopenia in terms of incident adverse outcomes. J Am Med Dir Assoc. 2015;16:247-52.
- Bahat G, Yilmazi O, Kilic C. Performances of SARC-F in regard to sarcopenia definitions, muscle mass and functional measures. J Nutr Health Aging. 2018 doi:10.1007/s12603-018-1067-8. Epub ahead of print.
- Ishii S, Tanaka T, Shibasaki K. Development of a simple screening test for sarcopenia in older adults. Geriatr Gerontol Int. 2014;14(Suppl 1): 93-101.
- Christensen JF, Jones LW, Anderson JL, Daugaard G, Rorth M, Hojman P. Muscle dysfunction in cancer patients. Annals of oncology. 2014;25(5):947-58.
- Kilgour RD, Vigano A, Trutschningg B. Cancer-related fatigue: the impact of skeletal muscle mass and strength in patients with advanced cancer. J Cachexia Sarcopenia Muscle. 2010;1:177-85.
- Kim J, Davenport P, Sapienza C. Effect of expiratory muscle strength training on elderly cough function. Arch Gerontol Geriatr. 2009;48:361-6.
- Beaudart C, McCloskey E, Bruye O, Cesari M, Rolland Y, Rizzoli R. Sarcopenia in daily practice: assessment and management. BMC Geriatrics. 2016;170(16):1-10.
- Chen LK, Liu LK, Woo J, Assntachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc. 2014;15:95-101.
- Quest editors. Growing research on sarcopenia in Asia. Geriatr Gerontol Int. 2014;14 (Suppl. 1): 1-7.
- Mortzakis M, Prado CM, Lieffers JR. A Practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab. 2008;33:997-1006.
- Kim EY, Kim YS, Park I. Prognostic significance of CT-determined sarcopenia in patients with small-cell lung cancer. J Thocac Oncol. 2015;10:1795-9.
- Gu DH, Kim MY, Seo YS. Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis. Clin Mol Hepatol. 2018;24:319-30.
- Baracos VE. Psoas as a sentinel muscle for sarcopenia: a flawed premise. J Cachexia Sarcopenia Muscle. 2017;8”527-28.
- Lynch NA, Metter EJ, Lindle RS. Muscle quality. Age-associated differences between arm and leg muscle groups. J Appl Physiol. 1999;86:188-94.
- Heymsfiled SB, Gonzales MC. Skeletal muscle mass and quality: evolution of modern measurement concepts in the context of sarcopenia. Proc Nutr Soc. 2015;74:355-66.
- Limpawattana P, Kotruchin P, Pongchaiyakul C. Sarcopenia in Asia. Osteoporosis and sarcopenia. 2015;1:92-7.
- Montero-fernandez N, Serra-rexach JA. Role of exercise on sarcopenia in the elderly. Eur J Phys Rehabil Med. 2013;49:131-43.
- Malafarina V, Uriz-Otano F, Iniesta R, Gil-Guerrero L. Sarcopenia in the elderly: diagnosis, physiopathology and treatment. Maturitas. 2012;71:109-14.
- Liu CJ, Latham N, Can progressive resistance strength training reduce physical disability in older adults? A meta-analysis study. Disabil rehabil. 2011;33:87-97.
- Burton LA, Sumukadas D. Optimal management of sarcopenia. Clin Interv Aging. 2010;5:217-28.
- Peterson MD, Rhea MR, Sen A, Gordon PM. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev. 2010;9:226-37.
- Kim HK, Suzuki T, Saito K, Yoshida H, Kobayashi H, Kato H. effects of exercise and amino acids supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. J Am Geriatr Soc. 2012;60:16-23.
- Anagnotis P, Dimopoulou C, Karras S, Lambrinoudaki I, Goulis DG. Sarcopenia is post-menopausal women: is there any role for vitamin D?. Maturutas. 2015;82(1):56-64.
- Daly RM. Independent and combined effect of exercise and vitamin D on muscle morphology, function and falls in the elderly. Nutrients. 2010;2:1005-17.
- Borst SE. Interventions for sarcopenia and muscle weakness in older people. Age Ageing. 2004;33:548-55.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.