Cachexia in gastrointestinal cancer

Patients with gastrointestinal cancers often experience body wasting, known as cancer cachexia. This complex phenomenon of progressive depletion of body tissues, manifests as persistent weight loss that cannot be reversed by conventional nutritional support methods. Cancer cachexia significantly diminishes patients’ quality of life, reduces the ability to treat the underlying disease, and imposes burdens on the healthcare system. The diagnostic criteria, clinical presentation, and stages of this disorder are intricate, with the disease progression depending on the individual patient characteristics and the underlying condition. Despite many studies, the intricate mechanisms of cancer cachexia remain incompletely understood. However, they appear to be related to the action of pro-inflammatory cytokines, pro-catabolic factors secreted by the tumour, and hormonal changes. In addition to these factors, appetite disturbances, alterations in protein and fat metabolism, and mechanical obstruction of food absorption in the gastrointestinal tract, depending on the location of the tumour, also play significant roles. Current management of patients with cancer cachexia is multifaceted. Non-pharmacological treatment involves multimodal interventions, which are currently recommended and combine multiple strategies acting synergistically. Pharmacological treatment options are also available; however, many of the substances studied have not yielded the expected results. The aim of this publication is to summarise the current state of knowledge on cachexia in gastrointestinal cancers, incorporating the latest scientific reports in this field.