Cancer cachexia and dysphagia: a systematic literature review
DOI:
https://doi.org/10.33178/SMJ.2024.1.4Keywords:
Cachexia, Dysphagia, Head and neck cancer, Tumour, Swallow, InflammationAbstract
Background: Dysphagia is a difficulty in swallowing. Cancer cachexia is a generalised muscle loss disorder common in patients with late-stage disease. The prevalence of dysphagia in patients with head and neck cancer is well documented. However, it is postulated that cancer cachexia can, through systemic muscle loss, cause weakening of swallowing muscles and dysphagia. This review aimed to evaluate the scope of the association between cancer cachexia (excluding head and neck cancer) and dysphagia.
Methods: A systematic review was conducted using the PRISMA P guidelines. PubMed and Embase databases were searched for papers including terms related to (1) cancer, (2) cachexia and (3) dysphagia. Results were imported to Zotero software manager, where duplicates were removed. The remaining articles were screened using pre-determined eligibility criteria. Eligible papers were retained for data extraction, data synthesis and narrative synthesis. Risk of bias was evaluated using the CASP cohort and case control tools.
Results: Four studies met the eligibility criteria. These papers reported an association between cancer cachexia and dysphagia, with odds ratios of 2.1 [P=0.033] and 1.8 [P=0.018]. Prevalence of dysphagia was 16% higher in cancer patients with cachexia.
Conclusion: These findings suggest a positive association between cancer cachexia and dysphagia. However, due to the limited number of papers included, their heterogeneity and their limitations, it is difficult to draw a robust conclusion. Sarcopenia or neurodegenerative disease may have contributed to these results. Regardless, these four studies support the requirement for dysphagia assessment in patients with cancers outside swallow regions.
References
Dysphagia - Guidance. RCSLT. (2021). Retrieved March 17, 2022, from https://www.rcslt.org/members/clinical-guidance/ dysphagia/dysphagia-guidance/#section-2
Cock, C., & Omari, T. (2017). Diagnosis of swallowing disorders: How we interpret pharyngeal manometry. Current Gastroenterology Reports, 19(3). https://doi.org/10.1007/ s11894-017-0552-2
Hutcheson, K. A., Lewin, J. S., Barringer, D. A., Lisec, A., Gunn, G. B., Moore, M. W. S., & Holsinger, F. C. (2012). Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer, 118(23), 5793–5799. https://doi.org/10.1002/cncr.27631
Raber-Durlacher, J. E., Brennan, M. T., Verdonck-de Leeuw, I. M., Gibson, R. J., Eilers, J. G., Waltimo, T., Bots, C. P., Michelet, M., Sollecito, T. P., Rouleau, T. S., Sewnaik, A., Bensadoun, R.-J., Fliedner, M. C., Silverman, S., & Spijkervet, F. K. (2011). Swallowing dysfunction in cancer patients. Supportive Care in Cancer, 20(3), 433–443. https://doi.org/10.1007/s00520-011- 1342-2
Frowen, J., Hughes, R., & Skeat, J. (2019). The prevalence of patient-reported dysphagia and oral complications in cancer patients. Supportive Care in Cancer, 28(3), 1141–1150. https:// doi.org/10.1007/s00520-019-04921-y
Panebianco, M., Marchese-Ragona, R., Masiero, S., & Restivo, D. A. (2020). Dysphagia in neurological diseases: A literature review. Neurological Sciences, 41(11), 3067–3073. https://doi. org/10.1007/s10072-020-04495-2
Nguyen, N. P., Vos, P., Moltz, C. C., Frank, C., Millar, C., Smith, H. J., Dutta, S., Alfieri, A., Lee, H., Martinez, T., Karlsson, U., Nguyen, L. M., & Sallah, S. (2008). Analysis of the factors influencing dysphagia severity upon diagnosis of head and neck cancer. The British Journal of Radiology, 81(969), 706–710. https://doi.org/10.1259/bjr/98862877
Szczesniak, M. M., Maclean, J., Zhang, T., Graham, P. H., & Cook, I. J. (2014). Persistent dysphagia after head and neck radiotherapy: A common and under-reported complication with significant effect on non-cancer-related mortality. Clinical Oncology, 26(11), 697–703. https://doi. org/10.1016/j.clon.2014.08.009
King, S. N., Dunlap, N. E., Tennant, P. A., & Pitts, T. (2016). Pathophysiology of radiation-induced dysphagia in head and neck cancer. Dysphagia, 31(3), 339–351. https://doi.org/10.1007/s00455-016-9710-1
Teunissen, S. C. C. M., Wesker, W., Kruitwagen, C., de Haes, H. C. J. M., Voest, E. E., & de Graeff, A. (2007). Symptom prevalence in patients with incurable cancer: A systematic review. Journal of Pain and Symptom Management, 34(1), 94–104. https://doi.org/10.1016/j. jpainsymman.2006.10.015
Fearon, K., Strasser, F., Anker, S. D., Bosaeus, I., Bruera, E., Fainsinger, R. L., Jatoi, A., Loprinzi, C., MacDonald, N., Mantovani, G., Davis, M., Muscaritoli, M., Ottery, F., Radbruch, L., Ravasco, P., Walsh, D., Wilcock, A., Kaasa, S., & Baracos, V. E. (2011). Definition and classification of Cancer cachexia: An international consensus. The Lancet Oncology, 12(5), 489–495. https://doi.org/10.1016/s1470 2045(10)70218-7
Argilés, J. M., Busquets, S., Stemmler, B., & López-Soriano, F. J. (2014). Cancer cachexia: Understanding the molecular basis. Nature Reviews Cancer, 14(11), 754–762. https://doi.org/10.1038/nrc3829
Giordano, A., Calvani, M., Petillo, O., Carteni', M., Melone, M. R., & Peluso, G. (2003). Skeletal muscle metabolism in physiology and in cancer disease. Journal of Cellular Biochemistry, 90(1), 170–186. https://doi.org/10.1002/jcb.10601
Ross, P. J., Ashley, S., Norton, A., Priest, K., Waters, J. S., Eisen, T., Smith, I. E., & O'Brien, M. E. (2004). Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers? British Journal of Cancer, 90(10), 1905–1911. https://doi.org/10.1038/ sj.bjc.6601781
Couch, M., Lai, V., Cannon, T., Guttridge, D., Zanation, A., George, J., Hayes, D. N., Zeisel, S., & Shores, C. (2007). Cancer cachexia syndrome in head and neck cancer patients: Part I. diagnosis, impact on quality of life and survival, and treatment. Head & Neck, 29(4), 401–411. https://doi.org/10.1002/hed.20447
Arthur, S. T., Noone, J. M., Van Doren, B. A., Roy, D., & Blanchette, C. M. (2014). One-year prevalence, comorbidities and cost of cachexia-related inpatient admissions in the USA. Drugs in context, 3, 212265. https://doi.org/10.7573/dic.212265
Okuni, I., Otsubo, Y., & Ebihara, S. (2021). Molecular and neural mechanism of dysphagia due to cancer. International Journal of Molecular Sciences, 22(13), 7033. https://doi.org/10.3390/ijms22137033
Kenny, C., Regan, J., Balding, L., Higgins, S., O'Leary, N., Kelleher, F., McDermott, R., Armstrong, J., Mihai, A., Tiernan, E., Westrup, J., Thirion, P., & Walsh, D. (2019). Dysphagia prevalence and predictors in cancers outside the head, neck, and upper gastrointestinal tract. Journal of Pain and Symptom Management, 58(6). https://doi.org/10.1016/j.jpainsymman.2019.06.030
Amano, K., Morita, T., Koshimoto, S., Uno, T., Katayama, H., & Tatara, R. (2018). Eating-related distress in advanced cancer patients with Cachexia and family members: A survey in palliative and supportive care settings. Supportive Care in Cancer, 27(8), 2869–2876. https://doi. org/10.1007/s00520-018-4590-6
Lasheen, W., & Walsh, D. (2009). The cancer anorexia-cachexia syndrome: Myth or reality? Supportive Care in Cancer, 18(2), 265–272. https://doi.org/10.1007/s00520-009-0772-6
Wakabayashi, H., Matsushima, M., Uwano, R., Watanabe, N., Oritsu, H., & Shimizu, Y. (2015). Skeletal muscle mass is associated with severe dysphagia in cancer patients. Journal of Cachexia, Sarcopenia and Muscle, 6(4), 351–357. https://doi.org/10.1002/jcsm.12052
Tamura, F., Kikutani, T., Tohara, T., Yoshida, M., & Yaegaki, K. (2012). Tongue thickness relates to nutritional status in the elderly. Dysphagia, 27(4), 556–561. https://doi.org/10.1007/s00455-012-9407-z
White, G. N., O'Rourke, F., Ong, B. S., Cordato, D. J., & Chan, D. K. (2008). Dysphagia: causes, assessment, treatment, and management. Geriatrics, 63(5), 15–20.
Kunieda, K., Ohno, T., Fujishima, I., Hojo, K., & Morita, T. (2013). Reliability and validity of a tool to measure the severity of dysphagia: The Food Intake Level Scale. Journal of Pain and Symptom Management, 46(2), 201–206. https://doi.org/10.1016/j.jpainsymman.2012.07.020
Crary, M. A., Mann, G. D., & Groher, M. E. (2005). Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Archives of Physical Medicine and Rehabilitation, 86(8), 1516–1520. https://doi.org/10.1016/j.apmr.2004.11.049
Santilli, V. (2014). Clinical definition of sarcopenia. Clinical Cases in Mineral and Bone Metabolism. https://doi.org/10.11138/ ccmbm/2014.11.3.177
Boehm, I., Miller, J., Wishart, T. M., Wigmore, S. J., Skipworth, R. J. E., Jones, R. A., & Gillingwater, T. H. (2020). Neuromuscular junctions are stable in patients with cancer cachexia. Journal of Clinical Investigation, 130(3), 1461–1465. https://doi.org/10.1172/jci128411
Downloads
Published
License
Copyright (c) 2024 Mark Leahy
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
