Nutritional Problems and Changes in Body Composition in Patients With Non-small Cell Lung Cancer (LEKS)
Nutritional Problems and Changes in Body Composition in Patients With Non-small Cell Lung Cancer (LEKS)
Weight loss and loss of lean body mass are common and associated with adverse outcomes such
 as loss of strength, reduced immune- and pulmonary function and increased disability in
 advanced cancer. Progressive weight loss interferes with cancer therapy and is responsible
 for reduced quality of life (QoL) as well as shorter survival irrespective of tumour mass or
 presence of metastases. Weight loss in advanced cancer is regarded as a major clinical
 challenge because of its serious consequences, its varying aetiology and the contribution of
 multiple pathophysiological mechanisms that are poorly disentangled.
Weight loss and loss of lean body mass are common and associated with adverse outcomes such
 as loss of strength, reduced immune- and pulmonary function and increased disability in
 advanced cancer. Progressive weight loss interferes with cancer therapy and is responsible
 for reduced quality of life (QoL) as well as shorter survival irrespective of tumour mass or
 presence of metastases. Weight loss in advanced cancer is regarded as a major clinical
 challenge because of its serious consequences, its varying aetiology and the contribution of
 multiple pathophysiological mechanisms that are poorly disentangled.

 The main contributor to weight loss in advanced cancer is considered to be development of
 cancer cachexia. The term refers to a syndrome of progressive loss of body weight and muscle
 atrophy involving two parallel pathways, i.e. negative energy balance and inflammation-driven
 catabolism. The negative energy balance may be a direct result of malnutrition caused by
 cancer and treatment related symptoms that interfere with food intake and routine assessment
 of nutritional status is therefore advocated. The interaction and relative contribution of
 these pathways in the development of cancer cachexia are, however, poorly understood. Through
 novel use of traditional clinical data and biological markers, we propose to investigate the
 interplay and magnitude of the processes involved in the development of cancer cachexia. This
 will contribute to a new understanding that may lead to more precise identification of
 remediable factors and improved treatment. In this context, we will also investigate the
 relevance of using screening tools for nutritional status, as advocated by the Norwegian
 Health Authorities. However, in advanced cancer the identifying ability of the recommended
 screening tools is poorly documented.

 The present study is part of a larger project by our group. The overall project includes two
 parallel studies based on the same comprehensive data collection, targeting patients with
 non-small cell lung cancer (NSCLC). Tumours of the lung are one of the most common causes of
 cancer related weight loss. These patients are therefore an ideal target for studying the
 mechanisms and impact of nutritional problems and cachexia, as proposed in the present study.
 The other parallel study, which is approved by the Regional Committee for Medical and Health
 Research Ethics (REC), Region South East (2012/830), aims at describing the frequency and
 development of weight loss in NSCLC patients, and its relation to tumour stage, response and
 side effects of chemotherapy.

 This study also makes part of a larger research effort focusing on cachexia and changes in
 body composition in cancer patients by our group. A study on the impact of sarcopenia (severe
 muscle loss) in NSCLC is ongoing as well a prospective study on cachexia in pancreatic
 cancer, using the same assessments as the present study. The present study will significantly
 contribute to the understanding of the mechanisms of weight loss and cachexia in advanced
 cancer in general and in NSCLC in particular, and will provide knowledge that is needed to
 improve medical treatment and follow-up of a large group of patients. Thus, the study is in
 line with the research strategy from the South-Eastern Norway Regional Health Authority
 (South-Eastern Norway RHA). Furthermore, the study emerges from a multidisciplinary research
 network representing several areas of medical and nutritional expertise and with an
 established international partnership.
Inclusion Criteria:

 -  Clinical diagnosis of NSCLC.

 -  No other active cancer.

 -  Must be able to consent.

 -  Fluent in Norwegian.

 Exclusion Criteria:

 -  Other active cancer than NSCLC

 -  Younger than 18 years