Andrea Škripeková
Neoplastic cachexia lowers tolerance of anticancer treatment and it is associated with shortened overall survival of patients with advanced oncological disease. According to the new definition(1) neoplastic cachexia is multifactorial condition syndrome characterized by progressive loss of muscular mass (with the loss or without loss of adipose mass), which is not possible to reverse by conventional nutritious support and it leads to progressing functional worsening. Pathophysiology is characterised by negative energetic and protein balance with reduction of muscular mass (with or without the loss of adipose mass), which cannot be reversed by a simple nutritious supplementation and it leads to progressive lowering of functionality. According to different clinical expression we distinguish so-called phenotype of cachexia (weakness, catabolism induction, with metabolic changes, anorexia) and stages of cachexia (pre-cachexia, syndrome of refractional cachexia). In the management we discuss indications of nutritional intervention (nutritional guidance, oral nutritional supplements, probe nutrition and parenteral nutrition) and medicamentous influence.