Cachexia, anorexia, and feeding difficulties in palliative care patients

Symptoms related to anorexia (loss of appetite), cachexia (muscle loss and wasting), and dysphagia (reduced ability to eat) are devastating for a person with a palliative illness and their families. They are common, especially as illness advances, and occur in both malignant and nonmalignant illness. Not only do the conditions serve as a visual reminder of chronic disease, they also affect the psychology governing the social aspects of eating. For many years, anorexia, cachexia, and dysphagia as distinct conditions were overlooked by healthcare professionals and researchers as the focus was on the primary chronic illness instead (Fearon et al., Nat Rev Clin Oncol 10(2):90–99, 2013). Clinical research, particularly in the field of cancer cachexia, has gained new insight into the pathogenesis and management of the conditions, including anorexia and dysphagia. This chapter will define the conditions and outline the epidemiology, etiology, and pathophysiology and assessment and management of these symptoms.