I read with great interest the recent article reporting the relation between skeletal muscle mass and dysphagia in cancer patients by Hidetaka Wakabayashi et al.1 In criteria for the diagnosis of sarcopenia, loss of muscle mass, reduced handgrip strength, or gait speed is assessed as representative value of impaired muscle strength or physical performance.2, 3 Assessment of oral motor and feeding function is not common in diagnostic testing for sarcopenia or cachexia; however; loss of muscle mass is supposed to be spread throughout the entire body.
Insufficient dietary intake and decreased appetite are major factors for loss of muscle mass.4 Therefore, increasing dietary intake and appetite could be one of the treatments for improvement of muscle wasting. However, some complications of cancer or chemotherapy often interfere with appetite, oral motor and feeding function in cancer patients.5, 6 Loss of muscle mass and impaired physical performance, and activity of daily living (ADL) induced by cancer and chemotherapy cannot be fully reversed by conventional nutritional support alone.7, 8 These clinical trials support the hypothesis that nutritional support would not be enough for strategy in advanced cancer patients with of oral motor and feeding dysfunction. In order to make a better understanding the strategy of cancer patients with sarcopenia or cachexia, evaluation of the oral motor and feeding function is no less important than assessment of dietary habit or nutritional status according to biochemical, anthropometric measures, and nutritional screening tool. It remains unclear whether hybrid strategy combining both nutritional support and exercise or rehabilitation affected on the loss of muscle mass, impaired ADL, and quality of life in cancer patients with dysphagia accompanied by sarcopenia or cachexia.4, 9 Further advances are required.
Acknowledgements
We acknowledge support by the German Research Foundation and the Open Access Publication Funds of the Göttingen University. The authors certify that they comply with the ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2015.10
Conflicts of interest
M. Saitoh, J. Ishida, M. Konishi, and J. Springer declare that they have no conflict of interest.
Saitoh, M. , Ishida, J. , Konishi, M. , and Springer, J. (2016) The concept that focuses on oral motor and feeding function in cancer patients with muscle wasting. Journal of Cachexia, Sarcopenia and Muscle, 7: 233–234. doi: 10.1002/jcsm.12119.
References
- 1. Wakabayashi H, Matsushima M, Uwano R, Watanabe N, Oritsu H, Shimizu Y. Skeletal muscle mass is associated with severe dysphagia in cancer patients. J Cachexia Sarcopenia Muscle 2015;6:351–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Cruz‐Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M. European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412–23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Morley JE, Cao L. Rapid screening for sarcopenia. J Cachexia Sarcopenia Muscle 2015;6:312–4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Anker SD, Morley JE. Cachexia: a nutritional syndrome? J Cachexia Sarcopenia Muscle 2015;6:269–71. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. Dysphagia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO) , Raber‐Durlacher JE, Brennan MT, Verdonck‐de Leeuw IM, Gibson RJ, Eilers JG, Waltimo T, Bots CP, Michelet M, Sollecito TP, Rouleau TS, Sewnaik A, Bensadoun RJ, Fliedner MC, Silverman S Jr, Spijkervet FK. Swallowing dysfunction in cancer patients. Support Care Cancer 2012;20:433–443. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6. Vaughan VC, Martin P, Lewandowski PA. Cancer cachexia: impact, mechanisms and emerging treatments. J Cachexia Sarcopenia Muscle 2013;4:95–109. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7. Aapro M, Arends J, Bozzetti F, Fearon K, Grunberg SM, Herrstedt J, Hopkinson J, Jacquelin‐Ravel N, Jatoi A, Kaasa S, Strasser F; ESMO (European School of Medical Oncology). Early recognition of malnutrition and cachexia in the cancer patient: a position paper of a European School of Oncology Task Force Ann Oncol 2014; 25: 1492‐9. [DOI] [PubMed] [Google Scholar]
- 8. Omlin A, Blum D, Wierecky J, Haile SR, Ottery FD, Strasser F. Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case‐control study. J Cachexia Sarcopenia Muscle 2013;4:55–61. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9. Bowen TS, Schuler G, Adams V. Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training. J Cachexia Sarcopenia Muscle 2015;6:197–207. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10. von Haehling S, Morley JE, Coats AJS Anker SD. Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2015. J Cachexia Sarcopenia Muscle 2015;6:315–316. [DOI] [PMC free article] [PubMed] [Google Scholar]