The socioeconomic impact of cachexia in elderly patients with advanced lung cancer

This study looked at the impact of cachexia (weakness or wasting of the body) in elderly patients with advanced non-small-cell lung cancer on disability, hospitalization and medical costs. The authors concluded that patients with cachexia had a higher risk of disability, longer hospital stays and higher medical costs, while being treated with chemotherapy.

Due to the aging global population, there is a larger population of elderly people living with advanced lung cancer. These patients are commonly dependent on others for daily activities. Furthermore, there is a financial impact as they are frequently hospitalized and require regular treatments.

Cachexia refers to the wasting of the body, with decreased muscle and tissue mass, due to a chronic illness. Cancer cachexia is common in elderly patients with advanced non-small-cell lung cancer (NSCLC). These patients are physically weak, have a higher risk of disabilities and prolonged hospitalization. There is currently very limited information on the impact and management of cachexia in elderly patients with advanced NSCLC.

This study aimed to estimate the impact of cachexia on daily activities, length of hospital stay and inpatient medical costs among elderly patients with advanced NSCLC. The study included 30 elderly patients receiving chemotherapy for advanced NSCLC.

Of these 30 patients, 19 had cancer cachexia. Patients received chemotherapy and were followed up for an average of 10.7 months.

There was no difference in treatment response or survival rate between patients with cachexia and those without. Patients with cachexia had a shorter disability free survival (DFS, time from beginning study until disability onset) than those without, with an average DFS of 7.5 months compared to 17.1 months. Cachectic patients had longer average post-disability survival of 2.5 months compared to 0.7 months for non-cachectic patients.

Cachectic patients had longer combined hospital stays of 80.7 days per person compared to 38.5 days for non-cachectic patients. They also had more frequent unplanned outpatient visits and emergency hospitalizations with 4.2 times per person compared 1.7 times per person for non-cachectic patients.

Finally, cachectic patients had higher inpatient medical costs.

The authors concluded that during chemotherapy treament, patients with cachexia had a higher risk of disability, prolonged hospitalization and increased medical costs than those without cachexia.