Dr Aoife Ryan, dietitian and lecturer in nutritional sciences at UCC and Principal Investigator with CCRC, said the wastage affected muscles involved in movement, breathing, and the heart.
“Ten years ago it was thought patients were losing fat. Now we can use their CT scans to measure exactly what patients are losing and we are gaining a huge understanding that the weight loss is actually muscle. It is rapid loss of muscle,” said Dr Ryan.
Cancer patients often develop severe muscle wasting or ‘sarcopenia’, commonly associated with old age.
However, in cancer patients it develops much more rapidly and at a much younger age.
“I have seen cancer patients with a normal muscle mass at diagnosis and two months later they are sarcopenic,” said Dr Ryan.
Severe muscle loss isn’t always hugely visible, as a person could still be overweight or obese.
This is evident from a UCC study, ongoing since 2011, involving 1,020 cancer patients attending chemotherapy at Cork University Hospital and Mercy University Hospital, of whom just 4% looked underweight.
“We rarely see obviously wasted cancer patients anymore, nowadays they look normal or overweight but, underneath that fat, there is very little muscle,” said Dr Ryan.
“Over 40% have sarcopenia and these patients live about half as long as people who maintain their muscle.”
Dr Ryan said up to 80% of cancer patients unintentionally lose weight, which can have a devastating impact on quality of life, reducing ability to tolerate chemotherapy and leading to poor survival rates.
“They are losing weight because cancer causes huge amounts of inflammation in their bodies,” she said.
The goal, therefore, is to dampen down the inflammation and stabilise weight.
To this end, nutritionists and food scientists at UCC are researching the development of innovative protein gels, dietary drinks, and appetite-increasing supplements.
Dr Ryan has spent 12 years studying the EPA fish oil found in salmon, mackerel, and herring. Nutritionists at UCC have joined forces with food scientists to put a high dose of fish oil into a nutritional drink. Dr Ryan said the results have been encouraging.
“Several clinical trials have shown that if we give patients with cancer calories, protein, and a very high dose of a fish oil that it will dampen down inflammation and they will lose less muscle,” she said.
UCC is set to take part in an international study, the MENAC trial, involving patients with lung cancer and pancreatic cancer, designed to tackle ongoing loss of skeletal muscle mass.
Participants will be put on a regimen of fish oil, proteins, calories, Ibuprofen, and exercise therapy and assessed after six and 12 weeks, with the hope of laying a foundation for future nutritional and physical intervention for patients undergoing chemotherapy.