Although there has been significant growth in the understanding of cancer cachexia (1) there has been less published on how best to design specific clinical services for cachexia to assist patients and carers or what outcomes these services achieve (2).
The author initially piloted a dedicated cancer cachexia clinic in Melbourne approximately 11 years ago at another organisation.
Upon moving to Barwon Health in Geelong a dedicated cancer cachexia service (CCS) has been in operation since 2008.
The service has developed constantly during this time and is run very differently than when first piloted. It has been interdisciplinary throughout with the core professional disciplines being Palliative Medicine, Physiotherapy, Dietetics and in the last number of years included a Nurse Practitioner candidate form our community service. Our approach is very much based on multimodal therapy for multidimensional problem (3).
We have had a formal link with a group of basic scientists.
I will describe how the clinic runs from referral / triage, initial assessment, follow-up as well as an overview of the common interventions. We will present the outcomes based on a retrospective audit of the last 8 years showing that we “stabilise / improve” weight, stamina and strength, for a period of time, in a high proportion of patients.
We have also adapted how we support those with advanced cachexia, as we still get many late referrals, in contrast to early or established cachexia as outlined in recent literature (4).
Lastly we will briefly outline future directions of the service that will include Telehealth consultations and additional functional monitoring using accelerometers.