[music] ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses. Greg Guthrie: Hi, everyone. I'm Greg Guthrie, a member of the cancer.net content team. And I'll be your host for today's Cancer.Net podcast. Cancer.Net is the patient information website of ASCO, the American Society of Clinical Oncology. Today, we're going to be talking about cachexia. And our guests are Dr. Charles Loprinzi and Hester Hill Schnipper. Dr. Loprinzi is the Regis Professor of Breast Cancer Research at the Mayo Clinic in Rochester Minnesota where he is an emeritus chair of the Division of Medical Oncology and an emeritus vice-chair of the Department of Oncology. He is also the Cancer.Net Associate Editor for Psychosocial Oncology. Thanks for joining us, Dr. Loprinzi. Dr. Charles Loprinzi: It's good to be here, Greg. Greg Guthrie: And Hester is the emeritus manager of oncology social work at Beth Israel Deaconess Medical Center in Boston. And she now works in private practice. A 2-time breast cancer survivor, she's a nationally known speaker, is active in numerous oncology organizations, and has written 2 books about breast cancer. Her daily clinical responsibilities include working with individuals, couples, and families living with cancer, and facilitating support groups. She is also a member of the Cancer.Net Editorial Board. Thanks for joining us today, Hester. Hester Hill Schnipper: Thanks for inviting me. Greg Guthrie: Great. Now, today, ASCO is publishing a new guideline on the management of cancer cachexia. Dr. Loprinzi and Hester both served on the panel for this guideline. Before we begin, we should mention that they do not have any relationships to disclose related to this guideline. But you can find their full disclosure statements on Cancer.Net. Now, let's talk a little bit about what this guideline means for people with cancer and those who care for them. So Dr. Loprinzi, what is cancer cachexia, and how common is it? Dr. Charles Loprinzi: So cancer cachexia, the definition. We oftentimes call it cancer anorexia/cachexia, and so I'll try to define both anorexia and cachexia. A lot of people have heard of anorexia nervosa where people do not eat very well, so it's a loss of appetite is what anorexia is. For the cachexia part, you think of the people in the World War II camps when they came out at the end, where they had not eaten for a long time, and they were very, very, very thin. So cancer anorexia and cachexia is a phenomenon that comes on in patients with cancer, very frequently when they have advanced cancer, but oftentimes when they're just diagnosed, where patients are much thinner, and they're not eating very well. Greg Guthrie:  Hester, did you have something to add on that? Hester Hill Schnipper: I think many patients, when they are newly diagnosed, experience appetite loss even if their weight has been normal up until then. But one of the ways to divide the world, are people who can't stop eating when they're under stress, and people who shut down and don't eat when they're under stress. So plenty of brand-new cancer patients fall into the second category, and, at least for some period of time during the particularly crisis anxiety-filled weeks around diagnosis, are not eating very much or very well. But that, generally, improves then