The Impact of Sarcopenia on Elderly Cancer Patients

Sarcopenia is a progressive loss of skeletal muscle mass and strength with consequent physical disability and negative impact on quality of life. Chemotherapy or surgery efficacy on cancer is influenced by the presence of sarcopenia. In particular, chemotherapy toxicity is influenced by genetic variability because the expression of specific muscular enzymes, i.e. dihydropyrimidine dehydrogenase (DPD), play an important role in the catabolism of anti-cancer drugs. The reduction of the total body DPD activity in muscle tissue due to sarcopenia is related to severe chemotherapy-related side effects such as nausea, vomiting, diarrhea, neutropenia, anemia, and infections. Sarcopenia and its detrimental impact on patients’ prognosis have been shown in several types of cancer, such as lung cancer, renal cancer, hepatocellular carcinoma, esophageal cancer, pancreatic cancer, breast cancer, medullary thyroid carcinoma, colorectal cancer, gastric cancer, urothelial cancer, hematologic malignancies etc. Sarcopenia may be optimally recognized by measures of muscle mass and physical performance and the diagnostic criteria. The presence of sarcopenia in elderly cancer patients should be routinely investigated by physicians in order to carry out appropriate nutritional and pharmacologic interventions.