Sunday, December 9, 2007

Cachexia Conference Review; Pal-pourri

I just came home from the 4th Cachexia conference in St. Petersburg, FL. This conference originated in Berlin, and this is the first time it has been hosted in the United States. The primary focus is basic science but the conference had a clinical track, which from prior participants sounds like it is becoming more significant. The speakers and attendees are mostly from Germany, Italy, Japan, and Australia, as well as the US, so this conference surely has an international flair. One great comment I heard from a German physician, after I introduced myself as a palliative care physician was, "Oh. You are finally doing that here in America. I didn't think that was something that had really caught on over hear yet." I heard something similar from a British scientist as well.

While we have been rather pessimistic about treatment of cachexia here at Pallimed, the conference speakers and attendees were are very hopeful about the future of cachexia research and treatment opportunities. It was enlightening to speak to scientists working with animal models of cachexia to give them some insight in how clinicians see (or really don't see) cachexia as part of the disease process in humans.

Approximately 300 attendees were present for the first plenary session which featured some of the leaders in cachexia research: John Morley (St. Louis, USA), Bill Evans (Little Rock, USA), Stefan Anker (Berlin, GER) and Giovanni Mantovani (Cagliari, ITA). Most of the initial lectures focused on the dilemma of definitions and differentiating cachexia from anorexia, sarcopenia, starvation. But despite that attempt at clarification there was still some overlapping definitions among all the speakers later in the conference.

Apparently, only recently has there been some effort to have a consensus statement on defining cachexia. There was even a push at one time to rename cachexia as 'wasting disease syndrome' to be more appealing to Americans. Thankfully that did not win out, since cachexia is a perfectly workable word. It even has an 'x' in it like most popular brand medications, so you think that would help.

While no major breakthroughs in clinical treatment were presented, the conference did help me to really understand how really complex a problem cachexia is, and how knowing this may assist may explanation to families, patients, and medical staff, that it is not as simple as just improving the calorie balance. I am hopeful to see more talks at upcoming palliative care meetings on cachexia. Christine Ritchie and Elizabeth Kvale from University of Alabama Birmingham Center for Palliative Care were also at the meeting to get ideas for their cachexia clinic (a part of their palliative care clinic). They may be good contacts if any readers are looking at working this model into your program or even joining them at UAB.Don't forget about the Pallimed Fund Raiser for, and the contest for HPCF-USA and the Pallimed coffee mugs.

Maurice Bernstein, MD at the Bioethics Discussion Blog brings up the common medical shortcut of referring to patients by their age/sex/room/diagnosis instead of their name and who they are as a person. For suggestions on how to help teach humanism in medicine check out his blog.

A report about deaths increasing from methadone use was released last week. We may feature this issue in an upcoming post.

Blogger Ed Leap with a interesting post on CPR. Could continuing CPR serve for purposes more than just prolonging life?

Photo of the Sunshine Skyway Bridge over Tampa Bay courtesy of Flickr user .Zickie.

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