{"entity":{"id":"idea-bio2-cachexia-pathway-code","kind":"idea","name":"Treat wasting like sepsis: a trigger, a bundle, an audit","aka":[],"tldr":"Hospitals have fast, standard responses to sepsis and heart attacks. Cancer wasting has no such pathway, so it is noticed late and treated inconsistently.","summary":"Cachexia care is fragmented across oncology, dietetics, physiotherapy and palliative care, with no trigger threshold and no bundle. A defined pathway is a service intervention that requires no new drug: automatic trigger on weight loss or low muscle mass, same-week multidisciplinary assessment, a standard bundle of nutrition, resistance exercise, symptom control and medication review, and audited outcomes.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Cachexia, toxicity and the limits of the patient): Fearon et al., Definition and classification of cancer cachexia (Lancet Oncology 2011)","url":"https://doi.org/10.1016/S1470-2045(10)70218-7"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["exercise-oncology","geriatric-assessment"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["nathan-cherny"],"bottlenecks":["b-cachexia-supportive","b-care-fragmentation","b-palliative"],"keyPapers":["paper-fearon-lancet-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A triggered cachexia bundle increases the proportion of at-risk patients receiving nutritional and exercise intervention from a minority to over 70%, and improves treatment completion and quality of life.","rationale":"Bundled care with automatic triggers transformed sepsis, stroke and hip fracture outcomes by reducing variation rather than adding technology. Cachexia has the same profile: known components, poor delivery.","test":"Stepped-wedge implementation across several centres with process measures and patient-reported outcomes, plus a cost analysis of avoided admissions.","maturity":"speculative","actor":"clinic","cost":"small","horizonYears":4},"route":"/ideas/idea-bio2-cachexia-pathway-code/","neighbours":{"technology":[{"id":"exercise-oncology","kind":"technology","name":"Exercise & lifestyle oncology","route":"/technologies/exercise-oncology/"},{"id":"geriatric-assessment","kind":"technology","name":"Geriatric assessment","route":"/technologies/geriatric-assessment/"}],"person":[{"id":"nathan-cherny","kind":"person","name":"Nathan Cherny","route":"/people/nathan-cherny/"}],"bottleneck":[{"id":"b-cachexia-supportive","kind":"bottleneck","name":"Cachexia, toxicity and the limits of the patient","route":"/bottlenecks/b-cachexia-supportive/"},{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-palliative","kind":"bottleneck","name":"Pain relief and palliative care are unavailable to most","route":"/bottlenecks/b-palliative/"}],"paper":[{"id":"paper-fearon-lancet-oncol","kind":"paper","name":"Definition and classification of cancer cachexia: an international consensus","route":"/key-papers/paper-fearon-lancet-oncol/"}],"idea":[{"id":"idea-nl-dietitian-in-every-mdt","kind":"idea","name":"A dietitian in every gastrointestinal and head and neck tumour board","route":"/ideas/idea-nl-dietitian-in-every-mdt/"}]}}