Customized care
The test results are used to gain more insight into the mechanisms of cachexia, but also to decide whether the patient can handle the surgery. Olde Damink: “How can you determine whether someone is fit enough? That is one of the great difficulties of surgery. We are now investigating which data we can use to predict whether it is wise to operate. Ultimately, we want to use the personal test results to decide that together with the patient.”
What is known is that a low oxygen uptake – measured with the bicycle test – increases the risk of complications after surgery. That is an indication that someone is too weak for the operation. Olde Damink and Hildebrand, together with the UMC Groningen and the University of Turin, are investigating a personalized training program that will allow patients to gain strength and possibly qualify for surgery.
This ‘pre-treatment’ is tailored to the patient. “People prefer to train at home,” says Hildebrand. “That is why they receive a bicycle ergometer at home, and guidance from a local physiotherapist. We measure progress every week and put together a personal training program based on that. A large proportion of patients have a higher oxygen uptake after training and are still operated on.”
Leader
Because cachexia also occurs in lung cancer and ovarian cancer, the departments of surgery, pulmonary medicine and gynecology work together. The fact that extensive research is being done into what happens in the body in patients with cancer cachexia is unique, says Olde Damink. “If you want to know what the tumor does to people, you have to go to Maastricht. The NUTRIM CRU continues our lead in that area.”