What is cancer anorexia-cachexia syndrome? A historical perspective

Cancer anorexia-cachexia syndrome (CACS) is a lethal but poorly defined involuntary wasting disorder. Loss of skeletal muscle and fat distinguishes it from starvation. Cachexia has been described as a clinical syndrome since ancient times, and the poor prognosis has long been acknowledged. In this article we have reviewed historical perspectives on cancer cachexia, and commented on modern definitions. In cancer cachexia, most historical descriptions included anorexia, wasting and a pale complexion.

Ring-fencing a budget for cancer drugs: is it fair?

Ring-fencing is defined as protecting funds for use in a specific area. In the National Health Service in the UK, various methods to ring-fence cancer have been employed over the years; more recently the Cancer Drugs Fund in England has enabled cancer drugs that would not normally be considered cost-effective to be provided to patients. This has created variation in provision between England and the devolved countries. While some would argue that ring-fencing allows major advances to be made in the treatment of a particular condition, others would argue that it is intrinsically unfair.

Diagnosis and management of bone metastases

Bone metastases are a common feature of many cancers and patients with a previous history of cancer may present with bony symptoms to many different specialties. It is, however, easy to mistakenly diagnose secondary bone cancer in patients who have abnormal imaging, when the cause of the symptoms and the abnormal imaging results is benign disease. In this review, common diagnostic mistakes are described with examples of imaging of both benign and malignant bony disease.