Ayurveda in Cancer Cachexia: Nutritional Interventions, Inflammatory Pathways, and QoL Outcomes - A Review Across Solid Tumors

Abstract

Background: Cancer cachexia is a multifactorial syndrome characterized by ongoing loss of skeletal muscle mass (with or without fat loss) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. It is common in advanced solid tumors and is associated with treatment intolerance, poor quality of life (QoL), and reduced survival. Objective: To synthesize evidence on (i) nutritional and multimodal interventions for cancer cachexia across solid tumors, (ii) key inflammatory and metabolic pathways that drive anorexia and muscle wasting, and (iii) the potential role of Ayurveda-informed nutritional and supportive strategies as adjuncts to standard care. Method: This structured narrative review integrates international consensus definitions and major guidelines with focused appraisal of clinical trials, systematic reviews, and widely used assessment/PRO instruments relevant to cachexia. Ayurveda-aligned interventions were included when clinical evidence plausibly mapped to cachexia domains (intake, inflammation, function, or QoL). Result: Consensus and guidelines emphasize early screening, dietitian-led counseling, symptom control, and escalation to oral/enteral/parenteral support when appropriate. Inflammatory signaling (IL‑6/STAT3, NF‑κB), neuroendocrine dysregulation, and altered muscle protein turnover drive muscle loss and anorexia. Nutrition-only approaches often yield modest benefits; multimodal strategies integrating nutrition and exercise are increasingly prioritized. Pharmacologic agents (e.g., progestins, corticosteroids, ghrelin agonists) mainly improve appetite and weight and less consistently improve function. Ayurveda-informed adjuncts - anti-inflammatory phytochemicals (curcumin), adaptogens (Withania somnifera), and symptom-focused measures such as mucositis prevention - may help selected patients with intake and QoL, but cachexia-specific evidence is limited and safety/interaction assessments are essential Conclusion: Cachexia care should be initiated early and delivered as integrated, patientcentered multimodal management. Ayurveda-informed strategies can be positioned as adjuncts within evidence-based care pathways, with emphasis on standardization, monitoring, and clinically meaningful endpoints (function, QoL, body composition).