Abstract / Summary
BACKGROUND: Cancer cachexia is a devastating multifactorial syndrome that significantly contributes to morbidity and mortality in oncology patients. Despite the availability of international evidence-based guidelines, effective management remains challenging, particularly in low- and middle-income countries. No prior study has systematically evaluated the barriers to cancer cachexia management among physicians in Nigeria, Africa's most populous nation. METHODS: A cross-sectional, questionnaire-based survey was conducted among 242 Nigerian physicians across eight specialties (family medicine, haematology, gynaecological oncology, surgical oncology, radiation oncology, anaesthesiology, gastroenterology, and dental surgery) who manage cancer patients. A barrier grading system (grade 0: <25%, grade 1: 25-50%, grade 2: 50-75%, grade 3: >75%) was developed across five domains: confidence, knowledge, perception, personal practice, and education. RESULTS: The overall practice barrier was highest (grade 2, 60.3%), characterized by inconsistent weight tracking (58.7%) and severe underutilization of multimodal treatments (anti-inflammatories 15.3%, exercise 10.3%). Perception barriers were also prominent (grade 2, 71.1%), with 82.6% citing lack of high-quality evidence and 77.3% lacking effective medications as major challenges. Knowledge barriers (grade 1, 34.7%) varied significantly by specialty (p=0.004), with family medicine showing the highest deficits (52.1%). Alarmingly, 54.5% received no formal education on cancer cachexia. Radiation oncologists demonstrated the lowest barriers overall, while anaesthesiologists and gastroenterologists faced the greatest challenges. CONCLUSION: Substantial and multifaceted barriers impede effective cancer cachexia management among Nigerian physicians. Urgent interventions—including national guidelines, targeted education, and institutional screening protocols—are needed to bridge this critical gap in oncology care.