What proportion of cancer patients present with weight loss at the time of diagnosis?

• A. Less than 10%
• B. About one quarter
• C. More than half
• D. Almost none

Answer: (D)

Weight loss at cancer diagnosis reflects cancer-associated malnutrition and cachexia, driven by tumor-induced catabolism, inflammatory cytokines, reduced appetite, and decreased intake. Because these processes are active early in many cancers, a large majority of patients experience some weight loss by the time they are diagnosed, often more than half. The exact proportion varies by cancer type and stage, with higher rates in cancers prone to cachexia and in more advanced disease. Recognizing weight loss is important because it predicts poorer tolerance to treatment, higher infection risk, impaired wound healing, and worse prognosis. The idea that weight loss is rare would not fit typical clinical experience.