Background There remains no cure for cachexia. In the UK up to 60% of patients with a diagnosis of advanced cancer will develop cachexia. Palliative patients and their family frequently experience emotional distress as a result.

Aim To critically appraise the literature relating to the emotional impact of cachexia to make recommendation to change practice.

Methods A systematic literature review was conducted using five databases exploring literature from 2008 to 2018. The research question was structured using the PEO framework, which assisted in narrowing down pertinent keywords. Critical appraisal of the articles was conducted using tools such as the Critical Appraisal Skills Programme.

Results 1042 articles were identified, limits were applied followed by set inclusion and exclusion criteria narrowing the search to 29 articles. Following critical appraisal eight papers were included.

Conclusion Palliative patients and their family frequently experience emotional distress, as a result of cancer cachexia. The review identified the main factors that contribute or exacerbate the wide range of negative emotions experienced between patients and their family are: reduced dietary intake, conflict over food, lack of information, lack of understanding and knowledge, and perceived neglect from Healthcare Professionals (HCPs). Therefore, there is a need from the patient and family for psychosocial and educational support from the HCP. However, this review demonstrated that the HCP also requires educational support around cachexia to be able to provide support. A theme was identified, that if a conversation began around cachexia that this would then lead onto more difficult conversations relating to death and dying, and the HCP did not feel capable of this. In summary, those HCP who routinely work within specialist palliative care appear to be more able to provide this support, whereas, for others in disciplines related to palliative care there appears to be a need for development.