How Cachexia and Cancer are Related
Cancer cachexia, sometimes referred to as cancer-anorexia cachexia, is a wasting condition that causes almost one third of all cancer deaths across the globe.
This syndrome can be distressing for not only patients, but also for their families. It is a type of metabolic revolt whereby the body aggressively digests skeletal muscle and fatty tissue. It is characterized by a gradual loss of muscle, unpremeditated weight loss and appetite loss. People with cachexia are usually so fragile and weak that even performing everyday tasks such as walking and getting dressed can be an arduous task. This syndrome is common in many cancers, especially in the later stages of the disease. It is most commonly seen in patients with certain cancers, including esophageal, lung, gastric, colorectal, pancreatic, neck and brain cancer.
This condition is characterized by catabolic metabolism, which involves the breakdown of natural bodily processes. Apart from being common in cancer, it also occurs in diseases like emphysema, HIV/AIDS, heart failure and kidney failure.
Causes of Cancer Cachexia
A wide array of factors are involved in the development and advancement of cancer cachexia. They include “tumor factors” which are ingredients synthesized and released by a tumor, and the response of the body to a tumor. More research on the immune system response to cancer and other cachexia triggers is needed to determine the specific factors that influence the development of cachexia.
What are the Symptoms of Cancer Cachexia?
Recent studies show that this syndrome starts well ahead of any weight loss, so symptoms may not manifest themselves during the early phase. Here are four key symptoms of cancer cachexia.
Unintentional Weight Loss
Cachexia triggers involuntary weight loss, which means that weight loss happens without trying to lose weight. It also goes beyond unexplained weight loss. Weight loss may continue even when a sufficient amount of calories are being consumed and when calorie intake exceeds energy expenditure. Involuntary weight loss can be described as a loss of 5% of total body weight within six months.
Loss of Skeletal Muscle
Muscle loss is the main sign of cancer cachexia and happens together with fat loss. In people who are obese or overweight at the time of being diagnosed with this syndrome, substantial muscle wasting can happen without noticeable weight loss.
Loss of Appetite
Cancer cachexia also causes loss of appetite in patients, but this symptom
is a bit different compared to normal appetite loss. This disorder causes a loss of longing for food rather than a reduced longing for food.
Reduced Quality of Life
Loss of skeletal muscle coupled with sudden weight loss can weaken your capability to walk and engage in activities that would otherwise be fun. Complete loss of appetite can keep you from enjoying your favorite meals and drinks.
How Common is Cancer Cachexia?
Given the fact that cancer kills one in four people and that cachexia develops in most people with acute disease, this wasting disorder is extremely common. It has been projected that more than 1.3 million individuals have cancer cachexia in the United States alone. It has also been estimated that this disorder accounts for 20% of all cancer deaths, resulting in over 7.4 million deaths each year around the world.
What Takes Place during Cancer Cachexia?
Cancer cachexia worsens over time due to continual weight loss, causing patients to experience difficulties in participating in daily activities. The condition may happen in phases that are determined by changes in food consumption, weight loss, muscle wasting and capability to function.
During the initial stages, people with this wasting disorder may only detect a minor loss of appetite accompanied by slight weight loss. As the syndrome progresses, patients will detect more weight loss and their appetite will be significantly low. In advanced stages, muscle loss becomes noticeable and the disorder may not respond to regular treatments such as nutritional supplementation and support, leading to significant morbidity and mortality.
Cancer Cachexia Treatment
So far, treatment approaches for this wasting condition have been relatively disappointing. Even with sufficient calorie consumption, reversing the process of cachexia can be an uphill task. The goal of treatment is to activate muscle building (anabolic processes) while impeding muscle breakdown (catabolic processes). Here are some of the treatment approaches for this syndrome.
A Healthy Diet
Calorie replacement and supplementation in the diet has not led to any major difference in the treatment of cachexia. For this reason, it is extremely important to ensure people with cancer and other advanced conditions that trigger the wasting syndrome consume a healthy diet. If someone has been eating less often for a long period of time, consumption should be increased slowly. Rapid intake of calories may cause a side effect known as overfeeding syndrome. If taking food orally becomes impossible, doctors may recommend a feeding tube.
Supplementing a diet with eicosapentaenoic acid (EPA), one of the major omega-3 fatty acids found in fish, is believed to increase inflammatory markers’ levels, which results in a huge difference in cancer cachexia patients. Various studies have linked EPA supplements with a reduction in hospital stays, further infections and complications.
While working out may appear counterintuitive for a person with cachexia, increasing physical activity may provide some relief. Simple exercises like walking may help in improving appetite, while endurance training may help with reducing the loss of muscle.
Various medications and supplements have been used as part of the cachexia treatment plan with some degree of success. They include:
- Megace (megestrol)
- Celebrex (celecoxib)
- Medical marijuana
Cancer cachexia affects many people with cancer. It results in psychological suffering in cancer patients and affects their ability to function, respond to anti-cancer therapies and survive. More research is needed on this life-threatening condition so effective treatment options can be developed to help improve the quality of life and survival rates of cancer patients.