What is cachexia?

Related conditions:
Anorexia

Definition:


Cachexia is a complex syndrome in which changes in the way the body uses food, particularly fat and carbohydrates, lead to loss of muscle and fat. Anorexia (loss of appetite) is sometimes, but not always, associated with cachexia.

Risk factors: Certain cancers such as lung cancer or any cancer of the digestive tract particularly of the esophagus, stomach, and pancreas are more likely to be accompanied by cachexia. It is also common in advanced cancer, although infrequently it occurs in early cancers, sometimes even before diagnosis. Cachexia can also occur with acquired immunodeficiency syndrome (AIDS).

Etiology and the disease process: In cancer-related cachexia, it is thought that the tumor releases chemicals that change food metabolism. Patients with cachexia tend to have poor appetites. Even with nutritional supplementation, the wasting cannot be reversed while the cancer remains.

Incidence: According to the National Cancer Institute (NCI) in 2014, when diagnosed, about 80 percent of patients with cancers in the upper gastrointestinal tract and 60 percent of patients with cancers of the lung have already lost considerable weight. The NCI also reported in 2014 that cachexia is the immediate cause of death in 20 to 40 percent of cancer patients. Patients with any solid tumor except breast cancer are generally more prone to cachexia, and it is also more common and more pronounced as the disease progresses in children and in the elderly.

Symptoms: Cachexia is one of the most overwhelming symptoms of cancer, demolishing quality of life with numbing fatigue, loss of appetite or changes to taste, and severe weight loss of 10 percent or more of body weight.

Screening and diagnosis: When a person experiences unexplained weight or appetite loss or fatigue, medical practitioners without more specific clues might perform such general screens as a complete blood count and a chest x-ray. When the source of the problem is suspected, tests are more specific.

With a known cancer, cachexia diagnosis is based on clinical history, substantial weight loss, and physical examination. The concentration of plasma albumin in blood will usually be low. Extensive diagnostics are not normally required.

Treatment and therapy: The best course of action for cachexia is treatment of the underlying disease. After successful treatment, patients regain lost muscle and fat mass.

Prognosis, prevention, and outcomes: Prognosis is very poor with cachexia in advanced disease. When cachexia occurs in the early stages of cancer, the cancer that causes it is often responsive to treatment, and successful treatment removes the source of changes to metabolism.

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