Definition & Overview

Cachexia refers to severe weight loss and muscle wasting. It is a common side effect of many long-term diseases (such as cancer) and one of the factors that can increase a patient’s risk of death. It occurs when the body of the sick person releases certain substances that keep new muscles from growing. Thus, even when they eat more, they find it very hard to gain weight. Without enough muscle mass and energy, many patients are too weak to undergo any form of treatment. This can further worsen their condition and their prognosis.

Weight loss caused by certain diseases is different from when a person intentionally tries to lose weight. When a person consciously lessens the food he eats and exercise more, his body will start to burn excess body fat. This will make him leaner and more energetic. In this scenario, the muscle mass is not affected. Patients with cachexia, on the other hand, lose fat and muscle mass no matter how much they eat and exercise. This makes them very weak that it becomes very hard for them to endure the symptoms and side effects of treatment for their underlying disease. In oncology, cachexia is believed to be the cause of death in up to 40% of cancer cases.

Causes of Condition

Cachexia can occur in people suffering from:

  • Severe eating disorders

  • Cancer

  • End-stage lung diseases

  • End-stage kidney disease

  • Celiac disease

  • Heart failure

  • Crohn’s disease

  • Cystic fibrosis

  • Dementia

  • HIV/AIDS

  • Multiple sclerosis

  • Parkinson’s disease

  • Rheumatoid arthritis

  • Tuberculosis

  • Uncontrolled diabetes

The link between many advanced diseases and cachexia is not clear. However, researchers believe that inflammatory cytokines play a role. Cytokines are produced by different types of cells. They balance immune responses. They also regulate certain cells by making sure they grow and mature at the right time. However, proinflammatory cytokines that the body produces when a person is sick can make certain diseases worse. Certain studies on animals have found that these cytokines can attack and degrade adipose tissue and muscle protein. However, more studies in humans are needed to support these findings.

Key Symptoms

Cachexia causes patients to lose lots of weight and muscle mass. Patients with the disease have:

  • High albumin levels

  • High levels of inflammatory cytokines

  • Body mass index (BMI) that is less than 20%

  • Less than 10% body fat

  • Lost more than 5% of their body weight

Cachexia symptoms are:

  • Tiredness

  • Not feeling well

  • Low energy

  • Swelling, often in ankles

  • Loss of appetite

  • Infections

  • Poor response to any form of treatment

  • Lower quality of life

  • Steady weight loss

  • Weakness

Patients suffering from cachexia for a very long time have an increased risk of dying. This is because the disease causes them to continuously lose fat and muscle that their body needs to store food and glucose. Without enough supply of these nutrients, many organs in the body will start to shut down.

Who to See and Types of Treatments Available

It is important for patients to not lose more weight and muscle mass. If able, they are advised to perform regular exercises using weights. They are also advised to eat more. It is common for doctors to provide them with medications to boost their appetite and block proinflammatory cytokines. If the disease is treated early, it is possible for patients to avoid its serious side effects. However, it is not often that patients make a full recovery.

In most cases, eating more and exercising are not enough. This is because patients are also dealing with other diseases that have negative impact on their body. In such cases, doctors recommend a form of treatment (palliative care) that focuses on improving the patient’s quality of life instead of trying to cure the underlying disease. This is often seen in patients with end-stage disease where little can be done to stop it from worsening.

The prognosis for patients with cachexia is usually poor especially for those who have certain types of cancer. Most forms of cancer treatment cause patients to lose their appetite and become nauseated most of the time. With decreased food intake, patients tend to lose even more weight. This prevents them from making a full recovery.

References:

  • Ebner, Nicole; Springer, Jochen; Kalantar-Zadeh, Kamyar; Lainscak, Mitja; Doehner, Wolfram; Anker, Stefan D.; von Haehling, Stephan (July 2013). “Mechanism and novel therapeutic approaches to wasting in chronic disease”. Maturitas. 75 (3): 199–206. doi:10.1016/j.maturitas.2013.03.014.

  • Garcia J.M.; Garcia-Touza M.; Hijazi R.A.; Taffet G.; Epner D.; Mann D.; Smith R.G.; Cunningham G.R.; Marcelli M. (May 2005). “Active ghrelin levels and active to total ghrelin ratio in cancer-induced cachexia”. J. Clin. Endocrinol. Metab. 90 (5): 2920–6. PMID 15713718. doi:10.1210/jc.2004-1788.

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