Why Am I Wasting Away? Cachexia Questions and Answers
Cachexia, also known as wasting syndrome, comes from the Greek words kakos (bad) and hexis (condition). It is more than weight loss or malnutrition due to anorexia — from the Greek words an (without) and orexis (appetite) — although these often play a part in it. Cachexia is a complex change within your body that causes muscle wasting with or without fat loss, despite what you eat.
How Do You Say Cachexia?
It’s not the most elegant word. Doesn’t roll off the tongue, almost trips you up in the mouth. And try spelling it … cakexia, cakexea, cakecksea, cakecksia, kakexia, kekexia, cucexia, kerkesia, kukeksea, cakecksea, kukeksia … Keep in mind when pronouncing it, the “ch” is a hard k sound: kuh-KEK-see-uh.
It’s fitting that pronouncing and spelling cachexia is not simple or straight forward.
How Do You Know If You Have Cachexia?
The best way to determine if you have cachexia is to be assessed by a doctor with experience in cachexia evaluation. First your doctor will determine if you fall within the definition of cachexia. They can evaluate you for cachexia through several methods. For example, for patients with advanced cancer, there is a cachexia staging score developed by researchers to help place them into one of the three stages of cachexia.
How is cachexia defined?
In 2011, a group of international experts settled on this definition of cancer cachexia: “a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that can be partially but not entirely reversed by conventional nutritional support.”
For a less clinical picture of cachexia, read this article on how cachexia is described by patients, caregivers, families, and health care providers.
How to calculate cachexia
In 2008, several scientists and clinicians came together in Washington, D.C. to form an agreed upon working definition of cachexia. During that conference, they came up with these diagnostic criteria for cachexia:
- Presence of a chronic disease;
- Loss of body weight greater than or equal to 5% within the previous 12 months or less; and
- Presence of at least three of the following: reduced muscle strength, fatigue, anorexia, low fat-free mass index, abnormal biochemistry, inflammation, anemia, low albumin
The National Cancer Institute posts these criteria for diagnosing cachexia in cancer patients:
- Weight loss greater than 5% over the past 6 months; or
- BMI less than 20 and any degree of weight loss greater than 2%;
- Appendicular skeletal muscle index consistent with sarcopenia (another wasting syndrome) and weight loss of more than 2%
Methods for assessing patients can include measuring body mass index (BMI), lean muscle mass, food intake journals, and blood tests.
When does cachexia start?
According to a 2017 article in the Journal of Cachexia, Sarcopenia and Muscle, postulated stages of cachexia are:
- Pre-cachexia: Weight loss less than or equal to 5%, anorexia, and metabolic change
- Cachexia: Weight loss greater than or equal to 5%, or BMI less than 20 and weight loss greater than 2%; often reduced food intake; systemic inflammation
- Refractory cachexia: Variable degree of cachexia; disease both procatabolic and nonresponsive to treatment; low performance score; less than three months expected survival
How fast does cachexia progress?
How fast cachexia progresses depends upon multiple factors including systemic (not local) inflammation, the type of disease you have and its stage, how much you are eating, and your response to treatment. Steve jobs, for example, can be observed in photos for several years (2007-2011) in varying states of cachexia as he fought prostate cancer.
But as described above, once a patient reaches the refractory cachexia stage, survival is not expected beyond three months.
Why Is Cachexia a Common Problem for Cancer Patients?
As many as 80% of people with advanced cancer are affected by cachexia. Cachexia is driven by inflammation and metabolic imbalances, two things affecting people fighting cancerous tumors. Along with these, anorexia, weight loss, and chemotherapy are all things that may come along with cancer, and, unfortunately, exacerbate cachexia.
Why does cancer make you lose weight?
A person can experience weight loss during cancer treatment for many reasons. Dehydration, diarrhea, and vomiting are common causes. You may suffer from anorexia — loss of appetite — as a result of pain, stress, depression, nausea, or having tumors in areas that make eating and digesting difficult. In addition, certain tumors can affect your hunger by releasing hormones.
Of course, another reason you may lose weight is from cachexia. While cachexia is not just simply weight loss, noticeable changes in weight and appetite loss can be a part of it along with other factors.
What is a possible reason for cachexia in a cancer patient?
It is believed that inflammatory signals from tumors or immune cells responding to tumors are contributing factors to cachexia. The NCI reports that inflammation is a central theme tied to cachexia. Inflammation is caused by an immune response to cancer, which produces cytokines. Cytokines can help fight tumors, but it’s believed they can also shift metabolism toward catabolism—the breakdown of muscles and fat, a kind of metabolic mutiny.
What is protein energy restriction in cancer cachexia?
During this metabolic mutiny, a vicious cycle persists where energy is wasted, tumors might gobble up glucose and turn it to waste products, convert the waste back to glucose, all to feed the tumor again. Additionally, the energy producing mitochondria in muscle cells begin to malfunction.
The disruption of metabolism worsens things for muscle cells. Nitrogen starvation occurs in muscles. Then inflammation induces catabolism, destroying protein and committing muscle suicide. The result is wasting—cachexia. Additionally, cachexia triggers disruption in homeostasis of the brain, liver, gut, and heart. The brain, for example, begins to suppress appetite.
On top of all of that, the side effects of cancer treatment tend to worsen cachexia.
Which cytokine is involved in producing cachexia?
According to a March 2020 article in the International Journal of Molecular Sciences, cachexia appears to depend on “an interplay between the release of cytokines from the tumor and some organ of the host, including liver, muscle, and adipose tissue. These cytokines produce an imbalance between pro- and anti-inflammatory responses that change glucose, lipids, and protein metabolism, restraining anabolism, while a catabolic state is sustained.” These cytokines, also called “tumorkines”, include interleukin 1 or 6 and tumor necrosis factor alpha, along with many others.
So, how does this translate? Unlike anorexia and malnutrition, scientists believe cachexia is greatly affected by cytokines (proteins that transfer signals from cell to cell) that are released by the cancer and your body. An imbalance occurs and throws your body into a metabolic state, causing it to essentially eat itself, and thus causing you to waste. How does cancer cachexia cause death?
Some of the factors involved with cancer cachexia that lead to death are cardiac arrhythmia, electrolyte imbalances, difficulty breathing due to muscle weakness, aspiration pneumonia, sepsis, and more.
As was previously noted, progression of cachexia varies from individual to individual and is dependent on disease, stage of cancer, and several other contributing mechanisms like systemic inflammation and metabolic imbalances. Once again, when a patient enters the refractory stage of cachexia, life expectancy rapidly decreases.
HIV Wasting Syndrome — Is It the Same as Cachexia?
Before AIDS was treatable, wasting syndrome or cachexia was a problem associated with HIV/AIDS. In the 80s and 90s HIV wasting syndrome was characterized by “unintended and progressive weight loss often accompanied by weakness, fever, nutritional deficiencies and diarrhea.”
At the time, HIV/AIDS cachexia often limited the patient’s quality of life, worsened the illness, and hastened death. HIV wasting is not just caused by HIV infection, but HIV-related infections and cancers, as well. Some degree of cachexia is experienced by most patients with advanced HIV/AIDS.
Along with the usual suspects of anorexia, inflammation, and metabolic imbalance, HIV/AIDS has a specific problem with nutrient absorption in the gut. Even when taking in sufficient calories, many HIV patients suffer loss of nutrients due to diarrhea, vomiting or malabsorption of nutrients in their intestines. Thought to be caused by the HIV itself, malabsorption is thought to be a result of HIV-related disease as well.
Read on to find out how the liposomal technology used by a new solution, Cachexinol™, is able to bypass malabsorption in the gut.
How long can you live with cachexia?
We know that in advanced stages of diseases like cancer, heart disease, and untreated AIDS, patients are not expected to live beyond three months. Progression before the refractory stage of cachexia varies from patient to patient.
But what if there was a way to stop cachexia before it really got started, so patients could receive the best standard of treatment for their disease? What if there was a solution that could work for issues that impact a patient’s appetite, like nausea, or their ability to absorb nutrients? And what if there was a treatment for cachexia that could pull a patient with a full-blown tumor out of the grips of cachexia and give them a chance to fight their disease?
Cachexinol™ is a new all-natural treatment that uses liposomal technology to bypass digestive issues and nausea. Read on to find out more about reversing cachexia and how Cachexinol™ is proven to work in preclinical studies.
Can Wasting Syndrome Be Reversed?
Cachexia is instigated by a pre-existing disease, such as cancer, COPD, heart failure, and many more. In early stages, often cachexia can be reversed if treatment of that pre-existing disease is successful. For example, the successful removal of a tumor can stop cachexia from developing to a severe stage.
Diet and exercise are also thought to be important for people with chronic diseases who are at risk for wasting syndrome. Increased caloric intake, rich in high-quality protein and amino acids is recommended. Resistance and cardio exercise is also suggested. These things will not reverse cachexia, but they can help prevent wasting or keep a patient from degrading even further if they’re in the first stages.
How serious is cachexia?
Cachexia is very serious, because if left unchecked, it will most likely lead to death. Wasting increases mortality in people with chronic diseases; it exists in about 30% of these patients that die.
How to increase the appetite of someone with cachexia
Some patients, when put on low doses of steroids, will experience an increase in appetite, which will lead to feeling better and even putting on weight. But that weight is water and fat, not lean muscle. After 2-3 weeks, the steroids are no longer effective and are, therefore, not a long-term solution.
A loss of appetite is often a part of cachexia, but even worse is that sometimes a person can eat, can take in loads of calories, but because of the metabolic mayhem going on inside them, they can’t put weight back on or build lean muscle.
What does terminal cachexia mean?
Terminal cachexia means that cachexia has advanced to a stage when multi-organ failure is imminent, which is known as the refractory or third and final stage of cachexia.
How Does Wasting Syndrome Affect Lung Cancer Patients?
Cachexia is especially common in colorectal, gastrointestinal, pancreatic, and lung cancers. It is estimated that wasting disease is responsible for 20-30% of all cancer-related deaths. Cachexia can be different in various illnesses, even in various cancers.
In most cancer-related deaths, it is thought that the patients die from late stage cachexia. But in the case of lung cancer, patients with cancer die sooner than those without it because cachexia affects the treatment.
Wasting can occur in early stages, before the cancer has even spread. In this case, surgery and even chemotherapy would be a patient’s best option, but if a patient has cachexia, they are too weak to endure these treatments. Cachexia also excludes these patients from clinical trials. Basically, cachexia tends to cheat lung cancer patients out of the standard of care.
How to deal with cachexia
One oncology radiologist and biologist, Puneeth Iyengar, MD, PhD, wants to level the treatment playing field for all cancer patients, with and without cachexia. He and his cancer biology team have discovered several different ways of affecting cachexia in mice with tumors, including feeding them high-fat diets, removing the tumor’s fuel source of fat before cancer, and genetically removing molecules that tumors use to break down fat. All of these had an effect on tumor growth,
Dr. Iyengar’s work may lead to better treatment for his future lung cancer patients with cachexia. But is there a solution for cachexia overall? For non-tumor related cachexia? Is there a natural way to stop cachexia?
How to Stop Cachexia Naturally?
Some studies have shown that natural herbs and spices like oregano and thyme can help increase muscle mass.
However, there is now a new all-natural treatment for cachexia that is proven to reverse cachexia in two mice studies, allowing the subjects to completely recover from wasting while still having cancerous tumors.
This new solution is called Cachexinol™, and it uses CELLg8® technology — an advanced liposome technology that has been perfected by Dr. Emek Blair over the last two decades. His liposome technology has already been successfully established and manufactured in many other all-natural supplements.
The important distinction about Cachexinol™ is its use of liposomes and the quality of science and experience behind it. Cachexinol™ is a curcumin-based treatment that is strategically placed in liposomes (all-natural fat bubbles that have special delivery access to your bloodstream).
Dr. Blair’s Cachexinol™ mice studies, the results of which are posted on the website, reveal that particular doses of Cachexinol™ delivered into the bloodstream are needed to have the reversing effect of cachexia. This kind of delivery is made possible through the use of liposomes, and Dr. Blair’s liposomes are held to standards and quality control that assures that they always deliver. Again, he has been doing this for nearly 20 years.
Furthermore, the criteria used in Dr. Blair’s studies is held to a higher standard than most studies using this mouse model, which you can also check out.
Cachexia has multiple complexities involved that contribute to its development and its effects and ultimate degradation on patients. Cachexinol™’s all-natural advanced liposomal formula (these liposomes are natural, by the way, made from natural fats) gets treatment into the bloodstream where it can have its effect, bypassing absorption through the gut, and, in turn, bypassing nutrition impact problems for patients with cachexia.
You need a specialized treatment to get around what’s failing. That’s where CELLg8® liposome technology comes in. Inspired by nature, backed by science — you get the best of both worlds to give you a fighting chance.
Cachexinol™ is a proven solution you deserve for the complex, devastating, and too-frequent problem of wasting in people suffering from and trying to fight chronic diseases.