Cachexia is a type of wasting disorder and its effects include abrupt excessive weight loss and loss of muscle mass. When a person has Cachexia, he doesn’t just lose the muscles but the fat component of the body as well. This type of disorder is developed by patients who have more serious chronic illnesses like that of HIV-AIDS, chronic renal disease, chronic obstructive pulmonary disease, congestive heart failure, cancer, etc.
In Cachexia, weight loss is involuntary, unlike other types of weight loss. People with this type of condition lose weight and become emaciated due to poor nutritional intake brought about by several reasons which makes them lose their appetite or change their metabolism and nutritional absorption. When there are fewer nutrients, the body tries to compensate and because of this mechanism, the body itself breaks down the fats and the muscle tissues in the body resulting in severe wasting; hence severe weight loss. This condition doesn’t just worsen the condition of cancer patients but greatly interferes with their quality of life because it can worsen the side effects of the necessary cancer treatments. Cachexia worsens cancer fatigue and this can be bothersome in some patients.
When a person is diagnosed with a medical condition like cancer, the body has its natural way of responding to the inflammation caused by the disease and the chemical substances being produced as a result of the disease process; and because of this, the person’s appetite is severely affected which results to massive caloric burning.
However, in some research made by medical professionals, Cachexia is viewed not as a disease or disorder but the body’s normal compensatory mechanism when the body is stricken by a serious illness.
There are three diverse classes of Cachexia, and these are:
- Precachexia. The person falls under this type when he loses five percent (5%) of his body weight during the course of his illness. This category is most commonly accompanied by metabolic changes, loss of appetite, and inflammation.
- Cachexia. When a person loses more than five percent (5%) of his total body weight in a span of a year or over without having to do the diet in an attempt to lose weight and the person has a diagnosed medical condition or disorder. This category involves signs and symptoms like the presence of inflammatory disorders, easy fatigability, muscle strength loss and loss of appetite.
- Refractory Cachexia. This is the type of Cachexia that cancer patients have. Other than the severe weight loss, manifestations include loss of muscle mass and function, with response failure to cancer treatments.
Based on studies, the risk factors or identified causes of cachexia are:
- Tumor factors are substances secreted or produced by the tumor
- Host response or the body’s natural response to the cancer cells or tumors
- The immune response of the body towards cancer
- Other underlying causes are still being identified by the experts
Cancer Cachexia is a complex wasting disorder or syndrome defined by symptoms such as anemia, anorexia, weight loss, and asthenia. This syndrome has complex or multifaceted pathogenicity because the host-tumor factors are to be considered.
The cancer-induced cachexia is a paraneoplastic condition and is present in almost eighty percent (80%) of all cancer patients who are in the late stages of the disease; this syndrome is responsible for the death of over 20% of all cancer patients globally. Simply explained, the cachexia is iatrogenic and may be brought about by the host’s response to the substances that the tumors produce. The substances released by these tumors suppress the appetite of the cancer patients, so cancer itself contributes to wasting. Second, the person’s response to cancer treatments like the chemotherapy and radiotherapy causes symptoms like nausea and vomiting because of the damage of the cells in the digestive tract; these responses to treatments make it harder for patients to eat and absorb the nutrients thereby causing the breakdown of muscle and fat tissues to keep the body functioning.
For a person to be diagnosed with such syndrome, it has been mentioned that there should be a weight loss of more than five percent (5%) of the total body weight within the last 12 months without having to diet to intentionally lose the extra pounds. The person has to be with a diagnosed disease or health disorder. Furthermore, the person has to manifest at least three (3) of the following:
- Loss of muscle strength
- Easy fatigability
- Anorexia or loss of appetite
- Below normal fat-free mass index calculated based on the body weight, height, and body fat
- Laboratory tests showing high levels of inflammation
- Low red blood cell levels or anemia
- Depleted levels of protein or albumin in the blood
Doctors base the patient’s prognosis based on the cancer cachexia signs and symptoms. In cancer patients, cachexia is considered to be an irreversible syndrome which is why treatments are symptomatic in nature. There is no particular treatment modality to treat cancer cachexia. Fundamentally, the goal of the treatment is the improvement of the symptoms and the person’s quality of life. Most physicians choose to employ treatments or therapies such as the following:
- Megestrol Acetate to improve the patient’s appetite
- Dronabinol to relieve nausea and improve mood and appetite
- Anti-inflammatory agents to treat inflammation
- Nutritional supplements
- Diet modifications
- Exercises (as applicable)
Most people just focus on the cancer treatments, however, cachexia may be a serious condition that would need prompt treatment to improve cancer treatment response. A matter of fact is that most patients with cancer who have cachexia are less likely to respond to chemotherapy and other treatments to be able to survive. Cachexia may truly cause overserious complications such as very low quality of life because patients develop depression and anxiety because they feel a lot weaker every day. Patients know that there is no particular treatment for cachexia which is why they have a worse outlook in life.
However, researchers and companies like Cachexinol are supporting the development of drugs to reverse the wasting process especially in patients with cachexia. Innovations are in progress in developing treatments that could help protect and reconstruct muscle mass as well as increase weight gain in patients with this type of wasting syndrome.