What is Cachexia?
Cachexia, also known as Wasting Syndrome or Anorexia Cachexia Syndrome, is a weakness and wasting of the body, caused by severe illness and disease. Cachexia is much more than just a loss of appetite – it is a serious problem. Ultimately, it changes the way your body uses protein, carbohydrate, and fat. In addition, it can also cause your body to burn calories at a much faster rate than usual. Though this sounds like a great thing to have, it can often result in serious consequences. People with cachexia often lose fat as well as muscle, which sometimes cannot be reversed with nutritional supplements.
What is Cardiac Cachexia?
Cardiac cachexia is where serious weight loss is caused by heart disease. At times, this weight loss can be life-threatening. In addition, it can also happen to patients that experience severe heart failure. Patients may have a decent appetite and consume a lot of calories but still unfortunately lose muscle and weight.
How is Cardiac Cachexia caused?
Heart failure can cause blood to go back up into the liver and intestines – which could cause these organs to swell. This swelling could lead to feelings of nausea and a loss of appetite. Furthermore, the swelling of the intestines could reduce the level of absorption of nutrients from food that is consumed.
Heart failure could also make it harder to breathe and therefore cause strain on your lungs and body. As a result, this could cause your body temperature to rise. An increase in body temperature as well as working harder to breathe can burn calories. Also, patients with severe heart failure, Tumor Necrosis Factor (TNF for short), and Cytokines (small proteins important in cell signaling) can increase the metabolic rate of tissues. This would lead to more calories being burned.
What are Cachexia Symptoms?
Cachexia seems to be more common in patients suffering from lung cancer or cancers anywhere in the digestive system.
The main symptoms can include:
- Severe weight loss, including muscle mass
- Loss of appetite
- Anemia (lacking enough healthy red blood cells)
- Tiredness, weakness, and fatigue
- Lack of any taste
Cachexia isn’t just associated with cancer though. It is also common in the later stages of other illnesses and diseases like; heart disease, HIV, AIDS, chronic kidney disease, congestive heart failure, and chronic obstructive lung disease,
Cancer Cachexia and Life Expectancy
As Cancer Cachexia is seen in the later stages of cancer, it can significantly reduce a patients life expectancy. Many patients with chronic diseases are more likely to die when they lose weight, as well as develop progressive cachexia. Patients with cancer cachexia are also less able to endure treatments, like Chemotherapy which could be crucial for the patient. For patients that need to have surgery, the risk of post-operative complications can increase. Although the loss of body weight, anemia, and the other symptoms listed previously all characterize the status of cancer cachexia, the main cause of death is due to respiratory failure.
How is Cachexia Diagnosed?
Cachexia is diagnosed by using a variety of measurements and tests. These include:
- Body Mass Index
- Lean Muscle Mass
- Blood Tests
- Food intake diaries
Since cachexia can often be present before weight loss begins, it is crucial to recognize it as soon as possible. This is so that the amount of weight loss, especially muscle loss, can be kept to a minimum.
Researchers have created a cachexia staging score (CSS for short) for patients with late-stage cancer. A number of points are assigned to each specific component and then added together to sort cachexia into three different stages. Here is a breakdown of these components:
- Weight loss over the last 6 months (0 – 3 points)
- A SARC-F questionnaire (aimed at muscle function and sarcopenia) (0 – 3 points)
- ECOG (Eastern Cooperative Oncology Group) performance status (0 – 3 points)
- Loss of appetite (0 – 2 points)
- Abnormal biochemistry tests (0 – 2 points)
Based on the above components, the total score will indicate the stage of cachexia the patient is at. These stages include:
- Non-Cachexia (a score of 0 – 2 points)
- Precachexia (a score of 3 – 4 points)
- This is characterized by a weight loss of less than 5%. Patients may have symptoms like a loss of appetite and impaired glucose tolerance.
- Cachexia (a score of from 5 – 8 points)
- This is characterized by a weight loss of greater than 5%. Patients may have other symptoms or conditions associated with cachexia.
- Refractory Cachexia (a score of from 9 – 12 points)
- This is characterized by patients who are no longer responding to cancer treatments and have a life expectancy of less than 3 months or so.