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Wasting Syndrome or Cancer Cachexia

Cachexia is a condition that causes a patient to waste away physically through loss of muscle mass and body fat. A patient may potentially lose between 10 and 20 percent of body weight. In general, cachexia is the result of chronic diseases such as cystic fibrosis, AIDS, or advanced-stage cancers.
A patient with cachexia may eat enough food, but the body does not absorb an adequate amount of nutrients leading to a starvation state. The body cannot protect itself by conserving the use of nutrients during a starvation condition; whereas, a healthy person’s body would be able to adjust.
It is the lack of nutrient intake that denies the body’s cells of amino acids, carbohydrates, fats, proteins, and complex sugars needed for survival. The body in turn uses the body’s healthy tissue as an energy source. This leads to the loss of muscle mass.

Another characteristic of cachexia is that the patient’s body seems to consume more energy than normal. Even when a patient is at rest, the metabolic rate is higher than normal. It is this unusual change in metabolic rate that seems to lead to a patient’s weight loss in spite of sufficient daily caloric intake. The reason for drastic changes in metabolic rate for a patient that suffers from cachexia is not fully known.

Although it may seem that cachexia and anorexia are similar, they are different in that anorexia is starvation from lack of appetite-not eating; whereas, cachexia is not caused from lack of food since the patient does get sufficient caloric intake. It is common for the two conditions to occur simultaneously.

Cancer and Cachexia

As many as 75 percent of cancer patients experience cachexia. The majority of cancer patients that have the condition are diagnosed with upper gastrointestinal tract cancers that include those related to the pancreas, esophagus, and stomach.

Research in this area has shown that approximately 85 percent of pancreatic cancer patients suffer from cachexia and on average have lost approximately 14.2 percent of their pre-cancer weight when diagnosed.

Lung cancer patients also commonly suffer from cachexia; however, it is rarely seen in breast cancer patients. Male cancer patients seem to be more vulnerable to cachexia than female cancer patients. It also seems that there is a correlation between cachexia and a patient’s decreased ability to respond to chemotherapy and poor functional performance.

Symptoms of Cachexia

Some of the most common symptoms of cachexia include severe loss of body weight due to decrease in muscle mass and body fat, weakness, fatigue, numbness, tingling, pain, and involuntary twitching from electrolyte imbalance.

This serious malnutrition state leads to reduction in a patient’s ability to be independent. Simple daily tasks such as dressing, bathing, and grooming become difficult.

There are cases where severe cachexia has resulted in death. Some examples of this are in cases where arrhythmias are present from drastic electrolyte imbalance or weak respiratory muscles that cause pneumonia and ultimately result in infection via the bloodstream.

Some symptoms of cachexia reduce a patient’s independence, overall quality of life, and may be fatal in some instances.

Treatments for Cachexia

One of the most common therapies for cachexia treatment is megestrol acetate, a synthetic progestin hormone. This hormone decreases overall hormone levels by disrupting normal estrogen cycles. This interference results in weight gain and increased appetite. The down side is that the weight gain primarily comes in the form of fatty tissue instead of muscle mass. The weight gain is normally temporary; however, the increased weight and appetite may be critical in helping improve a patient’s overall condition.

Corticosteroids are also used to help a patient with cachexia gain weight. The problem with this treatment is that it is a steroid and over a period of time it begins to disrupt muscle production, therefore defeating its purpose.

Recent research has investigated the use of fish oils that contain omega-3 fatty acids to help stabilize or increase weight, especially in pancreatic cancer patients. The use of omega-3 fatty acids has shown positive results in their ability to reduce the breakdown of proteins.

Other treatment possibilities for cachexia include drugs that have traditionally been used to reduce hypertension. Medications such as angiotensin-converting enzyme inhibitors and anti-cholesterol (statin) drugs have been shown to have an anti-inflammatory effect that helps limit the production of cytokine (a substance that may negatively affect immune response). In addition, antibiotics such as Erythromycin and Azythromycin have also been considered as treatments since they may also limit cytokine production.

A common dietary supplement used by athletes called creatin has been under investigation for the treatment of cachexia due to its muscle-building properties. Cysteine, a supplement normally used to increase lean body mass is also under consideration as a possible treatment.

 

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