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Cachexia – the wasting syndrome

Cachexia is a wasting syndrome with loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite in someone who is not actively trying to lose weight.

Cachexia might be described as an additional burden of the cancer. Firstly, there is the stress on the body of the illness itself. Not only is there the physical load of a cancer, there are many psychological stresses that surround this illness. On top of all this, some individuals develop cachexia.

There are certain cancers which affect the way the body metabolises or processes and uses the food that is ingested. This aspect of cancer is referred to as the ‘wasting syndrome’ or ‘anorexia cachexia syndrome’. Up to 6 out of 10 people (60%) with advanced cancer develop some degree of cachexia. It is also why some people find they keep losing weight despite their best effort to eat as well as they can.

Cachexia (kak-ex-ee-a) comes from the Greek word kakos meaning ‘bad’ and hexis meaning ‘condition’. Anorexia simply means loss of appetite and is often associated with cachexia, but not always. As mentioned, cachexia is more than a simple loss of appetite. It is a very complex problem involving changes in the way your body normally uses protein, carbohydrate, and fat. It leads to many problems including muscle wasting.

It isn’t usual to get cachexia in the early stages of cancer. Cachexia in advanced cancer can be very upsetting and make you feel very weak. It isn’t just associated with cancer though. It is common in the advanced stages of other illnesses such as heart disease, HIV and kidney disease.

Cachexia is more common in people with lung cancer or with cancers anywhere in the digestive system. The main symptoms are

  • Severe loss of weight, including loss of fat and muscle mass
  • Loss of appetite
  • Feeling sick (nausea)
  • Feeling full after eating small amounts
  • Anaemia (low red blood cells)
  • Weakness and fatigue

The processes of cachexia are not fully understood, but it is thought that the cancer releases chemicals into the blood that contribute to the loss of fat and muscle. These chemicals may make your metabolism speed up so that you use up calories faster. Because your body is using up energy faster than it is getting it, you can have severe weight loss even if you are eating normally. In effect, losing muscle and fat can make it look as though you are ‘wasting away’. This can all be made worse because of the side effects of cancer treatment.

In fact there are some inflammatory-type chemicals released by the cancer cells which can result in a situation that is a bit like the body putting the foot on the fat and muscle burn accelerator – this results in an increase in the metabolic rate and is why, despite people trying to eat well, ongoing problems with weight loss often still occur.