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Cancer Cachexia-“weight loss is still highly associated with mortality”

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“cachexia is considered the immediate cause of death of a large proportion of cancer patients, ranging from 22% to 40% of the patients.[8]

Based on the articles linked and excerpted below cachexia is both symptom of cancer and side effect of cancer therapy. While cachexia research is less than robust at this point in time, it is clear to me that patients should pursue a multi-pronged approach including nutrition and anti-inflammatory, non-toxic supplementation.

I am a long-term cancer survivor and cancer coach. Are you suffering from cachexia? Scroll down the page, post a question or comment and I will reply to you ASAP.

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Cachexia

Image result for cachexia pictures

Cancer- About 50% of all cancer patients suffer from cachexia. Those with upper gastrointestinal and pancreatic cancers have the highest frequency of developing a cachexic symptom.

This figure rises to 80% in terminal cancer patients.[7] In addition to increasing morbidity and mortality, aggravating the side effects of chemotherapy, and reducing quality of life, cachexia is considered the immediate cause of death of a large proportion of cancer patients, ranging from 22% to 40% of the patients.[8]

Malnutrition ‘almost epidemic’ among patients with advanced cancer

“Many oncologists overlook weight loss as an early indicator for malnutrition, which occurs when individuals do not get enough calories or consume the appropriate amount of key nutrients…

Monitoring involuntary weight loss in combination with BMI has been standard to determine malnutrition among patients with cancer…

A study by Martin and colleagues — published in 2015 in Journal of Clinical Oncology — showed that weight-stable patients with a BMI at or above 28 survived nearly five times longer than those who lost 15% or more of their body weight and recorded a BMI of 22 or less…

“That paper shows that — regardless of whether your starting body weight is large, medium or small — weight loss is still highly associated with mortality,” Baracos said.

This issue is “the elephant in the room in cancer care,” Walsh said…

“We know that being cachexic leads to worse outcomes from surgery, more side effects from chemotherapy or radiation therapy, and a serious impairment in life expectancy,” he said. “Lack of attention to this is a significant issue.”

The Evolving Approach to Management of Cancer Cachexia

Cancer patients are often referred for cachexia intervention treatments late in their disease trajectory-that is, at a point where attempts to reverse the weight loss process may be less beneficial. In addition, healthcare professionals frequently under-recognize the prevalence of cancer cachexia, and this may contribute to delayed treatment of weight loss, often until the refractory stage.

Weight loss is distressing to cancer patients and caregivers. Anorexia/cachexia syndrome is characterized by lipolysis and the loss of lean body mass, and is not reversible by increasing caloric intake.

The pathophysiology of cancer cachexia is complex and includes symptoms that impact caloric intake, as well as chronic inflammation, hypermetabolism, and hormonal alterations. Cancer patients require routine screening for cachexia and, ideally, interventions should be initiated in the early stages of weight loss.

No guidelines exist for the treatment of cancer cachexia. Appetite stimulants, such as megestrol acetate and glucocorticoids, have been shown to increase appetite and weight; however, single pharmaceutical interventions alone for cachexia do not result in meaningful functional outcomes.

In the future, clinicians should consider multimodality treatment that is personalized for each patient. These interventions would include nutritional counseling, assessing and treating symptoms that have an impact on caloric intake, and a rational combination of pharmacologic approaches directed at underlying pathophysiology. Use of an appetite stimulant could be considered for patients who exhibit decreased appetite.

Treatment with an anti-inflammatory agent should be considered for patients with elevated C-reactive protein, and hormonal alterations resulting from anti-cachexia therapy should be thoughtfully addressed.”

 

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7 comments
Debbie Lindsay says a couple of years ago

My brother is eating but has been loosing weight over the past few months . He has been to numerous Doctors and has been through numerous tests and all the test come back normal . There’s no cancer he does have gall stones and can eat spicy foods without having any problems at all . He was also diagnosed with osteoporosis and has 3 hernias due to surgery of the stomach . Can any of these conditions cause weight loss and muscle wasting . Desperate to find what’s wrong especially when every Doctor said they can’t find anything.

Reply
Perian Olson says 4 years ago

What do you think about HGH for cachexia. It is listed as something to try.

Reply
    David Emerson says 4 years ago

    Hi Perian,

    My quick research found HGH for cachexia due to maladies besides cancer but the theory seems valid. More importantly, the article below talks about a spectrum of therapies as the most effective approach to cachexia. Cachexia from cancer is nasty. I would throw everything but the kitchen sink at it.

    Optimal management of cancer anorexia-cachexia syndrome

    David Emerson

    Reply
Perian Olson says 4 years ago

Hello! I am convinced my father has this. His cancer doctor gave him a prescription for marinol which made him feel really weird. He is in remission from lymphomic cancer. His last chemo was in July. He started at 160 lbs. now is at 110. Hospitalized 5 times. On puréed foods. He is in a rehab. They have added 1300 extra calories in the form of supplements. He lost 1.5 lbs in two days. He was 111 two days ago. Not one doctor diagnosed him with cachexia. I researched it myself.

Reply
    David Emerson says 4 years ago

    Hi Perian-

    See my previous reply. Consider a variety of therapies to address your dad’s cachexia.

    David

    Reply
Sim says 5 years ago

Hi David,

I received your email and was very impressed of this finding on Cachexia.

Currently i am 160 lbs and 170cm tall. I guess my BMI is 24-25 somewhere there.

My question is, can we over come this with some form of therapy?

Reply
    David Emerson says 5 years ago

    Hi Sim- The research appears to be unsure about a cure. I’m pretty sure that you could certainly slow your weight loss. My thinking is that many of the therapies are also evidence-based anti-MM so you would get a kind of twofer.

    It is up to you.

    David

    Reply
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