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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.
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“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. 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.
“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.”
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.”