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Cachexia or wasting syndrome involves a complex change in the body
Cachexia or wasting syndrome involves a complex change in the body, causing the body to lose weight and muscles. There isn’t clear evidence as to how cachexia occurs. With cachexia, the cells in the muscles, fat, and liver fail to respond well to the hormone insulin. As a result, the body cannot use glucose from the blood for energy. Some scientist believes that cancer causes the immune system to release certain chemicals (cytokines) into the blood. Cytokines attribute to the loss of fat and muscle. They are also responsible for speeding up the metabolism. Thus, the body utilizes the energy faster compared to what it takes.
Some of the common causes of cachexia include:
- Dysphagia (difficulty or discomfort in swallowing)
- Chemotherapy or radiation therapy
- Cancer or surgery of the gut
- Severe pain due to certain diseases
- Anxiety
- Depression
- Anorexia
- Human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS)
- Congestive heart failure.
- Rheumatoid arthritis.
- Tuberculosis
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Crohn's disease
- Different types of cancer (particularly of the pancreas, stomach, esophagus, colon, and rectum)
- Elderly patients
- Chronic kidney disease
- Malaria
- Stroke
- Neurodegenerative disease
- Sepsis
- Extensive traumatic injury
What is cachexia?
Cachexia is a condition characterized by wasting of fat and muscles; it is a complex syndrome that combines weight loss, loss of muscle and fat tissue, anorexia, and weakness. Cachexia or wasting syndrome involves a complex change in the body, causing the body to lose weight. Anorexia, which is the loss of appetite, is sometimes associated with cachexia. However, cachexia is more than only a loss of appetite. The prevalence of cachexia ranges from 5-15% in chronic heart failure or chronic obstructive pulmonary disease (COPD) patients to 60–80% in advanced cancer patients.
What are the signs and symptoms of cachexia?
The notable signs and symptoms of cachexia include:
- Unintentional weight loss: Weight loss may occur involuntarily, which means that it happens without trying. It may occur even after getting an adequate amount of calories from the diet.
- Skeletal muscle wasting: Muscle wasting is a salient feature of cachexia. Muscle wasting may occur without any changes in the outward appearance. For instance, obese people may have muscle wasting inside without visible changes in the outward appearance.
- Anorexia/loss of appetite: Loss of appetite is another hallmark feature of cachexia. Loss of appetite in this context means the lack of desire to eat food.
- Lowered quality of life: It can decline a patient's ability to move around and participate in activities they enjoy.
Other symptoms may include:
- Pallor (because of anemia)
- Weakness and fatigue
- Shortness of breath
- Nausea
- Constipation
- Reduced sense of taste
- Electrolyte imbalance
- Frequent infections (due to a weak immune system)
How is cachexia treated?
The treatment of cachexia includes:
- Medications to stimulate appetites, such as hormones and corticosteroids
- Nutritional supplements, such as high calorie and high protein drinks
- Parenteral nutrition (nutrition through an intravenous or IV line)
Parenteral nutrition would be introduced only in the following conditions:
- BMI (body mass index) is less than 18.5 kg/m3.
- More than 10% of the total body weight is lost in the preceding 3-6 months.
- BMI is less than 20, and there has been 5% weight loss in 3-6 months.