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Recognizing Cancer Cachexia

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How is cancer anorexia cachexia syndrome recognized?

Cancer anorexia cachexia syndrome is due to both reduced food intake and to metabolic changes. As a result of these complex changes, individuals suffering from the condition will experience fatigue and physical disability, along with loss of skeletal muscle mass.1 As everyone knows, healthy adults often have considerable problems in losing weight. Thus, the sudden or gradual appearance of weight loss in any individual is highly unusual. Considering this, one of the best ways to recognize cancer anorexia-cachexia is unwanted weight loss. This makes it very important to monitor one’s body weight over time, especially in those with a new diagnosis of cancer.2 Cancer anorexia-cachexia, however, is also associated with a number of other symptoms as shown in the figure below.

Reaching a diagnosis of cancer anorexia-cachexia

Experts are still debating on the causes and criteria for diagnosis of cancer anorexia-cachexia. Recently, however, general agreement has been reached that diagnosis of cancer anorexia-cachexia should consider at least 3 factors as shown in the box below. These include weight loss, changes in BMI, and loss of skeletal muscle.2 Some experts also consider that reduced food intake (<1500 kcal per day) can be indicative of cachexia.3 In any case, your doctor can help determine if cancer anorexia-cachexia may be present.

Diagnosis of cancer anorexia-cachexia.1

  • Weight loss >5% over past 6 months (in absence of simple starvation); or
  • BMI <20 and any degree of weight loss >2%; or
  • Significant loss of skeletal muscle.

Hidden cancer anorexia cachexia syndrome

One problem that can be encountered when faced with cancer anorexia-cachexia is recognizing it in an increasingly obese population.2 When otherwise healthy but overweight individuals develop a chronic disease such as cancer, obesity can be associated with longer survival, which is perhaps related to the presence of greater fat reserves. If diagnosed with cancer, it is important to closely monitor body weight as already mentioned, but your physician may also use other types of techniques to determine if cancer anorexia-cachexia may be present. These techniques can help determine if there is loss of skeletal muscle or alterations in the distribution of body fat. This is useful since cancer anorexia-cachexia is more easily treated at the early stages.

Treating cancer anorexia-cachexia

Once identified, your physician may prescribe several types of treatments for cancer anorexia-cachexia. These may include increased food intake through better management of the symptoms of poor nutrition (for example, better control of pain or constipation), or even appetite stimulants. In more severe cases, artificial nutritional support may be considered. Your doctor can help you understand what treatments may be best. In any case, if cancer anorexia-cachexia is suspected as a result of weight loss or other symptoms it is best to seek professional help as soon as possible.1,4

References

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