What is Cachexia? Symptoms and Treatment

Brittany W., Danielle Haak
  • Author
    Brittany W.

    Brittany has a bachelor's degree in biological sciences and biochemistry.

  • Instructor
    Danielle Haak

    Danielle has a PhD in Natural Resource Sciences and a MSc in Biological Sciences

Learn the cachexia definition and meaning. See cachexia symptoms, explore the various causes of cachexia, and learn about possible treatments. Updated: 11/03/2021

What Is Cachexia?

What is cachexia? The cachexia definition is a medical condition involving an extreme loss in weight, muscle mass, and sometimes fat. Commonly known as wasting syndrome, it is a metabolic disorder that occurs as a result of a preexisting medical condition. Most often, the preexisting condition is in its late stage, making both the chronic illness and cachexia nearly impossible to reverse. Chronic conditions are defined as those that persist for an extended period or are constantly reoccurring.

Cachexia almost always presents as a comorbid condition, the state of having two or more diseases at once. It is estimated that more than 600,000 American patients are diagnosed with cachexia annually. The Greek word kakhexia is the precursor for cachexia meaning "bad habits" or "bad condition." Healthcare professionals often view cachexia as the last illness before death.

What is Cachexia?

Cachexia is a condition where a person loses substantial body weight and muscle mass in a short period of time due to a chronic illness. These illnesses could include type 1 diabetes, types of cancer, multiple sclerosis, HIV, and 'failure to thrive' conditions.

In these scenarios, weight loss is completely unintentional and is a side effect of a patient's illness. Once muscle mass decreases too much, the patient will no longer be able to move and will become completely immobile. Cachexia is common in cancer patients with poor prognoses who have stopped responding to treatment and is responsible for about 20% of cancer deaths.

Cachexia is difficult to treat because the weight loss is not just due to a calorie deficit. So simply telling a patient to 'eat more' on their own isn't always the best solution. The underlying causes of the condition are poorly understood, and it can be present before the patient even begins losing weight.

Patients with cachexia suffer from involuntary weight loss and a decrease in muscle mass. Additional symptoms include malaise, discomfort, and a lack of motivation.

Anorexia is one of several cachexia symptoms.

What Causes Cachexia?

What causes cachexia? As mentioned, cachexia usually occurs as a symptom of a late-stage preexisting medical condition. Comorbid chronic conditions include:

  • Cancer
  • HIV or AIDS
  • COPD: Chronic obstructive pulmonary disease
  • Type I diabetes
  • Kidney disease
  • CHF: Congestive heart failure

Biochemical, physiological, and metabolic changes emerge when the body fights a chronic illness because the majority of available energy must be devoted to fighting the disease. Additionally, most patients have no desire to eat and nutritional stores become dangerously low.

When the body begins to succumb to a disease, it pulls a last-ditch effort to gain energy by breaking down muscle cells. Muscles are made of protein, and protein can be converted into energy. As muscles deteriorate, the patient becomes thin, weak, and frail. A weak body is also susceptible to infections, and infections exacerbate the symptoms of preexisting conditions. In this way, cachexia is a multi-layered and complex condition with multiple variables to consider.

Cachexia presents in three main forms or stages:

  • Precachexia: This occurs when a patient has a preexisting chronic condition and loses up to five percent of their body weight. Precachexia is demonstrated by appetite loss, inflammation, and metabolic changes.
  • Cachexia: This occurs when a patient has a preexisting chronic condition and loses more than five percent of their body weight in 12 months or less. Cachexia is demonstrated by muscle weakness, appetite loss, fatigue, and inflammation.
  • Refractory cachexia: This applies to patients with cancer who are also experiencing weight loss, muscle weakness, decreased functionality, and a failure to respond to cancer treatment. Tumors release chemicals called tumor factors that often make cachexia symptoms worse.

Cachexia Symptoms

Cachexia symptoms, also known as wasting syndrome symptoms, include:

  • Involuntary weight loss: Patients will lose weight even with a high caloric diet. This is because the body can continue to break down muscle without utilizing fat stores.
  • Loss of skeletal muscle mass: This is a common symptom of cachexia and is one of the main contributors to muscle weakness and a lack of functionality. Skeletal muscle facilitates movement, and its decline results in a decrease in the ability to perform daily activities. Muscle weakness is also associated with malaise, discomfort, and a lack of motivation.
  • Complete loss of appetite: Some patients may even develop anorexia, a condition characterized by a refusal to eat and a very low body weight.
  • Fatigue and anemia: A low nutritional intake equates to low energy stores and leads to fatigue. Anemia results in a low red blood cell count. Low red blood cell counts lead to low oxygen levels because red blood cells deliver oxygen to the rest of the body. Low oxygen levels also contribute to fatigue.
  • Inflammation and edema: Infections from a weakened body state cause high levels of inflammation. Hallmarks of inflammation include redness, swelling, and warmth. Edema is excessive swelling due to a buildup of fluid.

Cachexia patients experience a decrease in skeletal muscle mass and the ability to perform physical activities..

Cachexia impacts skeletal muscle mass.

Complications of cachexia include:

  • Diminished quality of life and lack of independence
  • Unresponsiveness to treatment
  • Reduced immune function
  • Escalating symptoms in the preexisting chronic condition
  • Reduced life expectancy

Treatment of Cachexia

Currently, there is no cure for cachexia, and treatment largely depends upon the preexisting condition that led to its onset. Additionally, because cachexia is a multi-layered and complex disease, simply increasing a patient's calorie consumption is not enough to reverse its effects on the body. More often than not, cachexia is irreversible and fatal.

Symptoms of Cachexia

What are the symptoms of this mysterious condition? The most dramatic symptom is involuntary weight loss. In fact, weight loss may occur even when the patient is consuming a normal amount of calories each day. Another symptom is loss of skeletal muscle (muscle that facilitates movement). Both fat and muscle mass are lost with cachexia.

A patient may experience a lack of appetite or lose the desire to eat (known as anorexia). Interestingly, it isn't necessary just a lack of appetite in the case of 'nothing sounds good.' The patient may actually lose the desire to eat anything, generally speaking. The physical act of eating no longer sounds appealing, even if they understand they need to eat to survive. Unfortunately, this often leads to a lower quality of life, which is unavoidable as the condition progresses.

An example of the physical effects of cachexia
cachexia

Though the causes aren't completely understood, there are two hypothesized causes, or at least factors that may amplify cachexia: tumor factors and host response. Tumor factors are chemicals released by a tumor, and host response is the body's reaction to the tumor. It, in turn, releases its own chemicals.

Treatment Options

Unfortunately, there is no cure for cachexia. Though cachexia is not caused by a calorie deficit, it is still critical to make sure patients are eating a well-balanced diet. Once a patient loses the ability to manually eat, a feeding tube can be inserted to automate nutrition.

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Additional Info

What is Cachexia?

Cachexia is a condition where a person loses substantial body weight and muscle mass in a short period of time due to a chronic illness. These illnesses could include type 1 diabetes, types of cancer, multiple sclerosis, HIV, and 'failure to thrive' conditions.

In these scenarios, weight loss is completely unintentional and is a side effect of a patient's illness. Once muscle mass decreases too much, the patient will no longer be able to move and will become completely immobile. Cachexia is common in cancer patients with poor prognoses who have stopped responding to treatment and is responsible for about 20% of cancer deaths.

Cachexia is difficult to treat because the weight loss is not just due to a calorie deficit. So simply telling a patient to 'eat more' on their own isn't always the best solution. The underlying causes of the condition are poorly understood, and it can be present before the patient even begins losing weight.

Symptoms of Cachexia

What are the symptoms of this mysterious condition? The most dramatic symptom is involuntary weight loss. In fact, weight loss may occur even when the patient is consuming a normal amount of calories each day. Another symptom is loss of skeletal muscle (muscle that facilitates movement). Both fat and muscle mass are lost with cachexia.

A patient may experience a lack of appetite or lose the desire to eat (known as anorexia). Interestingly, it isn't necessary just a lack of appetite in the case of 'nothing sounds good.' The patient may actually lose the desire to eat anything, generally speaking. The physical act of eating no longer sounds appealing, even if they understand they need to eat to survive. Unfortunately, this often leads to a lower quality of life, which is unavoidable as the condition progresses.

An example of the physical effects of cachexia
cachexia

Though the causes aren't completely understood, there are two hypothesized causes, or at least factors that may amplify cachexia: tumor factors and host response. Tumor factors are chemicals released by a tumor, and host response is the body's reaction to the tumor. It, in turn, releases its own chemicals.

Treatment Options

Unfortunately, there is no cure for cachexia. Though cachexia is not caused by a calorie deficit, it is still critical to make sure patients are eating a well-balanced diet. Once a patient loses the ability to manually eat, a feeding tube can be inserted to automate nutrition.

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Frequently Asked Questions

What is meant by cachexia in medical terms?

Cachexia is derived from the Greek word kakhexia, meaning "bad condition." Cachexia is a medical condition that often exacerbates the symptoms of a preexisting condition. There is no cure for cachexia, and it is often viewed as the very last illness a patient will experience before death.

What causes cachexia?

Cachexia is often caused as a complication of a preexisting late-stage chronic illness. Such illnesses include cancer, HIV, AIDS, kidney disease, chronic obstructive pulmonary disorder (COPD), and congestive heart failure (CHF).

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