Cachexia: Severe weight loss in cancer


weight loss can be very distressing for cancer patients. The reasons are varied. For example, the absorption and utilization of food in the case of cancer can be impaired by the therapy: Some patients suffer from one chemotherapy an nausea, which spoils the appetite. Damage to the mucous membrane of the esophagus after radiation can make eating a torture. If large parts of the stomach or intestines have been removed, nutrient absorption can be impaired. Such weight loss in tumor patients can often be corrected, but this usually requires very specific nutritional advice. There should be a corresponding offer in cancer clinics. What seems helpful and sensible in the individual case is best discussed by patients with their doctor.

But he also leads Krebs themselves frequently to weight loss, which is sometimes the first symptom to be noticed. Unexplained weight loss should therefore always be clarified by a doctor. Some cancer patients experience severe wasting, known as tumor cachexia. The eyes sink in, the skin sags, the bones stand out. Not only are those affected weakened and stigmatized, cachexia is also a threatening condition. Because the massive loss of fat and muscle mass is difficult to counteract as long as the tumor continues to proliferate, which means that the strength of those affected dwindles.

Who is at risk of cachexia?

About 15 percent of all cancer patients suffer from severe weight loss at an early stage, i.e. they lose more than ten percent of their previous body weight. Patients with tumors of the pancreas and stomach are particularly frequently affected: in 85 percent of cases, cachexia already exists at the time of diagnosis. Also in lung, esophagus or colon cancer the problem often occurs.

What exactly happens in the body in cachexia?

“Cancer can lead to massive disruption of various metabolic pathways,” says Dr. Jann Arends, Senior Physician for Palliative Medicine in the Clinic for Internal Medicine I at the University Hospital Freiburg, explains the causes of the problem, which are not yet fully understood in detail.

Tumor cells waste energy because their metabolism is predominantly anaerobic, i.e. without oxygen. As a result, their sugar consumption is up to 40 times higher than that of normal tissue cells. However, this fact alone is not enough to explain the massive weight loss. The energy turnover of cancer patients is often completely normal.

However, there are disturbances in several metabolic pathways in the diseased organism, caused by various inflammatory and messenger substances that are released by the tumor, but also by the patient’s immune system. This typically leads to a massive breakdown of fats, but also of proteins and thus – in contrast to starvation – to muscle atrophy relatively quickly. Blood sugar is also often elevated. The exact biochemical mechanisms are highly complex and the details have not yet been fully elucidated.

What helps with weight loss?

loss of appetite and nausea can often be relieved with medication, particularly when it is a result of chemotherapy. If the patient is critically low in body weight, they should also eat a high-calorie diet and enrich the food, for example with cream, sour cream, fats and oils, if necessary with the offer of additional energy-rich liquid foods. Protein-rich foods such as cheese, quark and other dairy products, but also fish and meat support the maintenance of body cell and muscle mass. In some cases, the administration of omega-3 fatty acids and protein preparations that can be mixed with food and drinks has proven effective. However, this should always be done in consultation with your doctor or nutritionist.

If necessary, nutrients must be administered by infusion. This measure is particularly effective when normal food intake is made more difficult due to therapy, for example after radiation or an operation on the gastrointestinal tract.

New approaches to treat cachexia

The intake of calories alone counteracts the severe weight loss, but does not change the disturbed metabolic situation in cachexia. This applies above all to the breakdown of body protein, which cannot be remedied by pure “fattening”. In addition, very different influences lead to malnutrition, which is therefore hardly improved by individual measures. To date, the only truly effective treatment for cachexia is…

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