Treating Cancer Cachexia

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Cachexia, or "wasting syndrome," is a loss of skeletal muscle and adipose tissue* that occurs in the latter stages of cancers such as asbestos lung cancer (mesothelioma), as well as other chronic and degenerative diseases, including AIDS and cystic fibrosis. Cachexia associated with cancer is often called cancer cachexia. It is estimated that up to 75 percent of late-stage cancer patients suffer from cachexia.**

Because cancer cachexia usually goes hand in hand with cancer anorexia (loss of appetite), the term anorexia-cachexia syndrome has been coined to describe the resulting condition. In addition to causing dramatic weight loss, discomfort and pain, the onset of this condition often leads to malnutrition and marks the beginning of a quick decline in the health of a mesothelioma patient, eventually ending in death.

As a result, anything that can be done to delay its onset or minimize its effects is extremely important to a patient’s quality/length of life. In a nutshell, this often translates to nutritional strategies and steps to prevent loss of appetite from triggering the onset of cachexia or worsening its effects. Certain drug therapies have also proven relatively effective in delaying the loss of muscle and tissue associated with cancer cachexia.

Causes and Effects of Cancer Cachexia

Cachexia can be and usually is caused by a number of factors, including changes in metabolism, immune system changes, and inadequate intake of calories. In the case of malignant mesothelioma and other cancers, scientists originally believed that cachexia was caused by tumors robbing the body of nutrients. More recent studies have shown that a tumor’s main role in cachexia is its production of substances that prevent the liver from producing a protein called albumin. This process is a primary cause of wasting syndrome and, ultimately, the malnutrition it leads to.

The reason cachexia is so destructive is that when the body senses a lack of nutrients, it begins to tap into other sources of energy, namely skeletal muscle and adipose tissue. The weight loss caused by this process is made worse by the fact that many cancer patients experience a loss of appetite, and by the fact that cancer causes the body’s metabolism to speed up. Furthermore, cachexia can adversely affect a patient’s ability to fight off infection and withstand mesothelioma treatments such as chemotherapy and radiation therapy. As a result of all these negative effects, the body begins to waste away.

Unlike weight lost from anorexia, weight lost as a result of cachexia cannot be restored by changing one’s diet. However, in the early stages of mesothelioma, and during treatment (prior to the onset of cachexia), a diet plan that addresses a mesothelioma patient’s nutritional needs can help the patient prevent infection and tolerate the treatment. This is why it is so important that patients with mesothelioma and other diseases associated with wasting syndrome do everything they can to tackle anorexia, maintain proper nutrition and stave off the effects of cachexia. For more information, see our article on diet and nutrition.

Cancer Cachexia Treatments

Studies such as those mentioned above have led to treatments that can, in some cases, help delay the progress of cachexia. While changes in diet cannot reverse the effects of cachexia, it is nonetheless clear that patients suffering from this condition need more protein to minimize the loss of muscle mass. Oncologists sometimes prescribe drug and hormone treatments that have been shown to slow the breakdown of protein and reduce inflammation (another complicating factor). The following are some of the classes of drugs traditionally prescribed for cachexia:

Statins
Progestational agents
Glucocorticoids
Cannabinoids
Anabolic steroids
Cyproheptadine/anti-serotonergic agents
Metoclopramide

Those interested in learning how these medications work should speak with their doctors or refer to the following article from the Oncology Nutrition Connection [PDF].

In recent years, oncologists have also begun to experiment with a number of newer treatments, including thalidomide, megestrol, melatonin, and even ibuprofen.

In addition, there is some evidence to suggest that consuming fish oil can preserve protein and reduce inflammation, because it contains omega-3 fatty acids. Creatin, which is used by athletes to increase muscle mass, is also being studied.

What You Can Do

The sad truth is that most mesothelioma patients with cachexia face a grim prognosis. Measures taken to fight cachexia will not stop mesothelioma from progressing. The real goal is to slow the progression of the disease and improve the patient’s quality of life. In some cases this can be accomplished through drug therapies or nutritional strategies, which can alleviate mesothelioma symptoms and help the patient tolerate cancer treatments.

If you or a loved one have just been diagnosed with mesothelioma, asbestosis, or another asbestos-related condition, time is of the essence. Please refer to other articles on this site to learn more.

* Adipose tissue is loose connective tissue that contains fat cells.
** Abramson Cancer Center of the University of Pennsylvania

[Page updated February 2009]