Cachexia: A muscle wasting condition in advanced cancer patients responsible for 30% of deaths
Oncologists point out that despite ongoing treatments, Cachexia's complex nature makes it as elusive to cure as cancer itself
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Cachexia accounts for 30% of deaths among advanced-cancer patients, yet it remains poorly understood. According to oncologists, Cachexia is a lethal muscle-wasting and anorexic health condition accompanying advanced stages of cancer, and not cancer per se.
What is Cachexia?
Cancerous tumors can induce metabolic conditions such as anorexia and weight loss in the host even with increased food intake. The condition, termed as Cancer Cachexia syndrome or simply Cachexia, affects individuals in advanced stages of malignancy.
However, cachexia is not limited to cancer. It also accompanies other conditions such as HIV and kidney disorders.
The oncologists classify cachexia into three broad categories: Pre-Cachexia, True-Cachexia, and Refractive Cachexia.
“In Pre-Cachexia, the loss in body weight is less than 5% of the existing body weight. During this time cachexia may have set in. However, its advent is not very evident and may take a very experienced eye to diagnose,” Dr Mangesh P. Kamath, Additional Director, Medical Oncology at Fortis Hospitalin Bengaluru told FirstCheck.
Similarly, True-Cachexia refers to a weight loss of more than 5%, along with a body mass index (BMI) below 20.
“It is often marked by visible muscle loss in the face and arms,” Dr Kamath said.
In Refractive Cachexia, the most advanced form of the disease, the patient is not expected to live beyond three months.
“The progression in all forms of cancer could be looked at from the lens of funnel effect—initially, all cancers have different starting points but in their advanced stages, all result in cachexia,” Dr Kamath said.
Why is Cachexia fatal?
At an advanced stage of cancer, at which the onset of cachexia begins, the patient usually dies, although the cause remains unclear. Some cancer-related literature suggests that heart or respiratory failure due to muscle loss leads to eventual death.
Treatment
According to Dr Kamath, currently, progestin drugs, a synthetic form of the sex hormone progesterone, such as Megestrol Acetate are being used to treat anorexia and cachexia. Drugs such as Cyproheptadine, associated with helping the patient gain weight are also found to be effective. However, the drugs only mitigate the condition, not cure it. The effect too is short lived.
Currently the treatment for Cachexia is a work in progress, due to the extremely complex biochemistry of cancer. The treatment is further compounded by the non-uniformity in causal factors of cachexia accompanying different cancers.
“Finding a drug for cachexia is analogous to finding a cure for cancer, itself,” Dr Kamath said. “A drug specifically designed for Cachexia, if it works, will help salvage at least a few patients, who otherwise would lose the battle.”
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