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Cancer Cachexia

WHAT YOU NEED TO KNOW:

What is cancer cachexia?

Cancer cachexia is a condition that causes severe weight loss, muscle wasting (loss), and inflammation. It can develop during any stage of cancer, but it is most common during late stages. Cachexia can be caused by your body's reaction to cancer or to cancer treatment. Precachexia means you lost up to 5% of your original weight. Cachexia means you lost more than 5% of your original weight within 12 months. Refractory cachexia means you lost weight and muscle mass, and you are not responding to cancer treatment. You may go through any or all of the stages. Management of cachexia can help you feel better and enjoy your daily activities more easily.

What are the signs and symptoms of cancer cachexia?

  • Loss of appetite and suddenly eating less food than usual
  • Loss of muscle mass and at least 5% of your original weight
  • Feeling mentally and physically tired (fatigue)
  • Frail (weak, thin) body

How is cancer cachexia diagnosed?

  • Blood tests may be used to check for inflammation. The tests may also be used to check for anemia (not enough red blood cells), or for low protein or electrolyte levels. Blood tests can also show if you have insulin resistance (your body cannot use insulin easily).
  • Nutrition screening includes questions about changes to your appetite and weight. Healthcare providers will record your height and current weight. They will ask if you have been eating less than you used to eat. The providers will ask if certain foods are hard to eat, or if any food causes nausea or other problems. Questions will also include how much activity you usually get, and if this has changed. Tests may be used to find how many calories your body needs to function well. Your answers and test results help providers know if you are getting the right nutrition.

How is cancer cachexia treated?

No specific treatment is available. The following may help you feel better:

  • Medicines may be given to improve your appetite or help your body digest food more easily. Medicines may also be given to help relieve or prevent nausea, constipation, or diarrhea. Steroids may be given to help control nausea and vomiting or reduce inflammation or pain. Antidepressants may also be given if depression is causing a loss of appetite.
  • Medical nutrition therapy (MNT) is given by a dietitian. MNT may include creating meal plans with foods that do not cause nausea or other symptoms. The foods may be high in calories to help you gain or maintain weight. MNT may also include supplements or vitamins. High-calorie or high-protein drinks may be recommended. These should not be used instead of regular food, but it may help to drink them along with food.

What can I do to manage cancer cachexia?

You may need a swallow test to find the foods and liquids that are best for you. Your dietitian or healthcare provider may help you create specific meal plans based on your swallow test and nutrition needs. The following are general guidelines to follow:

  • Try to be active throughout the day. Even a little activity can increase your appetite. Activity can also help prevent or manage constipation. Exercises that use your body weight or weights you hold can help keep or build muscle mass. Talk to your healthcare provider about the best kinds of activity for you. He or she can help you create an activity plan. You may want to ask someone to be with you during activity. The person can help you if you feel weak, tired, or dizzy. Stop right away if you feel any of these. Sip some liquid before you try to stand or walk.
    Walking for Exercise
  • Eat a variety of healthy foods. Healthy foods include fruits, vegetables, dairy products, meat, fish, whole-grain breads and cereals, nuts, and cooked beans. Foods that are high in protein can help you keep muscle mass. Examples include meat, fish, cooked beans, and eggs. You may need to try certain foods to see which are easiest for you to eat. It may also help to eat several small meals during the day instead of 3 large meals. If possible, keep a record of what you eat and drink each day. Include the time of day, amount you had, and if it caused any symptoms. Bring the record with you to follow-up visits.
    Healthy Foods
  • Drink liquids as directed. Liquid helps prevent dehydration. Your healthcare provider can tell you how much liquid to drink each day, and which liquids are best for you. Drink liquids between meals instead of with meals so you do not get full too quickly.
  • Prevent or manage nausea. Eat small meals that are high in calories and protein every few hours. This may also help prevent diarrhea or constipation. Choose dry or bland foods. Examples include toast, crackers, pretzels, yogurt, cream of wheat, boiled potatoes, rice, and noodles. Avoid foods that have strong odors. If possible, let someone else prepare meals. Try to avoid being around the smell of food until it is time to eat. If you need to lie down right after you eat, use several pillows to keep your head high.
  • Manage a sore or dry mouth, tongue, or throat. Eat foods that are soft, moist, and blenderized (foods thinned in a blender). Use liquids to moisten dry foods, or take a sip of liquid with every mouthful of food. Do not eat foods that are crisp or tough. Do not have foods or drinks that can increase mouth and throat pain. Examples are anything spicy, salty, acidic, hot, or cold. The following may also help:
    • Rinse your mouth with club soda or baking soda mixed with water throughout the day. Do not use mouthwash that contains alcohol. The alcohol may burn mouth sores and dry your mouth. Your healthcare provider can recommend a mouth rinse to help clean your mouth and keep it moist.
    • Drink caffeine-free liquids throughout the day to decrease mouth dryness.
    • Suck on hard candy or chew sugar-free gum to help make more saliva if you have a dry mouth.
    • Limit or do not have salty foods and drinks that contain alcohol. These can all dry your mouth.

Where can I find more information and support?

  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • National Cancer Institute
    6116 Executive Boulevard, Suite 300
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address: http://www.cancer.gov

Call your local emergency number (911 in the US) for any of the following:

  • You suddenly feel lightheaded and short of breath.

When should I seek immediate care?

  • You are too weak or dizzy to stand, or feel faint.
  • Your abdomen is larger than usual.
  • You vomit for more than 3 days in a row.
  • You cannot swallow food at all.

When should I call my doctor?

  • You have new or worsening nausea, vomiting, or other symptoms.
  • You feel depressed or anxious.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.