What is cachexia?

Cachexia is a severe state of bodily exhaustion caused by starvation or disease, characterized by loss of appetite, weight loss, systemic failure, and abnormal metabolism of the three major nutrients (protein, carbohydrates, and fats). In its final stages, cachexia can lead to death.

Cachexia can be triggered by various diseases, including tumors, AIDS, severe sepsis, etc., with tumor-associated cachexia being the most common^[1].

What are the symptoms of cachexia?

• Loss of appetite: Due to the disease, patients may experience altered taste and reduced appetite, leading to anorexia.
• Weight loss: Tumor patients may lose weight rapidly due to reduced food intake, disease-related nutrient depletion, and metabolic abnormalities.
• Fatigue and weakness: Due to disease-related depletion and reduced food intake, patients may experience lethargy, exhaustion, and emaciation.
• Muscle atrophy: The disease increases skeletal muscle breakdown while reducing synthesis, leading to muscle wasting^[1].

What are the consequences of cachexia?

Patients with cachexia experience extreme physical weakness, reduced immunity, and are prone to infections, thrombosis, heart failure, and death^[1]. Studies report that approximately 10%–20% of advanced cancer patients die from cachexia, meaning that out of every 100 late-stage cancer patients, 10–20 succumb to cachexia^[2].

What causes cachexia?

The exact cause of cachexia remains unclear but may involve anorexia, abnormal nutrient metabolism, and disease-related demands.

• Disease-related depletion: Tumors are the most common cause of cachexia. As a consumptive disease, tumors deplete the body's nutrients severely. Gastrointestinal diseases can also impair digestion and absorption, leading to cachexia.
• Abnormal nutrient metabolism: Diseases like tumors disrupt the metabolism of carbohydrates, fats, and proteins, triggering cachexia.
• Anorexia: The pain and psychological stress caused by the disease can reduce appetite and food intake, contributing to cachexia^[1].

Which department should cachexia patients visit?

Patients can seek treatment in oncology or internal medicine departments.

How is cachexia diagnosed?

Since tumors are the most common cause of cachexia, we focus on the diagnostic criteria for cancer-related cachexia. Meeting any one of the following three criteria confirms a diagnosis^[3]:

• Unintentional weight loss of >5% over six months (e.g., a 100-pound patient losing >5 pounds) or a body mass index (BMI = weight in kg / height in m², e.g., 1.7m tall, 50kg = BMI 17.30) <20.
• Weight loss >2% over six months combined with sarcopenia.
• Decline in appendicular skeletal muscle index with weight loss >2% over six months.

How is cachexia treated?

The best approach is curing the underlying disease, but not all causes (e.g., cancer) are curable. Nutritional support, medications, and other methods are used to slow progression and improve quality of life.

What lifestyle adjustments should cachexia patients make?

• Ensure adequate rest and sleep.
• Engage in moderate activity within physical limits; avoid intense exercise to prevent injury.
• Maintain a comfortable, clean living environment.
• Relax by listening to soothing music, audiobooks, or meditating.

What dietary precautions should cachexia patients take?

• Eat a varied, nutrient-rich diet including both meat and vegetables; avoid picky eating.
• Increase intake of fresh vegetables and fruits.
• Ensure food hygiene; consume fresh foods and avoid spoiled or improperly stored items.
• Avoid alcohol^[1].