Medical expert of the article
New publications
Cancer cachexia
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Almost one of the main visual signs of the presence of a malignant tumor in the patient's body is cancer cachexia - a sharp weight loss.
The rate of development of cachexia does not depend on the location of the tumor, although in the case of defeat by the pathology of the gastrointestinal tract, the process is more progressive.
[Causes of cancer cachexia
To date, the etiology of cancer cachexia is not fully known, but physicians suggest two anchors:
- Tissue atypism. The ability of modified cells to provoke a change in the structure of the structure of the anatomical and histological format, which leads to the nucleation and development of the tumor.
- Toxicity of tumor neoplasms and their effect on metabolic processes, structural structure of healthy organs and tissues.
And as a result - cancer cachexia "cuts off" the patient all the processes of self-regulation, leading the body to a lethal outcome.
Tumor cells, having isoenzyme properties, use enzyme constituents (glucose, amino acids and lipids) to generate energy, which is used to synthesize proteins, nucleic acids, enzymes that support their division and growth. At the same time, healthy cells, due to their low competitive ability, lose these substances and enzymes necessary for their vital activity. As a result, brown atrophic spots begin to develop on the muscular tissues of the patient's organs, which leads to the exhaustion of the body and the appearance of other side manifestations.
Cancer cells not only block energy sources, but also "redraw" metabolic processes, that the necessary substrates for blood are sufficient only for their vital activity, other tissues simply do not absorb them. Analyzes of a cancer patient show an increased content of glucocorticoids in the blood. Excessive content of them activates gluconeogenesis in muscle tissues and liver, strengthens the procedure for the breakdown of fats and proteins, leading to cachexia.
Excessive uptake of glucose by the cells leads to hypoglycemia. Against the background of stress and lack of glucose, there is excessive formation and secretion of glands of internal secretion of their hormones (such as steroids), which leads to intoxication of the whole organism, hemic hypoxia (decrease in oxygen content in venous and arterial blood, decrease in arterial venous gradient difference for oxygen).
Cachexia with cancer
Loss of muscle and fat mass affects up to 70% of all patients who have a malignant tumor. Cachexia in cancer is caused by a significant weight loss of the patient (sometimes up to 50%) and this process is not related to the quantity and quality of the food. The most pronounced pathology is observed in patients who have a history of cancer, affecting the lungs and digestive tract. Such patients are able to lose up to 80% of fat cells and muscle tissue supporting the skeleton. Such damage weakens and depletes the body, riveting the patient to bed. According to the estimates of oncologists, about twenty percent of the "cancer deaths" occur in the dystrophy of the respiratory muscles, which is a direct consequence of cachexia in cancer.
Even before recently, representatives of medicine believed that malignant cells "reprogram" the work of the body in such a way that its energy potential is directed to nutrition and tumor growth, thereby depleting other tissues and organs. Today the opinion has changed. Experts believe that cachexia is the body's response to the emergence of an "aggressor".
Trying to find the cause of cachexia in cancer, practically all patients had fatty liver disease, and, based on the fact that this body is a "center for metabolic management" - the result is obvious. The gene responsible for lipogenesis is blocked. A low level of lipids in the blood indicates a lack of energy for the healthy functioning of the body, since lipoproteins are a transport that delivers fats and fatty acids to tissues and organs.
Recently, scientists discovered the gene TSC22D4, the blockage of which allowed to resume the production of lipoproteins and normalize energy metabolism. Apparently, this gene is the cause of the appearance of cachexia in cancer.
Who to contact?
Treatment of cachexia in cancer
Treatment of cancer patients is specific and is conducted only on the basis of a specialized dispensary. It begins with therapy designed to rid the patient of malignant tumors. In parallel with this, a struggle is also under way with concomitant complications of this pathology.
To stop cachexia, the doctor appoints the patient:
- Cocarboxylase
The drug allows you to remove pain symptoms, supports the work of all body systems, stimulates the normalization of the patient's body weight.
The drug is administered subcutaneously or intramuscularly. Dosage is individual. The daily dosage for adults is from 50 to 100 mg (depending on the nature and severity of the disease). The maintenance dosage is 50 mg per day. For babies up to three months of age - 25 mg in one to two doses, from four months to seven years - 25 to 50 mg (for 1 to 2 doses), adolescents 8 to 18 years old - 50 to 100 mg.
Side effects include allergic reactions to the drug. Contraindicated drug with increased sensitivity to one or more components of the composition.
A positive result is given by the use of megase (megestrol acetate), which is a synthetic prototype of the steroid hormone progesterone. This drug effectively stimulates the buildup of muscle and fat mass, which is important in the treatment of cachexia in cancer.
- Megace (Megace)
The dosage of the drug administered is individual and is prescribed by the oncologist, depending on the nature of the disease and its severity. The medicine is administered once or in several doses, the daily dose ranges from 400 to 800 mg.
Do not take megase when:
- Hypersensitivity to the constituent components.
- During pregnancy and lactation.
- Children and adolescents under the age of 18.
Life expectancy with cancer cachexia
The German Cancer Society cited monitoring data that shows that about 40% of cancer patients suffer from anorexia, half of patients suffer from a feeling of "premature satiety", 46% have a pathology of taste buds, more than half feel fullness of the stomach before physical saturation, about 40% feel dry mouth, nausea and vomiting. The consequence of this is the reluctance of cancer patients to eat, losing weight and bringing cachexia closer.
Loss of weight, skeletal muscle atrophy, and the burden of cancer treatment do not have the best effect on life expectancy with cancer cachexia.
About 80% of cancer patients with severe forms of the disease have a history of cachexia, while for about 20-30% of patients cachexia causes death. After all, if there is already atrophy of the pulmonary muscles - a person can not breathe freely.
This disease is ascertained in case of loss by the patient for half a year to 5% of the mass. In the case of diagnosis of refractory cachexia - treatment is unproductive. Consequently, the disease is progressing too actively, without reacting to the effects of chemotherapy, the metabolism is inhibited. In such a situation, life expectancy with cancer cachexia is not more than three months.
When artificial food is introduced artificially, a much greater risk is revealed than the benefits obtained, so oncologists strive to reduce the side effects of treatment in order to return the patient the desire to eat independently.