Medical expert of the article
New publications
Cancer cachexia
Last reviewed: 05.07.2025
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If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.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 – sudden weight loss.
The rate of development of cachexia does not depend on the location of the tumor, although in the case of damage to the gastrointestinal tract, the process is more progressive.
[ Causes of cancer cachexia
To date, the etiology of cancer cachexia is not completely known, but doctors suggest two connections:
- Tissue atypism. The ability of modified cells to provoke a change in the structure of the anatomical and histological format, which leads to the emergence and development of a tumor.
- Toxicity of tumor formations and their impact on metabolic processes, structural structure and functioning of healthy organs and tissues.
And as a result, cancer cachexia “turns off” all self-regulation processes in the patient, leading the body to death.
Tumor cells, having isoenzyme properties, use enzymatic components (glucose, amino acids and lipids) to produce 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 muscle tissues of the patient's organs, which leads to exhaustion of the body and the appearance of other side effects.
Cancer cells not only block energy sources, but also "reshape" metabolic processes so that the necessary blood substrates are sufficient only for their vital functions, other tissues simply do not absorb them. Cancer patient's tests show increased levels of glucocorticoids in the blood. Their excessive levels activate gluconeogenesis in muscle tissues and liver, intensify the process of fat and protein breakdown, leading to cachexia.
Excessive absorption of glucose by neoplastic cells leads to hypoglycemia. Against the background of stress and glucose deficiency, there is excessive formation and secretion of hormones by endocrine glands (such as steroids), which leads to intoxication of the entire body, hemic hypoxia (reduction in the level of oxygen content in venous and arterial blood, reduction in the difference in arterial-venous gradient of oxygen).
Cachexia in cancer
Loss of muscle and fat mass affects up to 70% of all patients with a malignant tumor. Cachexia in cancer is caused by a significant loss of weight of the patient (sometimes up to 50%) and this process is in no way connected with the quantity and quality of food consumed. The most pronounced pathology is observed in patients with a history of cancer affecting the lungs and digestive tract. Such patients are capable of losing up to 80% of fat cells and muscle tissues that support the skeleton. Such damage weakens and depletes the body, confining the patient to bed. According to oncologists, about twenty percent of "cancer deaths" are due to dystrophy of the respiratory muscles, which is a direct consequence of cachexia in cancer.
Until recently, medical professionals believed that malignant cells "reprogram" the body's work in such a way that its energy potential is directed to feeding and growing the tumor, thereby depleting other tissues and organs. Today, the opinion has changed. Experts believe that cachexia is the body's response to the appearance of an "aggressor".
Trying to find the cause of cachexia in cancer, fatty liver degeneration was found in almost all patients, and based on the fact that this organ is the "metabolism control center" - the result is obvious. The gene responsible for lipogenesis is blocked. Low blood lipid levels indicate a lack of energy for healthy functioning of the body, since lipoproteins are the transport that delivers fats and fatty acids to tissues and organs.
Recently, scientists have discovered the TSC22D4 gene, blocking which allowed the resumption of lipoprotein production and normalization of energy metabolism. Apparently, this gene is the cause of cachexia in cancer.
Who to contact?
Treatment of cachexia in cancer
Treatment of cancer patients is specific and is carried out only at a specialized dispensary. It begins with therapy designed to rid the patient of malignant neoplasms. In parallel with this, the fight against the accompanying complications of this pathology is also carried out.
To relieve cachexia, the doctor prescribes the patient:
- Cocarboxylase
The drug helps relieve pain symptoms, supports the functioning of all body systems, and stimulates the normalization of the patient’s body weight.
The drug is administered subcutaneously or intramuscularly. The dosage is individual. The daily dosage for adults is from 50 to 100 mg (depending on the nature and severity of the disease). Maintenance dosage is 50 mg per day. For children up to three months of age - 25 mg in one or two doses, from four months to seven years - 25 - 50 mg (in 1 - 2 doses), adolescents 8 - 18 years - 50 - 100 mg.
Side effects include allergic reactions to the drug. The drug is contraindicated in case of hypersensitivity to one or more components of the composition.
A positive result is also given by the use of megaceis (megestrol acetate), which is a synthetic prototype of the steroid hormone progesterone. This drug effectively stimulates the growth of muscle and fat mass, which is relevant in the treatment of cachexia in cancer.
- Megace
The dosage of the administered drug is individual and is prescribed by an oncologist depending on the nature of the disease and its severity. The drug is administered once or in several doses, the daily dose ranges from 400 to 800 mg.
You should not take Megace if:
- Hypersensitivity to the components.
- During pregnancy and breastfeeding.
- For children and adolescents under 18 years of age.
Life expectancy in cancer cachexia
The German Cancer Society has provided monitoring data showing that about 40% of cancer patients are subject to anorexia, half of the patients suffer from a feeling of "premature satiety", 46% have a pathology of taste receptors, more than half feel a full stomach even before physical satiety, about 40% feel dry mouth, nausea and vomiting. As a result, cancer patients are reluctant to eat, losing weight and approaching cachexia.
Weight loss, skeletal muscle atrophy, and the burden of cancer treatment do not have the best effect on life expectancy in cancer cachexia.
About 80% of cancer patients with severe forms of the disease have cachexia in their anamnesis, and for about 20-30% of patients cachexia becomes the cause of death. After all, if atrophy of the pulmonary muscles already occurs, a person cannot breathe freely.
This disease is diagnosed when the patient loses up to 5% of his/her weight over six months. In case of refractory cachexia, treatment is ineffective. Consequently, the disease progresses too actively, not responding to the effects of chemotherapy drugs, and metabolism is inhibited. In such a situation, the expected life expectancy for cancer cachexia is no more than three months.
When introducing nutrition artificially, the risk is significantly greater than the benefit received, so oncologists strive to reduce the side effects of treatment in order to restore the patient's desire to eat independently.