Cachexia

Cachexia

Cachexia is a health condition wherein a person suffers from significant physical wasting. This is usually associated with chronic medical conditions such as cancer and tuberculosis. ^[1]

Epidemiology

It is estimated that more than 5 million people are affected in the U.S.^[2] The condition is known to affect about 50% of patients with cancer and is approximated to be a direct contributor to the 20% of cancer mortality. ^[3]

Causes

Cachexia more often than not occurs as part of chronic diseases. Common among these are cancer, tuberculosis, AIDS and Chronic Obstructive Pulmonary Disease (COPD). Others include congestive heart failure, cystic fibrosis, rheumatoid arthritis and Crohn’s disease. Cachexia can also develop among the elderly without apparent significant disease. ^[4] The pathophysiology of cachexia is thought to be associated with cytokine excess and other probable mediators like testosterone and too much glucocorticosteroids. ^[2]

Signs and Symptoms

Patients present with loss of appetite, muscle and adipose tissue wasting, unintentional weight loss and poor performance status. ^[4]

Diagnosis

Cachexia is evaluated using certain indices such as Body Mass Index which is computed using the individual’s height and weight. Obtaining the lean muscle mass is also helpful through some tests like skin fold test. Blood examination is also done with focus on leukocyte or white blood cell count, uric acid level, serum albumin and markers of inflammation. ^[3]

Treatment

At present, treatment approaches have been described as unsatisfactory as the condition is difficult to be reversed as brought about by the underlying condition. Replacing calories has not been very helpful. Yet, it is still important for patients with cachexia to be given a healthy diet. One research found out that powder supplement of eicosapentaenoic acid (EPA) obtained by eating fish leads to improved levels of inflammatory markers. Exercise may help retard the decline in muscle mass of patients. Some medications given to patients with cachexia include megestrol, celecoxib and medroxyprogesterone. ^[3]

References:

1. http://copd.about.com/od/copdglossaryae/g/Cachexia.htm
2. http://ajcn.nutrition.org/content/83/4/735.short
3. http://lungcancer.about.com/od/effectsoflungcancer/a/Cachexia.htm
4. http://link.springer.com/chapter/10.1007%2F978-88-470-0552-5_15?LI=true

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