Anorexia and Cachexia Syndrome

Cachexia, which is the accelerated loss of weight due to loss of muscle mass, is a frequent complication in cancer patients, a poor prognostic factor that affects tolerance to cytostatic treatment and is a major cause of death.

It occurs in about 50% of patients with extensive tumors,[aa1.1] and in up to 80% of patients in the terminal phase, being more frequent in gastrointestinal and lung tumors.

It is usually accompanied by anorexia, forming the "anorexia-cachexia syndrome" characterized by a decrease in caloric intake with progressive depletion of fat and muscle tissue that leads to a weight loss that generally exceeds 10% in 6 months.

This type of weight loss differs from other types of slimming because it is not reversed by increasing calorie intake. The weight loss is associated with: loss of appetite, progressive weakness, increased resting energy expenditure (RBE), and metabolic disturbances (hyperglycemia, hypertriglyceridemia, excessive response to glucose overload, and proteolysis).

The most extensively studied appetite-stimulating drugs are corticosteroids and progestins. Prednisolone and dexamethasone have a favorable effect on appetite, providing a feeling of well-being, although their effectiveness in reducing weight gain is debatable and their effect diminishes over time. Regarding progestins (megestrol acetate and medroxyprogesterone), randomized studies using different doses demonstrate an increase in appetite and weight.

Detecting and treating malnutrition early is the best way to prevent cachexia in a person with cancer. Talk to your doctor about having regular nutritional assessments during treatment to determine if you are at risk for malnutrition and cancer cachexia.

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