Cachexia or “wasting syndrome” involves the loss of skeletal muscle and adipose (fat) tissue in the latter stages of mesothelioma and other cancers. Cachexia is the most common side effect of malignant cancers: At least half of all patients with cancer are affected by cachexia.
Cancer cachexia usually goes hand-in-hand with loss of appetite, also called anorexia. The term “anorexia-cachexia syndrome” describes the resulting condition.
Cancer Cachexia: A Fatal Condition
In addition to causing dramatic weight loss, discomfort and pain, the onset of this condition often leads to malnutrition, and marks the beginning of a quick decline in the health of a mesothelioma patient. Patients with cachexia generally die more quickly than those without it.
Neil Schachter, MD, medical director of respiratory care and professor of pulmonary medicine at Mount Sinai Medical Center in New York City, says most mesothelioma patients develop the wasting condition. “It’s just part of the disease,” he says.
Cancer Cachexia: How It Happens
Dr. Schachter says cachexia probably happens to mesothelioma patients because it’s “thought that these tumors secrete certain chemicals that make the body [react].”
Bartolome R. Celli, MD, chief of pulmonary care at St. Elizabeth’s Medical Center in Boston, says that cachexia occurs due to the “secretion of inflammatory cytokines such as tumor necrosis factor alpha, also known as cachexin. These factors appear responsible for the symptoms of fatigue, malaise, and weight loss.”
A cytokine is a powerful molecule that acts a messenger between cells; it is involved in immune system regulation. When a cytokine’s function is altered, it plays an important role in disease, including cachexia.
These altered cytokines, as well as other molecules, interfere with the body’s normal metabolism, causing it to burn calories faster.
Cancer Cachexia: Drug Treatments
Drugs are available that work to increase appetite and minimize tissue wasting.
- Gastroprokinetic agents. These drugs delay food from being emptied from the stomach, which may result in better absorption of nutrients.
- Eicosapentanoic acid. This type of omega-3 fatty acid is essential to good nutrition and seems to have a positive effect on cachexia.
- Cannabinoids. These drugs, found in marijuana, which have shown comforting effects on cancer pain, may help inhibit tumor growth as well as stimulate appetite.
Cancer Cachexia: Nutritional Treatments
While nutritional remedies have been used, simple remedies are not helpful.
“There are ways to increase appetite and get a little weight on people, but they are not ideal,” Schachter says. “In other words, you can give them dietary supplements, like a high-protein milkshake. And then there are appetite stimulants. Wine is an appetite stimulant. Then there’s [megestrol acetate] Megace, a hormonal preparation that stimulates the appetite.”
Also, says Raffit Hassan, MD, senior investigator and chief of the solid tumor immunotherapy section of the laboratory for molecular biology at the National Cancer Institute’s Center for Cancer Research, nutritionists can help mesothelioma patients achieve better quality of life.
“We use a multi-[treatment] approach, and have these patients evaluated by nutritional experts while we treat them with chemotherapy,” says Dr. Hassan.
Cancer Cachexia: Other Possible Treatments
It’s possible that short-term group psychotherapy, relaxation techniques, and hypnosis could help cancer patients with fatigue and anorexia; some research has shown there could be some benefit for these patients.