Cancer Cachexia is a wasting syndrome that over half of cancer patients will experience. Some of the symptoms of cancer cachexia include weight loss, loss of appetite, early satiety, changes in taste, ascites, and dry mouth. There are two forms of this syndrome, primary anorexia cachexia and secondary anorexia cachexia. Primary anorexia cachexia is directly related to the disease process while the latter version is a consequence of other factors not directly associated with the disease such as chronic infection, inadequate food intake, and impaired absorption of nutrients among other things. Treatment measures are mainly to improve quality of life and reverse the condition through early detection, nutrition counseling, exercise, medications and treating the secondary causes as well as taking care of their emotional well being.
Patients have been shown to benefit from dietary counseling in treating cancer cachexia. When assessing the patient it is important to review the patient’s medical history, medications/supplements taken, weight changes, dietary intake, labs, bioimpedance analysis, skin fold thickness, mid arm circumference, and DEXA scan. Pertinent labs in the nutritional assessment of the patient include transferrin, retinol binding protein, albumin and prealbumin. Patients should be encouraged to consume nutrient and energy dense foods. High calorie nutrition supplements are also beneficial in treating this condition. Exercise can help build lean body mass in these patients. For patients with very poor appetites, appetite stimulants like megace, medroxyprogesterone, and prednisolone can be effective in improving oral intake of food. Nutrition support may be warranted in situations where oral intake is not adequately meeting the patient’s nutritional needs. Enteral tube feedings, as always is the preferred method of administering nutrition support if the patient is agreeable to such methods of nutrition support and if the patient’s condition exhibits no contraindications for enteral tube feeds. In cases where enteral tube feeds are contraindicated (ex. bowel obstruction, malabsorption, etc.) parenteral nutrition is preferred.
There is some evidence that omega-3 fatty acid supplements may improve appetite and hinder growth of tumors. Additionally, growth hormones, testosterone, melatonin, cannabinoids and thalidomides have shown that they may be beneficial in combatting symptoms such as weight loss and lack of appetite but these benefits have also not been established.Reference:
Granda-Cameron, Clara. "Cancer Cachexia." A Guide to Oncology Symptom Management. Ed. Mary P. Lynch. Pittsburgh: Oncology Nursing Society, 2010. 65-89. Print.