What Is Cachexia?
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Cachexia - Types, Causes, Symptoms, and Treatment

Published on Nov 01, 2022 and last reviewed on Jan 31, 2023   -  4 min read


Cachexia is called a wasting disorder that leads to extreme weight loss. This article explains this condition in detail.


Cachexia is a "wasting" disorder that causes extreme weight loss and muscle changes, including body fat loss. This syndrome is more commonly known to affect people in the late stages of serious diseases like HIV, cancer, COPD, diseases of the kidney, and congestive heart failure (CHF). The term "cachexia" has been derived from the Greek words "Kakos" and "Hexis," meaning bad condition.

Cachexia is an involuntary type of weight loss, whereas the other types of weight loss are voluntary. People experiencing it undergo weight loss without any changes in diet or exercise. One of the mechanisms behind developing this is that people undergo weight loss because they cannot consume the proper quantity and quality of diet for other reasons.

Also, these people experience changes in their metabolism. Thus, the body tends to break down too much muscle and fat. Factors that can affect the appetite are inflammation and substances produced by tumors. This can make the body burn calories faster than usual. Studies have shown that cachexia is part of the body's response to fight against the disease. Our body tends to break down the fat and muscle in the body when nutritional stores become low in the body.

A person with cachexia undergoes various changes along with losing weight. He tends to get weaker. Thus, the body becomes more vulnerable to infections. Thus, the affected person becomes more prone to die because of developed conditions. Nutrition and calories alone cannot help in recovering from this condition.

What Are The Types of Cachexia?

Following are the three main categories of cachexia:

1. Pre Cachexia

It is clinically characterized as losing up to 5 percent of the body's weight while suffering from a known illness or disease. It is associated with loss of appetite, inflammation, and metabolic changes.

2. Cachexia

This is the stage in which thereis a loss of more than 5 percent of the body weight over 12 months or less when the individual has been diagnosed with a disease and is not trying to lose weight. Various other criteria for diagnosis include loss of muscle strength, tiredness, decreased appetite, and inflammation.

3. Refractory Cachexia

This is the condition that is observed in cancer patients. This involves loss of weight, muscle, and the functional loss, including failure to respond to cancer treatment.

Studies have reported that up to 80 percent of the patients diagnosed with late-stage cancer have cachexia. Almost one-third of people with cancer face death due to this condition. The mechanism is that tumor cells tend to release various substances that can reduce the appetite.

Also, patients with cancer undergoing treatment can experience severe nausea or damage to the digestive tract, thus, making it difficult to eat and absorb nutrients. When the body gets fewer nutrients, it attempts to burn fat and muscle. Cancer cells use the limited nutrients left in the body for their multiplication and survival.

How Is It Caused?

As mentioned earlier, cachexia occurs in the late stages of serious conditions as follows:

  • Cancer.

  • Cystic fibrosis.

  • CHF: congestive heart failure.

  • COPD: chronic obstructive pulmonary disease.

  • Chronic kidney disease.

  • Rheumatoid arthritis.

The prevalence of this condition in various diseases is as follows:

  • Five percent to 15 percent of people are diagnosed with congestive heart failure or COPD.

  • Up to 60 percent of people are diagnosed with lung cancer.

  • Up to 80 percent of people are diagnosed with stomach and other upper gastro-intestinal cancers.

What Are The Signs And Symptoms?

The most common symptom in these patients is weight loss and muscle mass. Some people may look malnourished, whereas others may appear to be having a normal weight. Besides asking questions about your family history, medical history, and personal history, the physician will use certain criteria to diagnose cachexia. First, the individual must have lost at least 5 percent of the body weight within the last 12 months or less. Also, he or she should have a known illness or disease.

The patient should also have at least three of the below-mentioned findings:

  • Fatigue.

  • Anemia: a clinical condition characterized by decreased red blood cells.

  • Reduced muscle strength.

  • Anorexia: appetite loss.

  • Low fat-free mass index: It is a calculation done based on the weight, body fat, and height of the individual.

  • Decreased levels of the protein, albumin.

  • Increased levels of inflammation which various blood tests can identify.

How Can It Be Treated?

No specific treatment or reversal method has been reported till now for cachexia. The main goal of management is to alleviate the symptoms and improve the individual's quality of life.

Following are the current therapies used for the management of cachexia:

  • Adapted exercise after discussing with your physician.

  • Appetite stimulants can be used like megestrol acetate.

  • Medications that can help in decreasing inflammation.

  • Drugs like dronabinol which can be used to improve nausea, appetite, and mood.

  • Changes in the diet.

  • Nutritional supplements.

Are There Any Complications?

Cachexia can prove to be a very serious condition. It can affect the primary disease treatment response of the individual. People diagnosed with cancer and cachexia are known to tolerate chemotherapy and other therapies that they need to survive to a lesser extent when compared to other individuals. Hence, individuals with cachexia have a lower quality of life and a poor prognosis.


Cachexia does not have any treatment currently. However, studies are being done to understand this condition's exact cause and mechanism. Until now, Discoveries have helped invent medicines to manage cachexia symptoms. Left untreated can decrease the quality of life and cause death. Thus, consulting a specialist at the earliest is crucial. You can consult a specialist online with the help of online medical platforms to know more about this condition.

Frequently Asked Questions


When Does Cachexia Indicate Cancer?

Cachexia is linked to other diseases besides cancer. It frequently occurs in later-stage diseases like kidney disease, HIV, and heart disease. Losing muscle and fat leads to cachexia.


What Exactly Is a Cachectic Appearance?

Cachexia is a wasting disorder that can lead to body fat loss, extreme weight loss, and muscle wasting. This syndrome affects individuals in the advanced stages of severe illnesses such as cancer, HIV or AIDS, COPD, kidney disease, and congestive heart failure.


Which Stage of Cancer Is Cachexia?

Cachexia progresses through three stages: 
 - In pre-cachexia, less than 5 % of the body weight is lost.
 - Weight loss of over 5 % of the body weight is called cachexia. 
 - In refractory cachexia, a patient's cancer is not being treated, and the expected lifespan is no longer than three months.


How Long Does a Cachexic Person Live?

Depending on the underlying cause, cachexia has a different survival rate. Progressive cachexia frequently indicates a poor prognosis and a relatively short life span. The syndrome is marked by diminished functional capacity, increased susceptibility to cancer, and a life expectancy of less than three months.


How Does Cachexia Affect The Body?

Cachexia, a wasting syndrome characterized by the loss of skeletal muscle and fat, is considered to affect up to 80% of individuals with advanced cancer, depending on various factors. Systemic inflammation caused by these conditions can have a negative impact on metabolism and body composition.


Does Cachexia Involve Starvation?

The main distinction between starvation and cachexia is that refeeding reverses starvation but is less effective in treating cachexia. The ineffectiveness of refeeding in the treatment of cachexia may explain some of the poor clinical trial results from direct nutritional interventions.


How Is Cachexia Treated?

There is no cure for cachexia. Treatment aims to reduce the symptoms and improve the quality of life. Cachexia is not the same as average weight loss. It cannot be completely reversed.


How Does Cachexia Cause Pain?

Pain associated with metastatic cancer is adversely associated with inflammation, implying that inflammation is a common link between cancer pain and cachexia. In addition to affecting appetite and food intake, pain can exacerbate tiredness and functional decline, increasing the severity of cachexia.


How Fast Does Cachexia Develop?

The presence of cachexia is indicated by a weight loss of 10% or higher within a span of six months. Cachexia symptoms include involuntary weight loss, muscle wasting, and appetite loss (specifically, a loss of the desire to eat).


When Does Cachexia Become a Fatal Condition?

Cachexia survival rates vary depending on the cause. In individuals with conditions such as HIV, cancer, and other diseases, the extent and pace of weight loss, as well as the duration of survival, are closely linked to the underlying condition's survival time. It causes muscle mass loss, changes in body image, and a decrease in physical functional level. It is also connected to the terminal phase of life.


Which Blood Tests Reveal Cachexia?

White blood cell counts (WBC), serum albumin, transferrin levels, uric acid, and inflammatory markers like C-reactive protein (CRP) can be useful in evaluating cachexia. CRP levels were higher in cachectic patients than in non-cachectic patients.


What Is the Cachexia Mortality Rate?

Patients with cachexia have a mortality rate ranging from 15 to 25% per year in severe COPD to 20 to 40% per year in chronic heart failure. Cachexia is the leading cause of death in 22% to 30% of cancer patients. Up to 30% of patients with other chronic illnesses die of cachexia.

Article Resources

Last reviewed at:
31 Jan 2023  -  4 min read




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