Anorexia and Cachexia in Cancer Patients

Anorexia is a loss of appetite, not to be confused with anorexia nervosa, a psychiatric condition.

Cachexia is the loss of weight and muscle mass that leads to wasting away.

While these conditions are often grouped together as Anorexia Cachexia Syndrome or Cancer Cachexia, they may also present independently.

Cachexia can be diagnosed without anorexia, as an involuntary failure of the body to absorb nutrients due to a cancer tumor or complications of the disease process or therapies. It is a life threatening syndrome, and per Nutrition in Clinical Practice, it is “estimated that one third of all cancer patients die from cachexia rather than the tumor burden itself.”

Anorexia doesn’t necessarily lead to cachexia.

Cachexia may be present first and lead to anorexia.

It is a complicated issue. While both anorexia and cachexia are common side effects of cancer and or cancer therapies, they are not accepted as simply part of the process of cancer and advanced cancer. Current cancer management is focused on understand and treating the underlying causes to improve the quality of life of a cancer patient and increase chances for survival.

Some Causes of Anorexia in the Cancer Patient:

• Effect of the tumor on the body’s metabolism
• Side effect of chemotherapy
• Nausea
• Metallic taste in the mouth
• Depression
• Taste changes
• Sores in the mouth or throat
• Inability to eat
• Indigestion
• Vomiting

Nutritional Intervention:

Cancer cells steal nutrients from healthy cells and the body expends extra nutrients during the healing process associated with cancer therapies. Nutritional therapy is focused on replacing these lost nutrients.

For the cancer patient who is still able to eat orally consider the following tips:

• Small but frequent meals every one or two hours

• Eat complex proteins which build muscle, tissue and cells

• Limit fat intake as fats take longer to digest making you not hungry

• Avoid extremes in taste

• Avoid extremes in smell (poultry, fish and eggs have a milder aroma)

• Create a pleasant eating atmosphere

• Sip or eat slowly to reduce nausea and/or gas

• Try small portions on large plates

• Increase your appetite with light exercise before meals

• Prepare food ahead of time in case you don’t feel like cooking

Other Types of Nutritional Intervention:

• Nutritional Supplements are complementary therapies utilizing vitamins, minerals and herbs. These may include Omega-3 fatty acids and Alpha Lipoic Acid.
• Appetite Stimulants include medications such as Megace or Marinol. Megace is a hormonal agent and Marinol is a cannabinoid agent.
• Parenteral nutrition is an intravenous tool for supplementation or complete nutrition.
• Enteral nutrition is for patients with oral, esophageal and/or stomach issues preventing normal ingestion of food. A tube is place either through the nose to the small intestine or stomach or the tube is placed directly into the stomach.

For more information on nutrition therapy and complementary and alternative therapies in nutrition, see Cancer and Nutrition Therapy in the Battling Cancer archives.

Additional Resources:

National Cancer Institute: Nutrition in Cancer Care.

Health Salon: Cutting Edge Information in Alternative Health Care.