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Cachexia Treatment In Oncology Rehab

Updated: Jul 19

What is Cachexia?


Otherwise known as 'Wasting Syndrome", a loss of body mass, including lean body mass and fat in the presence of a disease.


What is the difference between Sarcopenia and Cachexia?


Sarcopenia is the loss of muscle mass and function due to the effects of ageing in the absence of a chronic disease.


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Image showing the effects of Sarcopenia in a 40 year old female marathon runner


What is the difference between Cachexia and Anorexia?


Anorexia is the loss of appetite and/or aversion to food. Cachexia is in the presence of a chronic disease process.


At what age does Sarcopenia commence?


After the age of 30 you begin to loose 3-5% of your muscle mass per decade. Most men loose 30% of their muscle mass over their lifetime.

In women the percentage is higher, accelerating after menopause due to the drop in hormone progesterone which assists with muscle retention.


What causes Cachexia?


Certain types of cancer including pancreatic, gastric, lung, oesophageal, colorectal and head and neck cancers. Less commonly seen in breast cancer. Present in 30-70% of people with cancer.

Also seen in congestive heart failure, chronic obstructive airways disease, chronic kidney disease and AIDS.

Systemic inflammation from these conditions can cause detrimental changes to the metabolism and body composition.


What does Cachexia look like?


Some can look malnourished, others appear normal weight.


How is Cachexia diagnosed?


When you have lost at least 5% of your body weight in the last 12 months, or less and have a known illness or disease.


What are the main symptoms of Cachexia?


  • Severe weight loss, including loss of fat and muscle mass,

  • Loss of appetite,

  • Anaemia, (low red blood cell count),

  • Weakness and fatigue.


Does Cachexia cause pain?


  • Decreased functional capacity,

  • Malaise, fatigue and low energy levels,

  • May include feelings of discomfort, extreme tiredness and lack of motivation.

  • If intercostal muscles are affected there is a decreased blood flow to muscles, increased chance of lung infections and breathlessness on exertion.


Can Cachexia cause death?


Cachexia is the cause of death in 22-30% of cancer patients.


What is the best treatment for Cachexia?


Exercise due to its anti inflammatory effect is effective at counterbalancing muscle catabolism, (breaking down), by increasing protein synthesised reducing protein degradation, thus successfully improving muscle strength, physical function and quality of life.



Image of female in late 40's squatting against resistance to stress muscle


Progressive resistance training shows the best results, along with supplementing amino acids post exercise, increasing weight in the first 20 weeks.


With some cancer patients COX-2 inhibitors are used in combination with progressive resistance training. COX-2 inhibitors are a subclass of nonsteroidal antiinflammatory drugs (NSAIDs). NSAIDs work by reducing the production of prostaglandins, chemicals that promote inflammation, pain, and fever.


Steroids provide a false weight gain by causing increased hunger and fluid retention.


Progesterone can assist with a small rise in body mass which is not sustained.


Cannabinoids cause increased snacking but minimal effect on muscle mass.


A high protein diet with carbohydrates timed before and after resistance training can assist with slowing but does not reverse Cachexia.


When and how do I start?


It is important to work on resistance training in early stages of treatment to prevent muscle loss which is hard to recover.



Image of Physiotherapist and author, Emma Najman, demonstrating resistance band training to strengthen muscles in the upper back and arms


It is never too late to start to prevent further loss of muscle mass for function and wellbeing.



Image of Physiotherapist and author, Emma Najman, performing resisted barbell rows to build and maintain upper back and arm muscle


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Related Terms:


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