Cachexia or Wasting Syndrome

Cachexia, also known as Wasting Syndrome, describes a condition in which the body begins to deteriorate during the end-stages of diseases such as cancer and AIDS. The onset of AIDS wasting and cancer wasting usually occurs when a person is close to death, and it is signaled by a loss of ten percent or more of body mass when the person is not intending to lose that mass. Often, both fat and muscle tissue will degrade, but they may not be lost in equal amounts. The most important factor is the loss of lean body mass, or muscle, as body fat can be shed with fewer adverse health effects. In some patients and for some diseases, there will be episodes of wasting to a lesser degree as the disease progresses without leading to death, but when a sudden loss of ten percent or greater occurs, it is a sign that the stage of the disease is advanced to a terminal stage.

The main symptoms of wasting syndrome are its defining factors, the loss of weight from muscle and fat deterioration. Secondary symptoms include:

  • Diarrhea or vomiting lasting for 30 days or more
  • Progressive weakness over a 30 day period
  • A fever lasting for several days
  • Loss of appetite or anorexia

While healthy individuals can lose a percentage of their lean body mass and fat, the dangers are especially pronounced for cancer and AIDS patients as their bodies will burn large amounts of muscle to fight an infection. Converting fat is much more difficult for the body than converting the protein in muscle, so the primary signature of wasting syndrome is that the body loses muscle much faster than fat.

Wasting syndrome is caused or contributed to through many factors. A loss of appetite, common with patients who have HIV or patients undergoing chemotherapy, can lead to rapid loss of body mass. When diarrhea or intestinal lining abnormalities occur, it also impedes the body's ability to absorb nutrients. Often, infections will cause changes in metabolism or body chemistry, and when those changes are severe, it causes the body to stop accepting nutrients as it normally has. Another cause of cachexia is through addiction to amphetamines or other drugs such as cocaine.

Wasting syndrome will most likely be found in a co-morbid situation with another disease. Aside from AIDS and various forms of cancer, it will be found alongside with the following:

  • Congestive heart failure
  • Tuberculosis
  • COPD, chronic obstructive pulmonary disease
  • Severe cases of schizophrenia

To identify wasting syndrome, a doctor can perform a BIA test, bioelectrical impedance analysis, to keep track of the patient's weight, or a doctor could track a patient's BMI, body mass index, to watch for sudden, pronounced weight loss.

While there is no standard treatment for wasting syndrome, there are methods to treat the symptoms while a person is affected to encourage a recovery. If diarrhea or vomiting are an issue, then anti-diarrhetics and anti-nausea medication may be prescribed. If the patient is experiencing a loss of appetite, drugs such as Marinol, a synthetic version of the compounds found in marijuana, may be prescribed to increase the appetite of a patient.

A patient can keep nutrients cycling through the body, but if the nutrients are not being absorbed, then it will not help. For changes in metabolism, intestinal lining, and other absorption factors, a doctor will have to prescribe a medication or treatment which will address those issues for the specific patient. Due to the variable nature of wasting syndrome, there is no set way to treat it, and a doctor will need to identify and treat specific symptoms on a case-by-case basis.

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