The mechanisms and treatment of weight loss in cancer

Abstract

This syndrome is known as cancer cachexia, the term cachexia being derived from the Greek words ‘kaxos’ and ‘hexis’ meaning poor condition. The patient with cachexia is characterized by a group of symptoms including anorexia, early satiety, marked weight loss, aesthenia, anaemia and oedema. The importance of weight loss in cancer has long been recognized. As far back as 1932 Warren in a post-mortem study estimated that as many as 22% of patients with cancer die primarily as a result of cachexia (Warren, 1932). More modern studies would put this percentage at perhaps 10 (Inagaki et al. 1974). Nevertheless, currently the majority of cancer patients die from sepsis, and there remains the complex inter-relationship between poor nutritional status and a propensity to infection... With the recognition of the morbidity and mortality associated with cachexia, the past 15 years have seen attempts to use nutritional support to try to reverse the nutritional deficit associated with progressive cancer growth. These studies have, however, not met with great success. Conventional nutritional support does not readily reverse the nutritional deficits associated with progressive tumour growth (Nixon et al. 1981; Cohn et al. 1982) and not surprisingly nutritional support has failed to reduce overall morbidity and mortality (Brennan, 1981; Chlebowski, 1986). These disappointing results have led investigators back to the drawing board.