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Cachexia Health Topic
Cachexia is characterized by unintentional weight loss, muscle wasting, decreased fat storage, hypermetabolism, and a loss of appetite. The onset of cachexia and the accompanying loss of energy and strength worsens survival rates, leading to diminished quality of life for sufferers as they are no longer able or interested in participating in activities that would ordinarily be enjoyable.
Cancer cells have a very inefficient metabolism. They use glucose (sugar) as a form of energy, but due to their anaerobic (without oxygen) metabolism, they can only extract a small fraction of the energy (in the form of ATP) that a healthy cell would using aerobic metabolism. Lactate (lactic acid), the resulting waste product of this inefficient anaerobic metabolism, is carried away by the blood stream to the liver and kidneys. Through the process of gluconeogenesis and the Cori cycle, this waste product is converted back into glucose, but at a net energy loss. Excess lactate production from cancer cells therefore exacerbates energy wasting.
A cancer cells voracious energy needs divert much needed energy from the rest of the body. This imbalance between energy intake and energy expenditure eventually depletes the body’s energy reserves. Food intake becomes inadequate to the ongoing energy demands, which leads to the vicious cachexia cycle: loss of weight, loss of muscle mass, loss of energy, and loss of appetite.
Cancer cells have a very inefficient metabolism. They use glucose (sugar) as a form of energy, but due to their anaerobic (without oxygen) metabolism, they can only extract a small fraction of the energy (in the form of ATP) that a healthy cell would using aerobic metabolism. Lactate (lactic acid), the resulting waste product of this inefficient anaerobic metabolism, is carried away by the blood stream to the liver and kidneys. Through the process of gluconeogenesis and the Cori cycle, this waste product is converted back into glucose, but at a net energy loss. Excess lactate production from cancer cells therefore exacerbates energy wasting.
A cancer cells voracious energy needs divert much needed energy from the rest of the body. This imbalance between energy intake and energy expenditure eventually depletes the body’s energy reserves. Food intake becomes inadequate to the ongoing energy demands, which leads to the vicious cachexia cycle: loss of weight, loss of muscle mass, loss of energy, and loss of appetite.
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Cachexia Research Links
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Understanding Cachexia in Cancer Patients: Symptoms, Importance, and Treatment of Cancer Cachexia
Cachexia is a common complication of cancer. Cachexia is characterized by symptoms of unintentional weight loss, progressive muscle wasting, and a loss of appetite. Even though the symptoms and signs of cachexia are usually noticed late in the course of cancer, we're learning that...cachexia is often present before any weight loss occurs.
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Attacking Cancer's Sweet Tooth Is Effective Strategy Against Tumors
An ancient avenue for producing cellular energy, the glycolytic pathway, could provide a surprisingly rich target for anti-cancer therapies. This is an exciting contribution that reveals a surprising Achilles heel in cancer cells.
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Cachexia: Pathophysiology and Clinical Relevance
Cachexia is a common problem in persons with severe disease and is highly predictive of increased mortality. Cachexia also contributes to the decline in quality of life that accompanies end-stage disease. The pathophysiology of cachexia is reviewed in this article. The major cause appears to be cytokine excess. Numerous diseases can result in cachexia, each by a slightly different mechanism. Both nutritional support and orexigenic agents play a role in the management of cachexia.
SCIENTIFIC STUDY
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Cancer Anorexia-Cachexia Syndrome: Current Issues in Research and Management
Cachexia is among the most debilitating and life-threatening aspects of cancer. Associated with anorexia, fat and muscle tissue wasting, psychological distress, and a lower quality of life, cachexia arises from a complex interaction between the cancer and the host. This process includes cytokine production, release of lipid-mobilizing and proteolysis-inducing factors, and alterations in intermediary metabolism. Knowledge of the mechanisms of cancer anorexia-cachexia syndrome has led to, and continues to lead to, effective therapeutic interventions for several aspects of the syndrome. Because weight loss shortens the survival time of cancer patients and decreases performance status, effective therapy would extend patient survival and improve quality of life.
SCIENTIFIC STUDY
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Cancer Cachexia Demonstrates the Energetic Impact of Gluconeogenesis in Human Metabolism
In growing tumours the oxygen concentration is critically low. Mammalian cells need oxygen for the efficient oxidative dissimilation of sugars and fatty acids, which gives 38 and 128 moles of ATP per mole glucose and palmitic acid, respectively. In the absence of sufficient oxygen they have to switch to anaerobic dissimilation, with only 2 moles of ATP and 2 moles of lactic acid from 1 mole of glucose. Growth of these tumour cells will require about 40 times more glucose than it should require in the presence of sufficient oxygen.
SCIENTIFIC STUDY
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The Cori Cycle
The Cori cycle (also known as the Lactic acid cycle) refers to the metabolic pathway in which lactate produced by anaerobic glycolysis in the muscles moves to the liver and is converted to glucose, which then returns to the muscles and is metabolized back to lactate.
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The Effect of Polyunsaturated Fatty Acids on the Progress of Cachexia in Patients with Pancreatic Cancer
Cachexia is common in patients with pancreatic cancer and has been associated with persistent activation of the hepatic acute phase response and increased energy expenditure. Fatty acids have been shown to have anticachectic effects in animal models and to reduce inflammatory mediators in healthy subjects and patients with chronic inflammatory disease. Patients had a median weight loss of 2.9 kg/month prior to supplementation. At a median of 3 months after commencement of fish oil supplementation, patients had a median weight gain of 0.3 kg/month. Changes in weight were accompanied by a temporary but significant reduction in acute phase protein production and by stabilisation of resting energy expenditure.
SCIENTIFIC STUDY
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Influence of Hydrazine Sulfate on Abnormal Carbohydrate Metabolism in Cancer Patients with Weight Loss
Glucose tolerance was significantly improved in patients receiving 30 days of hydrazine sulfate. In addition, the rate of total glucose production was significantly decreased after 30 days of hydrazine sulfate compared to placebo treatment. Toxic effects of hydrazine sulfate were minimal. Our results suggest that hydrazine sulfate can influence the abnormal carbohydrate metabolism associated with weight loss in patients with cancer.
SCIENTIFIC STUDY
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Fish Oil and Treatment of Cancer Cachexia
The patho-physiology of cancer-induced weight loss is mainly due to failure of food intake and to various metabolic abnormalities, including hypermetabolism. Multiple biologic pathways are involved in this process, including proinflammatory cytokines, neuroendocrine hormones, and tumour speciï¬c factors. As a result, a protein and energy depletion is observed that is greater than what would be expected based on the simple decrease of food intake and is associated with marked reduction of lean body mass. Omega-3 fatty acids in dose of at least 1.5 g/day for a prolonged time to advanced cancer patients with weight loss, are associated with an improvement of clinical, biological and functional parameters and with amelioration of quality of life.
SCIENTIFIC STUDY
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Adenosine Triphosphate for Cancer Cachexia (pdf)
Cancer cachexia adversely affects quality of life by invariably producing deilitating fatigue and psychological distress. The conclusion of the study was that ATP supplementation improved nutritional status by maintaining energy intake without reducing resting energy expenditure. In addition, muscle strength and quality of life did not decline in the ATP study group. The benefit of ATP appears to be in preventing further decline in nutritional and functional status produced by the cachectic process. Treatment should ideally be given at the earliest evidence of cachexia when patients still have good function.
SCIENTIFIC STUDY
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Clinical Trial: Omega-3 Fatty Acids in Treating Patients With Advanced Cancer Who Have Significant Weight Loss
Trial Rationalle: Omega-3 fatty acids are used by the body for energy and tissue development and may be an effective treatment for patients with advanced cancer who are unable to maintain their body weight.
CLINICAL TRIAL
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