Cachexia & Precachexia 
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Definition of cachexia 

Woman thinking of cancer cachexia
Early stages of cachexia (precachexia) is often invisible. Appetite loss can be a first sign.

The word "cachexia" comes from ancient Greek and means "bad condition" ("kakos" = bad; "hexis" = condition).

But unlike malnutrition, cachexia is driven by inflammation and reduced appetite. This is a serious problem for cancer patients, as it’s associated with reduced physical function, progressive functional impairment, and lower tolerance to anticancer treatment.

So, it’s good to know the threat. We want to support you with valuable information.

What is cancer cachexia?

Today, we know more about the different stages. Cachexia is a complex syndrome affecting the metabolism, and it is associated with chronic illnesses like cancer and other conditions, such as loss of appetite, fatique or decreased muscle strength. If weight loss in combination with reduced appetite and inflammation occurs, it is called cachexia. This condition is characterized by loss of muscle with or without loss of fat tissue, and can progress through various stages — precachexia to cachexia. When cancer patients are affected, it is called cancer cachexia.

Much more than just weight loss  

Cachexia is very common in certain cancer types. What many see as a minor side effect means much more than just a harmless loss of weight. It means a loss of physical energy, a loss of mental strength, a loss of quality of life and a loss of chances to regain health. It is a serious syndrome, as it weakens the whole body, because of inflammation. Cachectic patients mainly lose skeletal muscle and tissue mass.

Cachexia can limit your activity

The loss of muscle mass and muscle strength usually affects your physical activity. Gardening, biking or walking are harder than before, and your limit can be reached sooner. Your overall quality of life can be negatively affected. Reduced muscle mass also can impact your tolerance and response to treatment. If the body is also weakened by malnutrition, important resources are missing to combat the additional strain. This may directly affect your treatment: Necessary surgeries may not be carried out or your current radio- and/or or chemotherapy must be interrupted, or can only be continued at a reduced level. 

In fact, cachexia worsens treatment outcome significantly! Due to time constraints, doctors often are focused on medical factors and data to help their patients. So, being attentive in addition will pay off. Although the positive effects of nutritional support are clinically proven and well documented, awareness is still increasing slowly.

Differences between precachexia and cachexia

How to distinguish between the two terms?

Precachexia is an early stage of cachexia and precedes involuntary weight loss (also in your muscle mass). As it starts with only little weight loss, it gets easily overlooked. That means you may not lose a lot of weight at first, but metabolic changes and inflammations occur, nonetheless. Precachexia is a risk for cachexia.

Cachexia is a complex syndrome affecting the metabolism. Primarily muscle and fat are lost, and inflammation also occurs.

In a nutshell

The mechanism is simple: When the body can’t absorb enough nutrients (because of metabolic derangements or a lack of intake), the body’s supply is necessarily reduced. The result is weight loss and malnutrition. Your weight serves as the first indicator for cachexia, too.

Weight loss due to metabolic processes and inflammation is what is known as cachexia. If the cause is cancer, it is called cancer cachexia. The preliminary stage of cachexia is precachexia.

What can you do to prevent the threat?

cancer patient talks about prevention of cachexia
Develop a coping strategy to prevent weight loss.

Watch your weight!

You can do a lot on your own: Be active and attentive. When talking to your doctor, it’s helpful if you record your weight once per week starting now. If necessary, also write down why it was hard for you to get enough to eat and drink.

In order to improve the general condition, quality of life and tolerance to treatment, maintaining your best possible nutritional status is an important way to support your treatment. To support you in preventing (pre)cachexia, oral nutritional supplements like Remune™ have been developed for the special needs of cancer patients.

Please note: Nutrition counseling is essential to adjust your diet to your changed nutritional needs. Dieticians/nutritionists can determine if you need further nutritional supplements or fortified food in case of precachexia or cachexia.   

5 recommendations for weight recording 

example picture malnutrition prevention
Prevent weight loss.

Malnutrition , precachexia and cachexia are much more than just counting kilograms/pounds. Nevertheless, your weight is a decisive indicator. If it seems useful, record the causes that made it hard for you to eat and drink enough.

Here are some recommendations for recording your weight:

  1. Always try to use the same scale to weigh yourself.
  2. Always weigh yourself under similar conditions (shoes, clothing).
  3. Always weigh yourself on the same day of the week at the same time (e.g., Mondays before breakfast).
  4. If suitable, measure your muscle mass with the support of a trained dietician/nutritionist or physician. You may use a body composition monitor (such as BIA [bioelectrical impedance analysis]). This analysis shows your personal amount of fat and muscle mass in addition to your weight. Find out if you can use this method, since it uses electrical impulses (e.g., not suitable for pacemaker patients).
  5. Tell your doctor if you are losing weight.