home Audience 5 Cachexia - what is it? cachexia in cancer. Cancer cachexia: what is it, life expectancy Cachexia in cancer patients

Cachexia - what is it? cachexia in cancer. Cancer cachexia: what is it, life expectancy Cachexia in cancer patients

Cachexia - what is it? Cachexia, in other words, exhaustion of the body, is a complex process characterized by a significant loss of body weight and general weakness, as well as a change in the psyche. At the same time, fat and carbohydrate reserves are sharply depleted, protein synthesis decreases with a simultaneous increase in its catabolism (destruction). Cachexia may also occur in oncological diseases.

Primary and secondary exhaustion

There are two forms of cachexia - primary and secondary. Primary exhaustion is also called pituitary, and secondary - symptomatic.

● Primary or exogenous cachexia occurs due to insufficient intake of nutrients, as well as as a result of the following disorders: brain injury, tumor or systemic damage to the pituitary gland, autoimmune hypophysitis, prolonged stress, hemorrhages (hemorrhages with thinning of blood vessels), anorexia, embolism ( entry into the blood stream of foreign particles that cause blockage of blood vessels), chronic specific infection.

● Secondary or endogenous cachexia is the result of diseases and is caused by factors such as hypoinsulinism (deficiency of insulin), increased synthesis of glucagon, malabsorption (malabsorption of nutrients), glucocorticoid deficiency, growth of neoplasms, excess somatostatin.

Causes

Cachexia disease occurs as a result of a number of causes and factors:
1. Prolonged malnutrition and starvation.
2. Diseases of the gastrointestinal tract, in particular the esophagus, as well as celiac disease, enterocolitis.
3. Prolonged intoxication with brucellosis, tuberculosis and other chronic infectious diseases and suppuration processes.
4. Psychogenic anorexia.
5. Diseases of the thyroid gland, adrenal insufficiency.
6. Endocrine diseases associated with
7. Heart failure.
8. Malignant tumors.
9. Hypotrophy in children.

What are the symptoms of cachexia? What are these manifestations?

Symptoms

There are a number of symptoms that characterize cachexia. does to our body:
1. Sudden weight loss up to 50% of body weight, and in severe cases more than 50%.
2. Dehydration.
3.
4. Loss of ability to work.
5. Sleep disorders.
6. Increased infection damage.
7. Decreased blood pressure (blood pressure).
8. Paleness and flabbiness of the skin.
9. Possible vitamin deficiency and tooth loss.
10. Trophic changes in hair and nails.
11. Development of stomatitis.
12. The occurrence of constipation due to impaired intestinal motility.
13. Low blood levels of protein, albumin, iron, B12.
14. Women may experience amenorrhea (cessation of menstruation).
15. Mental disorders.

Cachexia and the psyche

I would like to dwell on mental disorders in cachexia. They can manifest themselves in irritability, depression and tearfulness, which smoothly flow into apathy, a complete breakdown. With an exacerbation of the disease that caused cachexia, amentia / amental syndrome can be observed, characterized by an inability to navigate, chaotic movements and absent-mindedness, as well as incoherent thinking and speech) or delirium (insanity, in which a person is in a constant state of anxiety and arousal, sees hallucinations) , pseudoparalysis.

cachexia in oncology

Cancer cachexia is a syndrome in which the mass of skeletal muscle and adipose tissue continuously decreases with the development of tumor formations, regardless of food intake. Depletion is especially pronounced in those patients who have cancer of the gastrointestinal tract or lungs. Such people can lose as much as 80% of their body weight, leading to immobility.

Cancer as a Cause of Cachexia

Cachexia in oncological diseases is possible. The cause of cachexia may be the presence of a tumor. Due to the neoplasm, the metabolism becomes atypical, adjusting to it. The tumor needs substrates that can ensure its growth and development. It is no secret that cancer cachexia has a toxic effect on healthy organs and tissues, changing their structure and causing malfunctions.

When a large amount of lactic acid is formed in the tumor, the liver is damaged. In order to normalize the concentration of lactic acid, the body begins to use blood sugar and often cannot make up for the loss.

With cancer cachexia, there is:
- catastrophic weight loss and weakness;
- violation of self-regulation processes;
- lowering plasma cholesterol levels;
- the development of infections due to impaired cellular and humoral immunities;
- dysphagia (difficulty swallowing);
- vomiting, diarrhea;
- increase in energy demand;
- antidiuresis and, as a consequence, hyponatremia;
- hypercalcemia;
- swelling;
- increase in blood glucocorticoids;
- in some cases, delirium and even coma.

Consequences of cancer cachexia

Oncological cachexia is very dangerous. An increase in glucocorticoids in the blood activates the processes of gluconeogenesis (glucose synthesis) in the liver and muscle tissue, increases the breakdown of proteins and fats. Due to the absorption of glucose by cancer cells, hypoglycemia (low blood glucose) develops. Against this background (to which stresses can be added), the endocrine glands actively produce hormones, an excessive amount of which leads to intoxication of the body and hemic hypoxia (the difference in the arterial-venous oxygen gradient decreases). Homeostatic deviations occur. All this can lead to death.

Treatment of cachexia

Most of the treatment of patients with cachexia is carried out in hospitals or dispensaries. The main treatment includes therapy to get rid of neoplasms. Nutrition is also being restored, which is achieved by enriching the body with vitamins, microelements, fats and proteins. For this, easily digestible products can be used. Use such drugs: multivitamin for the treatment of hypovitaminosis, enzyme to improve digestion. Food is administered in two ways: enteral (when it enters the gastrointestinal tract) and parenteral (food passes by the gastrointestinal tract). The parenteral method is used to remove a patient from a serious condition (coma) with cancers and treatment after them, severe malnutrition, severe infections, and swallowing disorders. At the same time, glucose, vitamins, amino acid mixtures, electrolytes, protein hydrolysates are administered (introduced parenterally). Appetite enhancers are also used in practice. If the patient suffers from impaired digestion of food and its absorption, polyenzymatic preparations are used in the treatment (drug "Pancreatin", drug "Festal").
To prevent vomiting, prescribe the drug "Delta-9-tetrahydrocannabinol". It is also effective after chemotherapy. The cannabinoids contained in this preparation stimulate appetite, and, accordingly, weight gain. can be stopped with fish oil, so it is also included in the treatment program for a disease such as cachexia.

Treatment with drugs.
To eliminate cachexia, the following drugs are used:
1) "Carboxylase" - helps to normalize weight, relieves pain and supports the functioning of body systems. Side effects - allergies. Do not use if the body is susceptible to at least one component.
2) "Megeys" or "Megestrol acetate" - stimulates an increase in muscle mass and fat. Do not use in the presence of sensitivity to the components of the drug, persons under 18 years of age, during pregnancy and breastfeeding.
In the presence of infectious diseases, antibiotic therapy is included in the treatment. If necessary, anabolic hormones are administered. In cases of psychogenic disorders, a psychiatrist is involved in the treatment.
We hope that we have answered your question "Cachexia - what is it, how to define it and how to fight it".

Cancer cachexia is a dangerous disease that manifests itself with pronounced symptoms. With timely diagnosis and proper treatment, you can count on a favorable prognosis. Let's take a closer look at what cachexia is. , what are its main signs, etiology of appearance, diagnostic procedures and methods of therapeutic therapy.

What it is?

Rapid and excessive weight loss, leading to complete exhaustion of the body, is called cachexia. Most often diagnosed in patients who have been diagnosed with a malignant neoplasm. Cachexia is diagnosed when a person has lost 5% or more of their total body weight within 6 months.

Cancerous cachexia is formed against the background of any malignant neoplasms, but most often affecting the digestive and respiratory systems. Statistics say that in 25-55% of oncological diseases, against which cachexia develops, a person will die. This is due to the fact that cachexia leads to the failure of vital body systems. Against this background, violations incompatible with life occur.

The main danger of cachexia is that in some cases it cannot be cured. Therefore, doctors strongly recommend an annual routine examination with the delivery of all necessary tests.

To diagnose the disease, you must first contact an oncologist who will prescribe a further consultation depending on the location of the tumor (gynecologist, ophthalmologist, gastroenterologist, etc.).

Watch a video report on cancer cachexia and the importance of nutritional support for cancer patients:

Symptoms and degree of development of the disease

In order to recognize cachexia in cancer and distinguish it from simple weight loss for other reasons, it is necessary to know the main clinical manifestations. These include:

Loss of about 50% of weight, approximate body condition to anorexic.
Change in color and condition of the skin (flabbiness, gray-brown shade of the skin).
Drowsiness.
Trophic changes in the nail plate and skin.
Anemia.
Wrinkles.
The subcutaneous tissue thins out.
Loss of appetite, disability, lethargy.
Fever.
Violation of blood circulation.
Low blood pressure.
Constipation, diarrhea, vomiting.
Loss of teeth.
Decreased libido.
Impaired kidney function (swelling).
Dehydration.
Violation of the muscular and nervous systems.
Amenorrhea.

How cachexia develops, we show in the picture:

Also, the intensity of the manifestation of symptoms depends on the degree of development of the disease:

Primary (light) degree. At this stage, a person loses up to half of his weight, the subcutaneous layer of fat becomes thinner. All existing chronic diseases are activated, however, the internal organs fully retain their work.
Heavy. It is characterized by protein starvation of the body for a long time. It should be noted that in Russia it is rarely diagnosed. The main clinical manifestations are liver dysfunction, severe edema and hypoproteinemia.
Mixed. At this stage, a person experiences a lack of energy, most of which is used by cancer cells. In addition, there is a lack of protein.

All these symptoms are associated with systematic failures in the work of internal organs. As a result, vitamins and nutrients are poorly absorbed.

Disease pathogenesis

Science has not yet fully studied the pathogenesis of this type of disease. But it has been precisely revealed that the first main factor in the way of its development is the intoxication of the entire human body with substances secreted by cancer cells. The second includes the development of an inflammatory process or infection at the site of the tumor.

The main difference between cancer cachexia is that during its development there is an increase in the size of the liver, rapid protein breakdown, but the metabolism does not change. As for the simple depletion of the body (starvation, diet and other reasons), the metabolism itself is disturbed, which entails a decrease in the subcutaneous fat layer, a slowdown in protein breakdown and atrophy of the liver. If in the case of cancerous cachexia a person loses not only adipose tissue, but also muscle tissue, then with a non-cancerous type, adipose tissue becomes thinner.

The main causes of lack of appetite in cancer cachexia are:

pain sensations;
gastrointestinal disorder;
compression of the digestive tract by a tumor;
chemo- and radio exposure;
depressive state.

Etiology of occurrence

Scientists have established several main factors in the formation of cancer cachexia. These include:

Failure of the hormonal background.
Violation of metabolism and glucose, the work of the digestive tract.
Attacks of nausea, vomiting, diarrhea, or vice versa, frequent constipation.
Pathological changes in olfactory and taste receptors.
Severe dehydration.
Poisoning by decay products of cancer cells.

What is intoxication in cancer, we will describe in the picture:

Frequent and prolonged abstinence from meals.
Failure of the thermoregulation process.
Significant difference between consumed and incoming energy in the body.
Postoperative period during surgery.
Diseases of the digestive tract.
Purulent type abscesses and others.

During cachexia caused by a malignant neoplasm, the internal organs simply do not have enough nutrients and oxygen. They are absorbed by cancer cells, thereby contributing to the disruption of all functions in the body. Thus, all internal systems hardly have enough energy and necessary substances to maintain the body.

Stages of cancer cachexia

In medicine, there are three main stages in the development of cancer cachexia:

precachexia. Weight loss at this stage is insignificant, there is a loss of appetite, a decrease in glucose absorption;
cancerous. It is determined subject to weight loss over the past six months by 5 percent or more;
refractory cachexia. It is observed in the absence of positive results in radio- and chemotherapy, progressive deterioration of the human condition, as well as the complete ineffectiveness of drugs when trying to increase the total weight of a person.

Each case is purely individual, so at the first suspicion, you should immediately consult a doctor.

Diagnostic methods

The diagnosis of "cancerous cachexia" is possible only in the presence of a malignant neoplasm. If there is a suspicion of cancer cachexia, but the presence of a tumor has not yet been detected, then the patient is prescribed the following procedures:

x-ray;
MRI or CT;
colonoscopy;

How a colonoscopy is performed, see the picture:

gastroscopy etc.

The doctor also conducts a clinical examination of the patient's appearance, skin condition, muscle and adipose tissue of the body. Assigns a general urine test, bacteriological culture, general and biochemical blood tests. After that, a doctor's consultation is appointed, depending on the location of the neoplasm.

Treatment of cancer cachexia

Therapeutic therapy for cancer cachexia is carried out simultaneously with the treatment of oncology, because exhaustion in this case is only a consequence of the activity of cancer cells. Therefore, having defeated cancer, it will be easier to cope with other concomitant diseases. All treatment is reduced to a set of measures (nutrition, sports, drugs, radiation, etc.).

Any manipulations are carried out only in specialized dispensaries, with the necessary tools to provide possible emergency care. To maintain the body with cachexia, the following drugs are prescribed:

"Megeis". It is prescribed individually in each individual case, depending on the stage of cachexia, type, complications and general condition of the patient. This is due to the fact that the composition contains potent components.
"Cocarboxylase". It is often prescribed by an oncologist, as it helps to relieve pain, maintain the vital internal systems of the body. With prolonged use, it normalizes metabolism, the patient gradually gains weight.
"Retabolil".
"Hemoferon".
Fish fat. Helps the body to more easily tolerate chemotherapy and radiotherapy. It is also scientifically proven that while taking fish oil, irradiation of cancer cells is more successful.

In case of cancer cachexia, any manipulations are aimed primarily at restoring nutrition, maintaining weight and blocking the pain syndrome. But if a severe stage of cachexia is diagnosed, the patient must be prescribed:

Vitamin complexes.
Amino acids.
macro and micronutrients.
Protein hydrolysates.
Solutions of electrolytes and glucose.

When diagnosing a hormonal disorder, hormone therapy is prescribed along with anabolic drugs. In addition to drug therapy, nutrition correction and the introduction of light physical activity are required. In sum, such treatment can give positive results.

When cancer cells affect the esophagus, stomach, duodenum, etc., treatment does not bring positive results.

To date, all scientists on the planet are working on the creation of the latest and most effective drugs to combat weight loss in cancer cachexia. But, unfortunately, they are only being tested so far, so doctors are actively using the old traditional treatment regimens.

Nutrition and exercise

Nutrition for cancer cachexia should include a high level of fat and protein, but at the same time, be easily digestible. Excess load on a weak body will be dangerous.

It is necessary to include vitamin complexes from macro- and microelements in the diet. Enzyme preparations and enterosorbents are also needed to maintain the normal functioning of the gastrointestinal tract (Enterosgel, Festal, Lineks and others). Herbal medicinal preparations that contribute to the appearance of appetite will not be superfluous.

Food should be of high quality and frequent. Any type of diet should be abandoned, as they negatively affect the general condition of the body and can only aggravate the situation.

Sometimes the patient is prescribed parenteral nutrition. What components are included in its composition, we will tell in the picture:

As for sports, heavy physical activity is strictly prohibited. But light exercises are indispensable. They will help maintain muscle tone and build muscle and bone tissue. In addition, they will increase the overall endurance of the body, improve mood. These include walking (especially outdoors), swimming, fitness. Doctors also recommend aerobics, cycling, tennis, jumping rope, yoga, gymnastics.

Forecasts

In the world, a study was conducted that showed that about 40% of patients with oncology suffer from cancer cachexia. All of them have one or more clinical signs. These are erroneous premature satiety, malfunctions of olfactory and taste receptors, nausea, vomiting, dry mouth. For these reasons, a person quickly loses body weight and does not receive the necessary daily supply of nutrients and energy.

Then very soon comes the loss of fat and muscle tissue, necrosis of muscles and pathological changes in all organs and systems. This is not good for life expectancy.

Approximately 80% of all cancer patients suffer from cancer cachexia, but only 20-30% of them die. The main reason for this lies in the atrophy of the muscles of the lungs. If a patient is diagnosed with a refractory type of cachexia, then treatment is useless. Life expectancy in this case is about 3 months.

Cancer cachexia is a concomitant disease and is diagnosed only in the presence of a tumor. Depending on the location, the state of the body and the presence of other serious diseases, it is possible to predict the possible outcome. If a person undergoes an annual scheduled diagnosis, then the chance to detect dangerous diseases in a timely manner increases markedly. Thus, possible complications directly depend on the attitude of a person to his health.

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This disease changes the patient beyond recognition. Flashbacks from World War II documentaries about concentration camps come to mind. In modern life, the causes of cachexia are caused by a wide range of factors.

Diseases of the esophagus (stenosis), in which it is difficult for food to enter the patient's stomach.
Fasting for an extended period of time.
Severe form of heart failure.
Chronic forms of brucellosis and tuberculosis, in which the patient's body is subjected to prolonged intoxication.
Nodular polyarthritis.
Purulent processes in the body (progressive osteomyelitis and abscesses, festering bronchiectasis).
Cancer tumors.
Diseases of the gastrointestinal tract, the consequences of which are the failure of the functions of digestion of food and the absorption of its mucosa (gastrectomy, enterocolitis, the consequences of gastric resection (celiac disease), and so on).
Amyloidosis.
Failure of the endocrine system, violation of metabolic processes (pathology of the adrenal glands and the work of the thyroid gland).
psychogenic anorexia.
Prolonged use of psychostimulants.
Malnutrition.
Diseases of connective tissues of a diffuse nature.
Hypotrophy in young patients.
Acquired immune deficiency syndrome (AIDS).

Symptoms of cachexia

The course of the disease, the predicted outcome, and, accordingly, the symptoms of cachexia largely depend on the nature of the disease that caused it. But the main symptoms are:

Rapid weight loss (severe cachexia indicates a loss of half of a person's normal weight).
Loss of ability to work.
Decreased general vitality.
A dangerous loss of fluid by the body, its accumulation in the serous cavities of the body is a consequence of a failure of blood circulation and lymph flow (transudate).
Loss of fat cells.
General weakness.
Avitaminosis.
Protein-free edema.
The skin is flabby, wrinkled, the color is unnaturally pale, gray-green.
Increased fragility of hair and nails.
Stomatitis.
Dysbacteriosis.
Constipation.
Loss of teeth.
Decreased immunity.
Amenorrhea in women (absence of menstruation for several menstrual cycles).
Deterioration of potency in men.
Failure of intestinal peristalsis.
Blood pressure is low.
Constant feeling of cold.
Decreased glomerular filtration in the kidneys.
Reducing the volume of circulating blood.

Frequent mental disorders:

Asthenia.
subdepressive mood.
Tearfulness.
Clouding of consciousness.
Apathetic stupor.
The psycho-organic syndrome is less common.

Degrees of cachexia

Doctors distinguish three degrees of cachexia:

Hypothalamic form of the disease. It is characterized by complete or partial cessation of peptide synthesis in human plasma. The consequences of such a failure:

Inhibition of the production of protein kinases (phosphotransferases) involved in the modification of many proteins.
Blocking the process of lipogenesis, which includes the breakdown, digestion and absorption of lipids in the digestive tract, the transport of fats from the intestines, the metabolic transformations of triacylglycerols, cholesterols and phospholipids.
Decreased activity of endothelial lipoprotein lipase (regulates the level of lipids in the blood, which is essential in atherosclerosis).
There is a suppression of anabolism (metabolic processes).
The transport of fats is slowed down.
There is an intensification of catabolism (energy metabolism).

Cahechtinous form of the disease. It is accompanied by increased production of cachechtin, as a result of which the following are observed:

Frequent and prolonged emotional breakdowns.
Loss of appetite.
Imbalance in the synthesis of neuropeptides (protein molecules formed in the central or peripheral nervous system and regulating the physiological functions of the human body).
The rapid development of anorexia (pathological weight loss).

Anorexic form of the disease. It is represented by malabsorption (impaired absorption of substances in the small intestine):

An increase in the number of new formations, such as necrotic alpha tumors in the blood plasma.
Thymus hormone deficiency.
Hypocorticism (pathological changes caused by hypofunction of the adrenal cortex).
Hypoinsulinism (an endocrine disease characterized by attacks of a significant decrease in blood sugar).

Classification of cachexia

Depending on the etiology of the disease, cachexia is classified in several directions:

Exhaustion of the body associated with exogenous factors (influence of the environment, the external environment):

Lack of nutrition.
Starvation (of a religious nature or a manic desire to lose weight).

Endogenous causes (internal failures):

Chronic stage of radiation sickness.
Violation of the work of the adrenal glands.
Senile involution of the organism.
The presence of a malignant tumor.
Violation of the endocrine glands.
Myxedema (insufficient supply of organs and tissues of the body with thyroid hormones).
Consequences of trauma.
Terminal (dystrophic) form of chronic heart failure.
Postoperative hypothyroidism (long-term, persistent lack of thyroid hormones).
A significant decrease in mental activity.

Pituitary cachexia

Violation of the integrity of the functioning of the anterior pituitary gland and hypothalamic centers, manifested in insufficient production or complete absence of production of triple hormones of the adenohypophysis, leads to the appearance of hypocorticism (dysfunction of the adrenal glands), hypothyroidism (decrease in thyroid function) and hypogonadism (decrease in the amount of produced male sex hormones - androgens). All these failures lead to the fact that pituitary cachexia develops in the patient's body.

The cause of this pathology can be:

Injury.
Inflammatory process in the pituitary gland.
Malignant or benign tumor.
Bleeding and collapse during childbirth, followed by ischemia or vascular thrombosis in the hypothalamus-pituitary gland.
Spasm and thrombosis of the arteries supplying blood to the anterior lobe and stalk of the pituitary gland cause necrosis of the adenohypophysis.

Cerebral cachexia

Cerebral cachexia is diagnosed with pathological changes in the hypothalamus. Often, the disease affects not only the pituitary gland, but also inflammatory, dystrophic processes affect the diencephalon. When such a pathology dominates the pituitary gland, and there is a sharp weight loss, doctors diagnose the cerebral form of the disease.

There are known cases of sudden weight loss, while studies have not revealed any abnormalities in the work of the endocrine system. Often, such patients have a history of psychological trauma (shock, fright). Anorexia of this nature is quite common and leads to the onset and progression of the cerebral form of the disease. It is very difficult to treat a disease of this etiology, since medicine has not fully studied all the processes occurring in the brain.

Alimentary cachexia

If the cause of anorexia is prolonged malnutrition, malnutrition, voluntary or forced starvation, general exhaustion of the body develops, doctors refer this pathology to alimentary cachexia.

With such a pathology, a failure occurs in all metabolic processes of the body, dystrophy of organs and tissues progresses, disrupting their functioning. A person's physical activity decreases, changes in the psychological perception of the surrounding society appear.

The alimentary form of the disease acquires a massive social status during natural disasters (loss of food during floods and earthquakes ...) and social conflicts (war, artificial famine).

During a period of prolonged malnutrition, the body does not receive the nutrients, vitamins and microelements necessary for normal functioning, which are a source of energy. This leads to a reduction in energy costs, loss of psychological, intellectual and physical capacity for work. There is a redistribution of the necessary substances, which contributes to a mismatch in the work and trophism of various systems and organs. The hormonal background undergoes restructuring (malfunction of the thyroid gland, glands of the reproductive system, adrenal glands). The restriction of protein food provokes hypoproteinemia, which is manifested by protein swelling.

Gradually, atrophy of the muscles of the skeletal frame occurs, the patient loses subcutaneous tissue. When conducting studies of such patients, a decrease in the size of the liver by 2–2.5 times is revealed, and other organs also atrophy.

Malignant cachexia

Malignant cachexia is more likely to occur in patients suffering from the rapid decomposition of the tumor conglomerate, while the size of the tumor does not matter.

Causes of exhaustion:

Intoxication of the body with toxins of cancer cells or "waste products" of concomitant complications.
The accumulation of an excess amount of lactic acid, which has a detrimental effect on the condition and functioning of the liver. The patient's body counteracts it by breaking down sugar in the blood, mobilizing its carbon reserve. It cannot make up for the loss.

Most often, the malignant form of the disease is a companion of cancerous neoplasms of the gastrointestinal tract, respiratory tract. Due to diseases of the digestive system, there is an aversion to many foods. As a result, the body does not receive many nutrients necessary for normal life.

However, cases are not uncommon (for example, skirr - a type of stomach cancer - a sharply deforming organ that disrupts its motility and secretory work) when cachexia does not occur. While small tumors can provoke its rapid progression. Therefore, it is impossible to unambiguously identify the cause of the pathological deviation today.

Cardiac cachexia

As a result of a lack of nutrients, the myocardium is also exposed to pathological effects. The heart gradually loses its pumping ability to pump blood in the volume necessary for the normal functioning of the body. Defects and coronary heart disease lead to a similar result. As a result, a person acquires heart failure. In severe forms of chronic heart failure, significant weight loss is observed. This pathology is classified as cardiac cachexia.

Until the end, the mechanism of the appearance and development of cachexia is not clear, but it is definitely composed of multiple factors. The main ones for the cardiac form of the disease are:

Hepatomegaly, which is caused by stagnation of blood in the venous system.
Persistent feeling of fullness in the stomach.
An increase in the number of inflammatory cytokines.
Violation of intestinal motility.

It is very difficult to diagnose cachexia of this etiology, but the prognosis for recovery with it is quite favorable.

Senile cachexia

A person ages because his body ages. There is a slowdown in metabolic processes, the regeneration of the skin is slower, and so on, but the strong depletion of the body of an old person cannot be attributed to the norm. Often after the age of 50, there is a significant reduction in muscle mass, while the amount of fat increases. These are the consequences of a sedentary lifestyle, sedentary work, dietary restrictions.

The body ages, various diseases appear, which can cause severe depletion of the body, which falls under the category of senile cachexia.

Treatment of cachexia

Sharp exhaustion is already a consequence of external factors or some diseases that affect the body. Therefore, the treatment of cachexia is reduced to the elimination, first of all, of the causes that prompted progressive weight loss. If the wasting is a consequence of the disease, then the patient must undergo a full course of treatment. If cachexia was provoked by external factors, it is necessary, accordingly, to minimize their impact and undergo restorative therapy.

But a mandatory item in the normalization of the patient's condition is the systematic restoration of a balanced diet, careful care for him. Without fail, easily digestible proteins, vitamins, fats, foods rich in trace elements are introduced into the diet. If the patient has symptoms of a malfunction in the digestive tract and the suction system, the doctor prescribes polyenzymatic medications, such as pancreatin.

Pancreatin

The volume of the prescribed drug depends on the age of the patient and the degree of lack of enzymes produced by the pancreas. The drug is taken before meals or with food, drinking plenty of water or, preferably, an alkaline liquid (fruit juice).

The average daily dosage of the drug, divided into three to six doses, is 0.25 - 0.5 grams. In case of complete insufficiency of the secretory function, the dosage is increased to 0.75 grams of daily. For babies under the age of one and a half years, the starting dose is 0.1 grams, for older children - 0.2 grams.

The duration of the treatment course depends on the severity of the disease and varies from several days to months and years.

The contraindications of the remedy include:

Individual intolerance to one or more components that make up the drug.
Acute or chronic pancreatitis at the stage of exacerbation.

When taking the drug, side effects may occur:

Inflammation of the pancreas.
Allergic reactions.
With prolonged use - hyperuricosuria (urinalysis shows an increased amount of lactic acid).

If the patient is in serious condition, parenterally (bypassing the intestines - injections intramuscularly or intravenously) they inject glucose, mixtures of amino acids, vitamins, protein hydrolysates. If necessary, the doctor connects anabolic steroids (for example, andriol).

With cachexia of a psychogenic nature, a psychiatrist and a neurologist give their prescriptions (for example, drugs that increase appetite: periactin, primobolan depot).

Glucose

The drug is administered both orally, intravenously, and by intramuscular injection. The dosage of one dose is 0.5 - 1 gram.

Subcutaneously or into a vein, glucose is supplied with a solution of 4.5 - 5% in an amount of 300 - 350 ml. In the form of enemas - up to two liters per day.

With a large volume of the administered drug in the patient's body, a water-salt imbalance, an increase in fluid, and thrombosis may occur.

The only contraindication to the use of glucose may be the patient's diabetes mellitus.

Andriol

The required dose is assigned by the attending physician purely individually, depending on the clinical picture. The recommended initial daily amount is 120-160 mg for two to three weeks, followed by a decrease in dosage to 40-120 mg daily. The capsule of the drug is drunk after a meal, if necessary with a small amount of liquid. Do not chew or open the capsule, swallow it whole. The daily dosage is divided into two doses: morning and evening. If the daily amount is an odd number of capsules, a large dosage is taken in the morning.

The drug is contraindicated for use by patients with a history of verified carcinoma of the prostate or breast.

Periactin (Periactin)

The drug is attributed by the doctor to raise the patient's appetite. The adult dosage is:

tablets - 0.5 - 1 piece three - four times a day.
syrup - one - two teaspoons three - four doses per day.

Children aged two to six years - the maximum daily dose is two tablets or two tablespoons of syrup.

Children from 6 to 14 years old - the maximum daily amount of medicine is three tablets or three tablespoons of syrup.

The drug is contraindicated in cases of increased intraocular pressure, asthma, stomach ulcers, and the elderly.

Primobolan-Depot (Primobolan Depot)

The drug is administered intramuscularly:

adults, one ampoule every two weeks, then 1 ampoule every three weeks.
for children, the dosage is administered at the rate of 1 mg per kilogram of the baby's weight once every two weeks.

The medicine is contraindicated in men suffering from prostate cancer and pregnant women.

Nutrition for cachexia

The diagnosis of wasting is made to a person if his weight deviates significantly from the norm. Just as it is a problem for obese people to lose weight, so for very thin people it is a real problem to gain weight and bring it back to normal. In addition to medical means, nutrition in case of cachexia is also capable of normalizing the patient's weight.

Such patients often lack appetite, and it is quite problematic to feed them. Therefore, it is worth starting with small, but high-calorie portions. The body must gradually "get used" to food. The maximum effect is achieved if the meal is divided into five to six approaches and is subject to the schedule. Eating at the same time causes the patient's digestive system to be stimulated. Dishes should be tasty and aesthetically appealing - this is another incentive to stimulate appetite. Forcing a person to eat through force can achieve the opposite result.

Food should be varied, balanced, stimulating the desire to eat more. Nutritionists advise:

First courses on rich broth or strong broth with dressing of sour cream, cream or egg yolks.
Smoked fish.
Peppered sauces.
Spices.
Fruit and vegetable freshly squeezed juices.
Dessert.

If there are no medical contraindications, then you can eat everything. It should only be remembered that they must be high-calorie. It is also necessary to cook dishes using vegetable and butter oils, cream. The diet of such a patient must include:

Muffin.
Drinks containing a large amount of fat.
High calorie desserts.

Pieces of meat and fish are best baked with vegetables or fried in vegetable oil. Fatty meats go well with sour and spicy sauces and seasonings (spicy sauce, horseradish, adjika, lemon, mustard).

Salads consumed by the patient should contain:

Boiled vegetables with butter.
Vegetables fried and stewed.
The perfect condiment is mayonnaise.

For a side dish in this case, fit:

Cereal porridge seasoned with butter.
Pasta.
Boiled potatoes with butter.
French fries.
Potatoes - mashed with milk, cream or sour cream.
Potato baked with fat.

Dessert can be taken not only at lunchtime, but also with another meal:

Cottage cheese casseroles, pasta and cereals.
Pies and kulebyaki.
puddings.
Desserts can be not only sweet, but also salted.

Prognosis for cachexia

Any prognosis depends on the nature of the disease, the severity of its course. The prognosis for cachexia directly depends on the factors and the disease that provoked it. Cachexia, provoked by a cancerous tumor, speaks of a neglected late stage of the disease and gives an unfavorable prognosis for recovery. If a sharp depletion is caused by other reasons, then such a patient has a chance to recover, but on the condition that adequate effective treatment is carried out, in compliance with the diet and lifestyle of the patient.

In nature, everything is harmonious and a deviation, both towards a large weight, and its sharp loss leads to serious illnesses, the final of which can be a fatal outcome.

Cachexia is not a sentence (except for oncological diseases) and it can be fought, but this must be done only under the vigilant supervision of a certified specialist. Self-activity in this case is inappropriate, because your life is at stake!

What is this disease - cachexia? Many patients who have been diagnosed with this disease are interested in information about it. Doctors say that the disease is characterized by complete depletion of the body for various reasons. Such a condition is accompanied not only by weight loss, but also by metabolic disorders, impaired immunity, and changes in the psyche. This disease requires urgent hospitalization and conservative therapy. The prognosis is often unfavorable.

What is this disease?

Cachexia (according to ICD-10 code - R64) is a severe depletion of the body. The disease can be associated with many disorders of the internal organs, and sometimes develops through the fault of the person himself, who seeks to lose weight and get rid of extra pounds.

Cachexia (ICD includes it in the class of symptoms, signs and abnormalities) may be associated with disorders such as:

diseases of the nervous system;
tumors;
endocrine disorders;
drastic weight loss.

Despite the various causes of the problem, its manifestations are almost always the same. As weight decreases, a deficiency of nutrients occurs, as a result of which metabolic processes are disturbed, internal organs suffer.

The peculiarity of the course of the disease and its outcome is largely influenced by the age of the patient and the cause that provoked disorders in the body.

Causes

Cachexia (ICD-10 code above) refers to the catastrophic depletion of the body, which causes internal organs to suffer. The disease can be primary and secondary. Primary cachexia refers to the depletion that occurs on the background of a strict diet, when an insufficient amount of nutrients enters the body.

Such data are not reflected in the ICD, but cachexia of the secondary type can be caused by:

pathologies of the stomach and intestines;
infectious diseases;
cancerous tumors;
psychological disorders;
taking certain medicines;
endocrine disorders.

Malignant neoplasms play a special role in the occurrence of cachexia. The disease is characterized by the fact that during its course metabolic processes of the body are disturbed, and poisoning with toxic substances produced by the tumor also occurs. Infectious processes lead to intoxication, as a result of which a person begins to lose weight dramatically.

Symptoms

It is important to know what it is - cachexia, how exactly such a violation manifests itself in the body. The disease is characterized by symptoms such as:

When cachexia occurs, as a result of an insufficient amount of nutrients, the skin loses its former elasticity. The skin becomes sluggish and becomes earthy or very pale. Violation of tissue nutrition leads to severe brittle nails, the development of stomatitis and hair loss.

Cachexia can also be accompanied by disruption of the genitourinary system, intestines and stomach. In patients, sexual desire is sharply reduced and completely disappears. There are mental disorders, there is a strong irritability, lethargy, apathy, tearfulness, severe weakness.

Classification

It is important to know not only what it is - cachexia, but also what types of this disease are, so that it is possible to recognize the violations occurring in the body in a timely manner. In clinical practice, several forms of the course of the disease are distinguished, each of which differs in the mechanisms of development. In particular:

hypothalamic;
cachechtinic;
anorexic.

In addition, the disease can be divided into several types, depending on the cause that provoked exhaustion. Particular attention should be paid to the following types:

The pituitary and cerebral type affects the brain and develops as a result of a violation of its functioning. They are quite difficult to treat, there is a high risk of death. Alimentary cachexia occurs due to malnutrition.

The cardiac form is characterized by the fact that there is a decrease in the ability of the heart muscle to maintain normal blood circulation.

Cancer type of cachexia

Cancer cachexia usually occurs as a result of the course of severe stages of the development of a malignant neoplasm of the digestive system, lungs, brain and breast. Depletion is due to the fact that the tumor absorbs nutrients, and toxic substances that poison the human body are released into the bloodstream. With the progression of intoxication processes, there is a decrease in appetite, up to a complete refusal of food and nausea.

It is important to carry out aggressive therapy, since during chemotherapy, the decay of the tumor provokes a metabolic disorder in the body. A special group includes patients with cancer cachexia, which was provoked by the presence of a neoplasm in the area of the digestive organs, the oral cavity, which makes food intake impossible.

With the progression of this disease, irreversible changes occur in the body, and as a result, the death of the patient. Cachexia in oncological diseases is treated only symptomatically. A person should adhere to a dietary diet enriched with vitamins with the inclusion of easily digestible, but high-calorie foods. If cachexia in oncological diseases is difficult, with severe nausea and vomiting, then antiemetic drugs are prescribed. Slowing down the process of weight loss contributes to the intake of fish oil.

Alimentary cachexia

Many are interested in what it is - alimentary type cachexia, how this disease manifests itself. The pathological process occurs when the need for nutrients is not met by the food consumed. This may be due to the observance of strict diets, pathological processes of the digestive system, the presence of a tumor. As a result, patients experience an aversion to food, nausea, and difficulties arise with food consumption as a result of damage to the oral cavity.

As weight loss further joins the psychogenic factor, the woman ceases to adequately assess her condition, continues to refuse food, even when the usual way of life becomes impossible.

Pituitary cachexia

People who are diagnosed with a brain tumor are interested in what it is - pituitary-type cachexia. A similar condition is diagnosed during pathological processes occurring in the pituitary gland, which is observed during the death of cells that feed blood vessels.

A similar disease often occurs in the postpartum period, especially in those who have experienced large blood loss, as well as postpartum depression. The death of pituitary cells leads to a decrease in the amount of hormones they produce, so weight loss occurs, and dystonia, mental disorders, and hypotension are also observed.

Stages of the disease

Depending on weight loss and the characteristics of metabolic disorders, there are 3 main stages of cachexia:

precachexia;
cachexia;
refractory disorders.

Precachexia is characterized by the fact that in six months a person loses about 5% of body weight, signs of an inflammatory process are observed in the internal organs, the patient refuses food, and metabolic disorders occur. The second stage is due to the fact that there is a weight loss of more than 5% or a decrease in skeletal muscles.

The refractory stage is characterized by metabolic disorders, the lack of a result of therapy, as well as severe exhaustion. In the last stages, a person completely refuses to eat, sometimes consciousness is disturbed, and life expectancy does not exceed 3 months.

Carrying out diagnostics

The doctor can make a diagnosis when examining the patient, since a sharp weight loss can be noticed almost immediately. However, in order to conduct competent and adequate therapy, it is imperative to conduct an examination to determine the cause that provoked the pathological process, as well as the stage of metabolic disorders.

When conducting a diagnosis, laboratory tests of blood and urine are required, and in some cases a fecal analysis. In the blood, there is a decrease in the amount of proteins, glucose and cholesterol. With the course of the inflammatory process, leukocytosis, a decrease in the erythrocyte sedimentation rate, and anemia are possible. The volume of urine decreases, and there is also a sharp increase in leukocytes and protein. In addition, instrumental research methods are assigned:

As a result of the diagnosis, consultation with a cardiologist, oncologist, psychiatrist, infectious disease specialist, and also a neurologist is required.

Features of treatment

Treatment of cachexia is carried out in a complex and requires compliance with certain rules. This is due to particular difficulties in eating food, as there is a violation of appetite and a change in the digestive organs.

The choice of a method for replenishing the lack of useful and nutrient substances depends largely on the patient's well-being, the functioning of the digestive system, and the degree of exhaustion of the body. The patient must adhere to the rules of dietary nutrition, which is developed individually for each person by a nutritionist. It is worth noting that malignant neoplasms lead to a loss of energy, and this increases the need for calories, so nutrition should be high in calories.

When the oral cavity is affected by fungal processes, antifungal drugs are prescribed, as well as rinsing with antiseptics. During the treatment of cachexia, the patient must be under laboratory control at all times, which will help to detect complications in a timely manner and eliminate them.

If the patient cannot independently consume food, then intravenous support is required, indications for which may be:

inability to independently consume food;
severe exhaustion and weakness;
previous surgery;
significant nutrient requirements.

In addition, doctors prescribe drug therapy, which includes steroids for rapid weight gain, enzymes, antidepressants. Lifestyle and physical activity play an important role in therapy.

Danger to life

The hallmark of cachexia is that rapid and involuntary weight loss occurs. In addition, the patient has atrophy of the muscular system, and this leads to malaise, the occurrence of pain. Over time, it becomes difficult for a person to perform limb movement. The disease very often leads to the death of the patient.

Forecast and prevention

The disease is considered practically incurable, it is often observed in patients with the last stages of oncology. The prognosis is poor with high mortality rates.

Prevention in this case implies the timely treatment of malignant neoplasms, drug addiction, alcoholism. In addition, it is important to eat a balanced diet and eat foods high in fiber.

If the body is often affected by cancerous tumors of various localization, this condition is called cancer cachexia. In this case, the location of the malignant neoplasm does not matter. However, cancer cachexia develops faster and is more pronounced if there are malignant tumors in the gastrointestinal tract.

Currently, medicine has not figured out what causes cancer cachexia, but it is believed that two main factors are involved. This is a metabolic atypism that occurs in the tumor tissue, its high need for substrates necessary for development. The toxic effect of the tumor on the metabolic process, the functions of non-tumor tissues and organs, and their structure are also important.

As a result, with cancer cachexia, deviations of homeostasis occur, which are incompatible with life. The tumor is a real trap for glucose, amino acids, lipids, using them to get energy, to ensure the synthesis of proteins - nucleic acids, enzymes. Such a tumor has a high competitiveness, which is due to the special composition of the cells. Therefore, non-tumor tissues are deprived of these substrates. With cancer cachexia in various tissues, for example, in skeletal muscles, in the liver and myocardium, brown atrophy occurs, the patient develops exhaustion.

Symptoms of cancer cachexia

Cancer cachexia refers to a large number of changes that occur in the body, which are caused by the growth of the neoplasm and the decay of the tumor. In this case, a cancer patient's body receives a general poisoning. The characteristic features should include:

If there is a malignant epithelial tumor, the development of cancerous cachexia occurs in a shorter time, and severe degrees occur faster. In addition, the onset of tumors of the breast, skin, uterus, often occur without obvious symptoms. The course of gastric cancer is not always accompanied by cancer cachexia.

Basically, cachexia is typical for patients in whom tumor masses rapidly disintegrate during the course of the disease. Moreover, for the occurrence of cachexia, it does not matter how large the tumor is. It is known that the body has mechanisms that provide antitumor protection. They can function at every stage, while the development of a malignant neoplasm. Despite the fact that there is an active fight against cachexia, with serious oncological factors, the death of the body can occur, since developing, the tumor also has mechanisms that suppress the immune system.

Treatment of cancer cachexia

According to statistics, cachexia is established if a patient has lost more than five percent of weight in six months. Treatment is ineffective if there is a stage of refractory cachexia, since the disease is already at an advanced stage. The cancer progresses rapidly without responding to chemotherapy treatment. In this case, the metabolism is catabolic, the patient lives no more than three months. If we talk about artificial nutrition, then for the patient in such a situation there is more risk than likely benefit. In this regard, the work of doctors is focused on reducing complications, as well as on symptomatic treatment. Therefore, it is believed that the prevention of cancer cachexia is necessary from the moment it was detected.

Nutrition control is a necessity, doctors must constantly monitor the metabolism of a sick body. Moreover, this approach applies not only to patients with gastrointestinal tumors that complicate nutrition. This is equally true for all cancer patients. It is important to keep protocols that indicate how the patient eats, noted his physical activity, the presence of complaints. For example, whether there is nausea, or lack of appetite. In general, a proper and varied diet is of paramount importance for cancer patients. In addition, experts emphasize that cancer diets do not provide a self-treatment.