Also known as cancer cachexia, Wasting Syndrome is a serious symptom associated with cancer. Individuals diagnosed with cancer often appear malnourished and in most cases they would have experienced significant weight loss over a short period of time. The term “Wasting Syndrome” refers to involuntary weight loss in excess of 10% of an individual’s body weight. This condition results in considerable loss of muscle tissue and fat.

Wasting Syndrome leads to deterioration of vital muscle mass and body fat. Certain types of cancers such as stomach and gastrointestinal cancers cause wasting during the initial stages of their progression by making it difficult for the body to fully digest and absorb food. However, statistical data indicates that almost 80% of individuals with advanced cancers experience the Wasting Syndrome during the final stages of their treatment.

Patients suffering from Wasting Syndrome usually experience fatigue and tiredness accompanied by general malaise and a lack of enthusiasm in life. These patients often find it difficult to endure the prolonged cancer treatment sessions, for instance chemotherapy and radiation. It’s because they lack the strength required for enduring such treatments. Eventually, it may become difficult to beat the cancer because patients need to have the required strength to endure prescribed treatments.

The common symptoms associated with the Wasting Syndrome include nausea and vomiting, mouth ulcers, and loss of appetite. Patients can also experience a dry mouth which might make it difficult or nearly impossible to swallow food. A number of patients have reported that the food begins to taste metallic and as a result they lose their desire to eat. In the long-term, this can lead to liver problems and anemia due to lack of essential nutrients in the body. These symptoms can be alleviated if there is a break in cancer treatment, but even with parenteral feeding and renewed appetite, the weight loss resulting from severe Wasting Syndrome is not entirely reversed in some cases.

Wasting Syndrome is distinguishable by the loss of weight of at least 10% of the patient’s body weight without any apparent reason. The weight loss occurs almost equally due to the loss of fat as well as depletion of muscle. It implies that weight loss due to other reasons such as extreme nausea and vomiting does not necessarily mean that the patient is suffering from Wasting Syndrome. If it is the Wasting Syndrome, it has to be the depletion of a vital muscle that has resulted in weight loss of at least 10% of the normal body weight.

Patients who experience significant loss of muscle and body weight, and are consequently weakened, have less chances of responding to cancer treatments such as chemotherapy. In cases where patients do undergo chemotherapy treatments, they become more prone to other illnesses and toxic side effects associated with the treatment. It has been noted that Wasting Syndrome can actually lead to the onset of shingles. Since the immune system is compromised in a weakened body, it becomes difficult for the patient to fight off these illnesses and toxins.

It is believed that both biological factors and the side-effects associated with cancer treatment can cause Wasting Syndrome. Cancerous tumors cause the immune system to respond, which is characterized by the release of cytokines and other cytotoxic molecules. Specific types of cytokines, for instance Tumor Necrosis Factor (TNF), can force the body to speed-up the breakdown of fat and reduce the storage of fat. Other types of tumor-related metabolic products and the highly active immune system result in reduced muscle synthesis and increased muscle loss. A variety of factors can contribute to the Wasting Syndrome and may include malabsorption, opportunistic infections, altered metabolic rate and inadequate food intake.

Inadequate food intake can be due to loss of appetite, which is common among individuals diagnosed with mesothelioma. Chemotherapy drugs are a major cause of nausea and vomiting, and they may also lead to changes in the patient’s sense of smell and taste. It has been noted that weight loss often occurs after chemotherapeutic agents are used. Significant loss of appetite can also occur due to anxiety and depression that usually accompanies degenerative diseases. Decreased food intake can also be due to opportunistic mouth and throat infections that cause ulcers and lesions, making it difficult or painful to swallow food.

Malabsorption has been described as poor nutrient absorption in the gut. It can also occur due to opportunistic parasitical and bacterial infections that damage the intestinal lining of the gut. Nutrients are absorbed in the villi, which are finger-like protrusions lining the intestinal wall. These structures can get damaged due to infection, which may lead to impaired absorption of nutrients.

If left untreated, both Wasting Syndrome and shingles can be fatal. In specific cases, they can prove more fatal than the diagnosed cancer itself.

Treatment Options

As of now, a standard treatment protocol for Wasting Syndrome is not available. In order to increase food uptake, drugs which help control nausea and vomiting are often used. Patients having difficulties with swallowing solid food are administered liquid nutritional supplements. Appetite stimulants such as Marinol® and Megace® are also used.

Nutritional supplements are also administered to provide patients with easy-to-absorb nutrients. Specific non-prescription anti-diarrhea drugs, for instance loperamide, are administered to provide relief from gastro-intestinal irritation. Opportunistic infections are treated with antibiotics and anti-parasitic drugs.

When combined with exercise, anabolic steroids including testosterone can be effective in the treatment of weight loss by accelerating the built-up of muscle mass. It has been reported that use of steroids helps improve the quality of life of patients suffering from cachexia. Human Growth Hormone (HGH) is also administered to patients to increase muscle mass. Similar to steroids, HGH does not repair the metabolic process associated with wasting; it provides relief from the condition via other hormonal changes.

A number of drugs have been used in clinical trials in order to assess their effectiveness in correcting the metabolic processes associated with Wasting Syndrome. One of these drugs is thalidomide, which has shown to contain the production of tumor necrosis factor in the patient’s body. However, this drug has not yet received approval from the Food and Drug Administration for treating this specific condition.

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