Preventing Cachexia When You Have Metastatic Breast Cancer

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If you’ve never heard about cachexia, you are probably wondering why we have devoted an entire article to the problem. Yet cancer cachexia is a major concern for people with metastatic breast cancer.

It’s thought to occur in at least 50 percent of people with advanced cancer, lessening the ability to tolerate cancer treatments and worsening the already frustrating problem of cancer fatigue. By itself, it’s considered to be the direct cause of death in 20 percent of people with cancer.

And it’s not only survival that’s at stake. Cachexia can greatly decrease the quality of life for people living with advanced cancer.

We know that this description of cachexia comes off very strong, and that’s intentional. It’s only recently that this very problem has begun to be addressed, and it is still largely ignored, at least until it has become very serious.

It’s thought that cachexia may begin even before people lose any weight—and that’s the best time to try to make a difference.

What Is Cachexia?

Cachexia is a syndrome which includes unintentional weight loss, loss of muscle mass, and loss of appetite. We aren’t certain exactly what causes these symptoms, but some researchers believe it may be related to substances secreted by tumors or by the body’s reaction to a tumor.

It is most often recognized by the weight loss which occurs, but as noted, it’s thought that cachexia may begin even before any symptoms occur.

Signs and Symptoms

There are three primary symptoms associated with cachexia:

  • Unintentional weight loss - Unplanned weight loss is defined as the loss of five percent of body mass or roughly 7.5 pounds for someone who ordinarily weighs 150 pounds. This may occur even if someone is getting an adequate number of calories in their diet.
  • Muscle wasting – Muscle mass is affected disproportionately to fat, although a loss of fat can occur as well. Unlike fat, muscle mass loss can be very insidious and is not often recognized until a significant loss of muscle mass has occurred.
  • Loss of appetite – A decrease in appetite is common with cancer and cancer treatments, though this is somewhat different with cachexia. Rather than a loss of interest in food or a lack of symptoms of hunger, this is more of a loss in the desire to eat.

Prevention and Management Through Lifestyle

The best time to treat cachexia is before it occurs. If you’re losing weight or if you’re struggling to eat due to the symptoms of cancer treatment, talk with your oncologist.

You may want to add some high-calorie foods or snacks to your diet. If you are getting full easily, try eating more often. Supplements such as Ensure may also help you add calories to your diet.

Don’t be alarmed by the studies recommending weight loss for women with breast cancer. With early stage breast cancer, excess weight may contribute to a recurrence, but with metastatic breast cancer, cachexia is of greater concern.

Making your meals not only delicious but aesthetically pleasing is a bonus.

This may be the time to pull out the good dishes and add a few candles to the table. Dining with friends can be helpful, though you may not feel up to this at times.

We’re learning that the Mediterranean diet—touted to help with everything from cancer to heart disease—is more than just the foods. This diet makes eating an experience, with food slowly savored while pleasant moments are shared slowly with friends.

Engaging in mild to moderate exercise appears helpful as well, even though calories are burned in these activities.

Can Medication Help?

Many medications and supplements have been evaluated, although there has been limited success with many of these.

In recent years fish oil has been evaluated with some positive findings, especially with supplements of the type of omega-3-fatty acids known as eicosapentaenoic acids (EPA). In studies, these supplements were associated with a reduction in the incidence of infections and fewer complications of cancer treatment.

According to the National Cancer Institute, medical marijuana may also be helpful as well, at least for those who live in places where this is legal.

Always talk to your oncologist first. Many clinical trials are in progress and there will hopefully be better treatments available soon.

Sources:

Bruggeman, A., Kamal, A., LeBlanc, T. et al. Cancer Cachexia: Beyond Weight Loss. Journal of Oncology Practice. 2016. 12(11):1163-1171.

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