The treatment of cachexia can involve medications and nutritional support. Cachexia, also known as wasting, is severe weight and muscle loss that occurs in patients with serious illnesses like Acquired Immune Deficiency Syndrome (AIDS) and some cancers. It can be life-threatening, along with other complications of the illness, and is a cause for clinical concern. Treatments may not be able to reverse the muscle loss, but they can help patients put weight back on and remain stable.
Original theories about cachexia involved a combination of decreased appetite and the idea that cancers consumed energy from the body, encouraging it to burn its own tissues for food. Further research indicates that appetite decline is certainly a factor, in addition to the metabolic changes associated with disease. Cancer and AIDS can both cause inflammation, which leads to an increase in cytokines, and this appears to accelerate wasting; this can also be affected by the malabsorption caused by lesions in the gut or medications used to control the illness. A better understanding of the process can improve the options when it comes to treatment of cachexia.
Nutritional support is one aspect of the treatment for cachexia. The patient may need parenteral nutrition delivered intravenously and could also benefit from enriched drinks and meals. Hospitalized patients may require special meals; nutritionists have found that changing food presentation can make it easier for people to eat, and that traditional hospital meals may contribute to loss of appetite. Eating more can help patients stabilize the weight loss and protect their remaining muscle tissue.
Medications are also an option for the treatment of cachexia. Some medications can increase appetite, encouraging patients to eat more. Prednisone and other steroids are an example, and as a side benefit, they can also reduce inflammation, which may help address the metabolic problems. Other medications may directly fight inflammation and reduce the number of cytokines in the body to slow or stop the wasting. These options for the treatment of cachexia can address the root cause while the nutritional support keeps the patient as strong as possible.
Individual patient response can be a factor in the treatment of cachexia. Each cancer, and each case of AIDS, can be slightly different, which requires adjustments to treatment to offer the best benefits for the patient. If a patient does well on a given medication, for example, a doctor may decide to keep using it, while other patients may need to cycle through several drugs to find one that works well for their wasting condition. Another issue can be medication tolerance, which may make a drug less effective over time.
