A Serious Concern for Lung Cancer Survivors
If you’re a lung cancer survivor who’s lost weight and/or muscle, you may have been told that you are at risk for or have developed cachexia. But what is cachexia?
Cachexia is uncontrolled and unwanted loss of weight and muscle. It is seen in some serious illnesses, including lung cancer. Over half the people diagnosed with advanced lung cancer also have cachexia. Cachexia can affect
• How well you handle side effects of chemotherapy and other treatments
• Whether or not you can complete your cancer treatment
• How you feel, or your overall well-being
• Your ability to stay independent and to do the things that are important to you
• How long you may live
Understanding Cachexia Weight Loss Three things make up your total body weight:
• Body Fat: What people usually lose when they diet
• Lean Body Mass: What the rest of your body (muscle, fluids, organs, and other tissues), not including the bones, weighs
• Bone Mass: What your bones weigh
In cachexia, lean body mass is lost even if the amount of body fat decreases or stays the same. This means it is possible to be overweight and still have cachexia. The loss of lean body mass causes some symptoms of cachexia like weakness and fatigue. Although good nutrition is very important, the symptoms of cachexia cannot be reversed by just eating more or healthier.
What Causes Cachexia To understand cachexia, it is important to understand how the body works to break down food. A healthy body uses many signals to break down food into energy to keep working normally. Cancer can disrupt these signals, causing problems that lead to loss of weight and muscle even with normal eating habits.
Cancer can make the body unable to use all the food for energy. It can also make the body burn more energy than normal, even at rest, which breaks down healthy tissue. Inflammation caused by the cancer can speed up this process and lead to cachexia. Cancer can also cause appetite changes, make food taste differently, and reduce feelings of hunger even when the body needs food.
It can be very stressful to see a loved one lose their appetite and lose weight when they have lung cancer. Caregivers may blame themselves for not providing the right food or not encouraging their loved one to eat enough. Keep in mind that this is not your fault. Cachexia is complicated and is not fixed by nutrition alone. Remember, you are part of a team, so be sure your loved one’s healthcare team is aware of their symptoms and work with them to find ways to help.
You may have cachexia if you are losing weight without trying. Your healthcare team can assess if you have cachexia or are at risk for developing it by asking about your appetite, eating habits, and any digestive problems. They may also test your muscle strength. Symptoms of cachexia include
• Weight loss
• Loss of muscle mass or strength
• Loss of appetite
• Changes in taste or smell
• Feeling full after eating small amounts of food
In cachexia, lean body mass is lost even if the amount of body fat decreases or stays the same. This means it is possible to be overweight and still have cachexia.
Even if you have not been diagnosed with cachexia, your healthcare team may be concerned about loss of weight and muscle and work to try to avoid it. The proper treatment or prevention of cachexia will depend on your general health and other factors, such as the kind and stage of lung cancer you have.
What You Can Do Continuing your cancer treatment is important because cachexia tends to improve along with tumor response. Here are some other things you can do to treat, and possibly prevent, cachexia:
• Have a consultation or a nutritional assessment done by a registered dietitian. Good nutrition alone may not reverse cachexia, but it is very important.
• Stay as physically active as possible. Finding a fitness routine that works for you can help build muscle mass and improve your body’s condition.
• Get treatment for depression. Being depressed can affect your appetite and result in weight loss.
• Control lung cancer symptoms and treatment side effects. Easing nausea, pain, and constipation can make a big difference in your overall health and well-being.
• Talk to your doctor about medications or supplements for cachexia. While no medication is currently approved to treat cachexia, there are medications and supplements that may help. New ways to treat cachexia are also being studied.
The goal of preventing or treating cachexia is to reverse or stop the loss of muscle mass and weight if possible. The earlier this is done, the better. Preventing or treating cachexia may help you stay in cancer treatment, improve how you feel, and help you to live longer.
The Bottom Line Cachexia can affect how you feel and whether you are able to stay in cancer treatment. Weight and muscle loss can be very distressing to people diagnosed with lung cancer and to their loved ones. It is important to recognize and treat cachexia as early as possible to reduce or delay its effects, so bring up any questions or concerns you have with your healthcare team.
Reprinted with permission from the Lung Cancer Alliance, lungcanceralliance.org.
This article was published in Coping® with Cancer magazine, September/October 2018.