Most people can’t imagine hearing their doctor say the words – “you have cancer.” Every year
12.7 million people discover they have cancer and according to The National Cancer Institute
“almost all” people with advanced cancer develop anorexia.
When someone with a chronic illness develops an eating disorder it’s called cachexia
(ca·chex·i·a), or wasting disorder. The disorder has two different forms – the first occurs when
the patient eats normally but their body no longer uses the nutrients from the food they
consume. The latter develops when the patient stops eating because their illness has caused
them to lose their appetite. Either form can evolve into anorexia if the patient starves
Cachexia affects 50 to 80 percent of cancer patients and accounts for up to 20 percent of
cancer deaths. Additionally the eating disorder is associated with poor quality of life and has a
mortality rate of 80 percent. Many other cancer patients die with but not of cachexia. According
to data from the Nationwide Inpatient Sample, it is estimated that the annual prevalence of
cachexia admissions to community hospitals in the United States is over 160,000 cases. The
median duration of stay for the patients suffering from the disease was six days – double the
median stay for patients without cachexia. The median cost for these visits was $10,000, which
is $4,000 more than for non-cachexia patients.
Patients with cachexia may lose up to 20 percent of their body weight when suffering from the
disease. Unfortunately, there is no cure for the disease – unlike malnutrition which is reversible
with an adequate amount of food. The only way to manage cachexia is through managing
While there is no easy fix for patients who suffer from cachexia, some doctors recommend the
use of corticosteroids to increase their appetite. Additionally, the medication has been shown to
increase a patient’s mood. Medical marijuana has also been implemented in the hopes of
increasing hunger to encourage weight gain in underweight patients. Some doctors also work
with a nutritionist to determine a vitamin regime and specific foods a patient with cachexia
should be eating to maximize protein intake in the hopes of mitigating the disease.
Patients with cancers of the lung, such as the rare mesothelioma cancer, pancreatic, and upper
gastrointestinal cancers are more likely to develop anorexia. It remains the most commonly
diagnosed cause of cancer patient malnutrition.
Addressing the triggers of the cachexia can help to alleviate symptoms. Anorectic factors for
which specific strategies may be used include taste abnormalities, pain, nausea, depression
Acknowledging the issues of depression and anxiety can go a long way to improve the patient’s
willingness to both eat and battle their cancer. Talking with a therapist about their current health situation can help to lift the emotional burden felt by the patient. However, it is up to the patient
to first recognize that they are battling a depressive episode in addition to their cancer
diagnosis. Mental health issues often take a back seat while a course of treatment is planned
which can be a dangerous situation.
Having the resources readily available if/when they become necessary is paramount.
Mindfulness-based cognitive therapy (MBCT) and cognitive behavioral therapy (CBT) are just
two of the options that may be suitable for the patient based on his or her personal situation.
In an effort to encourage patients to maintain healthy eating habits to circumvent the cachexia,
studies have shown success with simple changes.
Possible adjustments include focusing on ambiance surrounding the patient’s meal, extra consideration to the patient’s food preferences, and attention to a pleasant social setting when serving meals. There is also value in eating with a family member, friend, or fellow patient and, if the patient likes, serving wine. The wine may improve the mood of a patient, stimulating both appetite and social interaction.
Generally speaking, it is important to stress to the patient that proper nutrition is an essential
part of managing their cancer. However, when having these conversations, be sure to
remember that they are suffering, and avoid judgemental or harsh tones. Love and support can
make a world of difference to someone who is fighting for their lives.