Cachexia

Cachexia is a wasting syndrome in which the body loses skeletal muscle and fat, causing weakness and fatigue; unlike malnutrition, nutrition support alone cannot reverse it. In cancer it is commonest in advanced pancreatic and lung tumours, though head and neck, bowel, ovarian and liver cancers can also cause it. Inflammation is thought to be the main driver, with faster metabolism and hormonal changes also contributing. The main features are loss of weight, muscle and fat, poor appetite, tiredness and weakness; severe muscle loss can lead to heart or breathing failure. It moves through pre-cachexia, cachexia and refractory stages, and treatment is most effective at the earliest stage. Diagnosis rests on recent weight loss with fatigue or reduced strength, often supported by simple tests of physical function. Management involves a team using appetite stimulants, anti-inflammatory medicines, dietary counselling, tube or intravenous feeding where needed, and physical therapy.

Seek urgent care for severe symptoms that come on suddenly, for difficulty breathing, or for drowsiness or confusion. See a doctor when symptoms persist, keep coming back, or affect daily life. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.