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Cachexia (wasting syndrome)

Cachexia is a complex change in the body, causing you to lose weight despite eating normally.

What is cachexia?

Cachexia (kak-ex-ee-a) comes from the Greek word kakos. It means bad. Hexis means condition. Anorexia means loss of appetite and is sometimes associated with cachexia.

Cachexia is also called wasting syndrome or anorexia cachexia syndrome.

Cachexia is more than only loss of appetite. It is a complex problem. It involves changes in the way your body uses proteins, carbohydrates, and fat. You may also burn up calories faster than usual. People with cachexia lose muscle and often fat as well.

Cachexia is very different to general weight loss. Doctors can’t reverse it fully despite you being able to eat. Feeding through a tube is not effective either.

What happens in cachexia

Scientists still don't know what exactly happens in cachexia. It is a complex process that involves several organs and systems in the body.

With cachexia, the cells in your muscles, fat and liver might not respond well to insulin. This is called insulin resistance. Insulin helps to take glucose from your blood. So your body can't use glucose from your blood for energy.

Scientists also think that cancer causes the immune system to release certain chemicals into the blood. This causes inflammation. These chemicals are called cytokines and contribute to the loss of fat and muscle.

The chemicals may make your metabolism speed up so that you use up calories faster. Because your body is using up energy faster than it is getting it, you can have severe weight loss. This can happen even if you are eating normally.

Symptoms of cachexia

Cachexia seems to be more common in people with lung cancer or with cancers anywhere in the digestive system. The main symptoms are:

  • severe weight loss, including loss of fat and muscle mass
  • loss of appetite
  • anaemia (low red blood cells)
  • weakness and fatigue

Who gets cachexia?

People with early stage cancers don’t usually get cachexia. Up to 8 out of 10 people with advanced cancer (80%) develop some degree of cachexia.

Cachexia in advanced cancer can be very upsetting. You can feel very weak and less able to do things.

Cachexia isn't just associated with cancer. It is common in the advanced stages of other illnesses such as heart disease, HIV and kidney disease.

Losing muscle and fat can make it look as though you are wasting away. This can all be made worse by the side effects of the cancer treatment you are having. If you are worried or upset about changes to your body and cachexia, talk to your medical team. They will support you.

Last reviewed: 
19 Mar 2020
Next review due: 
20 Mar 2023
  • Nutrition and Cancer
    Edited by Clare Shaw
    Wiley-Blackwell, 2011

  • National Institute for Health and Care Excellence (NICE) guidance
    Quality standard for nutrition support in adults (QS24), November 2012

  • Pharmacological management of cachexia in adult cancer patients: a systematic review of clinical trials

    S Advani and others

    BMC Cancer, 18(1), 1174 (2018) 

  • Pathogenesis, clinical features, and assessment of cancer cachexia

    A Jatoi and others

    UpToDate website

    Accessed March 2020