I wrote a bit about cachexia a while ago. There wasn't much comment other than several people saying that I should eat more. Tall Allen asked if cannabis helped, but at that time I hadn't taken any. So, let me give this one more try. I have tried cannabis, and it does help with appetite. I am currently eating a full caloric diet. I am still losing weight (although a bit more slowly perhaps). My weight drop is 20% in the past year.
"Up to 80 percentTrusted Source of people with late-stage cancer have cachexia. Close to one-third of people with cancer die from this condition."
"It's important that oncologists be aware of [trials] and offer participation to their patients," said Dr. Jatoi, a member of an international group of clinicians and researchers who earlier this year published a consensus statement to more precisely define cancer-related cachexia. The publication also provided a preliminary classification system for the condition—akin in some respects to the staging system used for tumors. (strangly, there's not dae on this post).
At any rate, I'm not finding much on this. If any of my fellow travelers here can add some information, I would appreciate it.
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Dmwalker
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Hi Dmwalker,Im far from someone with the medical knowledge to appropriately comment. I am sorry to hear of your struggles.
What does your Oncologist have to say about your apparent loss of appetite and your chemo that you have apparently just begun ?
My loss of appetite prior to diagnosis was theorized to be caused by the significant size and number of enlarged lymph nodes I had. Possibly impinging on my stomach as well.
Lupron must have started the shrinkage of my nodes because within a couple weeks or so my appetite came back. Further improvement as I got into my chemo infusions. Chemo did not suppress my appetite as it is sometimes reported to do. Quite the opposite however I felt like I was given a new life when my appetite returned and pigged out to some extent.
Im getting off point here as related to your post .....seems you now eat a full diet daily and still suffer from the weight loss. I guess I still wonder if the systemic treatment (chemo) of your systemic cancer will bring a change.
Anyway I am hoping that chemo brings improvement for you.
As Patrick referenced with his link, I too have heard the ketogenic diet has shown benefit for some. Perhaps counterintuitively, a fat-heavy diet low in carbs and protein CAN curb excessive inflammation, while a carbohydrate- and/or protein-heavy diet generally increases inflammation.
For cachexia this is not a DIY attempt but something only to be done with medical/nutritional assistance and monitoring, working with someone who understands the potential benefits of ketosis.
I was on the ketogenic diet for a while before all these problems started.
As to "experts", I've yet to find one that claims to actually have any real program of treatment for this disease. Quasimodo's line seems appropriate here.
I think the specific details of the keto diet that might best serve you, currently, could need fine-tuning by such an expert. One person you might consult is Miriam Kalamian (Dietary Therapies LLC). Another who uses diet to help treat different cancer-related conditions is integrative oncologist Dawn Lemanne (Oregon Integrative Oncology), who says...
"Cancer cachexia is not a problem of lack of calories, it's a problem of inflammation and the result of insulin resistance. Often patients with cancer cachexia are told to just get some calories in. The easiest way to get calories is to eat carbohydrates. They'll be drinking sweet drinks and milkshakes and things like that. But if you're insulin resistant from inflammation, you can't use the carbohydrate that you have, and you're just going to keep getting thinner and thinner.
The ketogenic diet is really much more helpful in cancer cachexia than just stuffing calories from any source into those patients. If you eat fat, it decreases the amount of oxygen needed to make ATP or energy compared to carbohydrate metabolism. So if you're eating fat, you're making more ATP with fewer molecules of oxygen, and you have less oxidative stress. That is very anti-inflammatory. The ketogenic diet decreases the inflammation that patients with cancer cachexia have, and it decreases their insulin resistance.
It can be useful in patients with cancer cachexia along with other things such as anti-inflammatory medications. Sometimes you’ll want to add anabolic steroids and there are other drugs as well..."
Thanks for the information noahware. I have found so little information available on cancer induced cachexia, that I get the impression that many doctors think nothing can be done. It is a separate problem from the actual cancer (which is responding well to chemotherapy BTW). I will try to get in touch with those specialists you mentioned. Been battling pc for so long now, I'd hate to get taken down by a flanking operation.
I agree about doctors generally not understanding the condition, and I think part of it comes from a lack of nutritional training. For many docs as well as regular folk, a calorie is a calorie is a calorie! The other part is that many docs see only drugs as the way to treat this, rather than a combo of drugs and diet and exercise. (Add to that, people may really need a different specialist than the one who just specializes in treating the certain cancer itself, as opposed to the cachexia.)
It is said the muscle wasting is from metabolic changes that are more like those occurring with severe infection rather than those of malnutrition or starvation. So just adding calories is not likely to cut it. Of course, for those with PC, being in a castrate state is just adding to the body's inability to maintain muscle mass when entering the catabolic state of an increased resting metabolic rate. (Basically, your body wants to burn muscle rather than just burning calories and fat.. it is a kind of hyper-metabolism.)
The idea of reducing simple carbs and sugars, and increasing calorie-dense fats, would seem to be in line with this description of cachexia metabolism:
"Decreased insulin sensitivity during tumor progression has also been reported in drosophila and in mice. Insulin has several metabolic activities that can affect tumor progression. The increase in insulin level, as it happens in the onset of insulin resistance, per se promotes directly tumor growth by acting as growth factors [and] indirectly by modulating host metabolism in at least two independent manners.
Insulin resistance (and similarly IGF-1-resistance) might promote muscle wasting, hence, amino acid mobilization into the circulation, potentially fueling cancer. Insulin signaling impairment also promotes liver gluconeogenesis, further increasing REE (resting energy expenditure), tissue wasting and ultimately fueling cancer aerobic glycolysis."
Glad the chemo is working, and good luck with the metabolic and anti-inflammatory approach to the cachexia.
This word scars me. I hope that you can break the cycle!
I saw your first post and while aware of the term I am sorry to say I have nothing to offer and those with something have already done so above. May I ask if your taking on this disease alone or you have a support system around you to help?
I have a good support team, MO, pallative specialist, and their respective teams, and family - the best support team of all. On this particular issue though, we're a bit blind.
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