Beyza Hilal BALCI, Selim YALÇIN
Intercontinental Journal of Internal Medicine - 2026;4(1):22-25
Cancer-related cachexia is a complex metabolic syndrome characterized by involuntary weight loss, systemic inflammation, and a significant disruption of protein-energy homeostasis. It serves as a primary determinant of mortality and negatively impacts the efficacy of oncological treatments such as chemotherapy. The prevalence of cachexia ranges between 40% and 70%, with the highest incidence observed in pancreatic and gastrointestinal cancers. The pathophysiology is driven by pro-inflammatory cytokines secreted by tumors (e.g., TNF-alpha, IL-1, IL-6), which cause systemic catabolism, such as faster proteolysis in skeletal muscles and more lipolysis in adipose tissue. Furthermore, the syndrome involves the impairment of the central nervous system's homeostatic control over energy balance, leading to anorexia and high resting energy expenditure. Diagnosis is mainly based on keeping an eye on unintentional weight loss and body mass index (BMI), with a weight loss of 5% being a key sign of a bad prognosis. Effective management requires a multisystemic and multidisciplinary approach. This includes early nutritional interventions (oral, enteral, or parenteral), the use of appetite stimulants (orexigens), and tailored exercise programs to mitigate muscle atrophy. Additionally, comprehensive symptom management-addressing pain, nausea, and psychological distress-is essential for holistic care. As cachexia gets worse, it may not respond to standard treatments, which will lead to a decline that cannot be stopped. Given the increasing global incidence of cancer, there is a critical need for specialized teams and further research to develop effective, targeted treatment strategies for this challenging condition.
