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Unwanted weight loss

Unwanted weight loss

Cachexia is a form of extreme wasting that occurs in the terminal phase of chronic conditions such as cancer, serious infectious diseases (tuberculosis, AIDS), in old age, etc. Cachexia occurs primarily in cancers of the lungs, esophagus, stomach, intestine and pancreas.

sYMPTOMS

The main symptom of cachexia is weight loss, in the form of muscle loss, fat, and even bone mass. Loss of appetite (anorexia), generalized weakness (asthenia) and lower hemoglobin (anemia) are also major symptoms. But, to treat cachexia, it's not enough to eat more! Even if the patient eats or tries to eat more or if he is fed directly by a catheter into the stomach or via the blood vessels, his situation continues to deteriorate.

causes

Recent studies allow us gradually to better understand the causes of cachexia. It is the result of a very complex pseudo-inflammatory reaction of the body, which totally disrupts the metabolism. Certain substances such as cytokines play a major role in this mechanism. In some cases, it is the tumor itself that produces the substances responsible for cachexia. In addition to the pseudo-inflammation reaction, cachexia is also accompanied by an increase in metabolism and a change in the way the body uses proteins, fats and carbohydrates.

Treatment

New drugs and dietary supplements that block these reactions are currently under development. In particular, the possibilities offered by substances such as omega-3 fatty acids, antibody-based compounds and even thalidomide (softenon, a substance that had been the subject of much publicity in the 1960s because of it caused malformations in newborns after being administered to pregnant women). Since cachexia does not occur exclusively in the context of cancer, but also in AIDS, advanced stages of kidney disease, some serious infections etc., it is hoped that a large number of patients will benefit from these new developments.

Unexplainable weight loss

Unexplainable weight loss is a common consequence of the cancer process. It is even sometimes the harbinger of a tumor not yet diagnosed. Weight loss in a cancer patient can have multiple causes. It will therefore be reversible in many cases, having nothing to do with the metabolic imbalance of a 'true' cachexia. For example, a tumor can block the throat, mouth, or esophagus to the point where it becomes painful or difficult to swallow or eat, which will ultimately lead to weight loss. In such cases, removal of the tumor in question will provide a solution.

Reversible weight loss

In addition to the tumor, the treatment itself can also be a problem. For example, a patient receiving esophageal radiotherapy may have difficulty swallowing, while radiation therapy from the gut may cause diarrhea. For its part, chemotherapy is often the cause of nausea, vomiting and other symptoms that disrupt the normal absorption of food. Such side effects temporarily cause weight loss. In the presence of this type of symptoms, which do not meet the definition of cachexia because this loss of weight is reversible, the advice of a food specialist or a dietitian may help the patient mitigate or resolve these phenomena and, in so doing, stop weight loss.

Cachexia, the patient and his entourage

Cachexia is not only difficult to manage for the patient, but also for those around him, for whom it is very hard to see a loved one 'declining' in this way. The logical reaction will therefore be to try by all means to feed the patient, which is not always effective and, even if it is, unfortunately does not stop the deterioration.

This is why it is usually recommended not to force the patient to eat. In the words of a famous American professor and oncologist-hematologist: "A lack of appetite is not painful, whereas forcing oneself to eat can be painful. However, it may be helpful to seek the advice of a dietary specialist or a specialist dietician to find out how to get the best profigmoments where the patient is willing to eat.


Food advice

- Try to drink at least 1.5 liters of water a day between meals.
- Divide the food intake throughout the day, into many small meals.
- Never skip meals.
- Take your time to eat; eat as much as you want and can.
- Eat what you want; the important thing at this stage is to take enough energy, even if you are pulling this - energy from foods that are not necessarily healthy, such as cakes, sweets, chips, etc.
- Opt for energy-rich foods and incorporate them into your preparations and meals: oily fish, vegetable oils
- for cooking vegetables, meat and fish; add a little vegetable cream to soups, sauces, coffee, ...
- Fat is a source of energy. No need to consume lean or lean products. Spread bread and biscuits -generously with butter or margarine and melt a piece of butter in the vegetables or porridge.
- Drink without worry about milk chocolate, eat ice cream, sweets or pastry.
- Try to limit vegetables, fruits and fiber-rich products during meals. They quickly provide a feeling of satiety. - Eat them as snacks, with a peanut dip (or other nut-based preparation) for fruit, or a guacamole sauce for -vegetables. You can also prepare "energy balls": finely mix dried fruits, nuts, honey and a little muesli, then - form small balls with this mixture. You can keep these dumplings in the fridge or in the refrigerator.
- Add honey or sugar to your drinks and dishes.
- As a snack, give yourself little extras (milk, pudding, cupcakes, pieces of cheese, nuts, dried fruit, crackers).
I- f the weight loss continues despite the application of these tips, you can consider adding to your food preparations in the form of powder (calories or protein, etc.); Or, add to your diet oral nutritional supplements that will provide you with most of the extra calories and / or protein. They are available in pharmacy. Never make this decision on your own. Discuss first with the treating physician or a dietician specialized in oncology.


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