ABSTRACT
This chapter considers the features and causes of the cachexia syndrome in advanced disease. Cancer patients with cachexia do not survive as long as cancer patients who do not have cachexia. Cachexia is seen in cancer patients, but is also seen in AIDS, end-stage cardiac disease and chronic infection, but not in neurological diseases. Cachexia is mediated by the body's own cytokines produced as part of a systemic inflammatory response to the presence of cancer. Cytokines are low molecular weight proteins that integrate cell activity and over 100 are known. Some cytokines, such as tumour necrosis factor and interleukin 6, cause loss of appetite, reduce the ability of the bowel to absorb nutrients, reduce the action of insulin and activate useless energy cycles. Additional chemicals such as proteolytic initiation factor and insulin growth factor encourage muscle loss.
