Cancer Cachexia

Why Cachexia is so dangerous.

Cachexia affects 50–80% of advanced cancer patients, with currently no effective treatments. Cachexia is defined by loss of muscle function and muscle mass, loss of body weight, and increased fatigue and weakness. This results in diminished physical activity, reduced tolerance to anticancer therapies and overall increased death (By some estimates, nearly one-third of cancer deaths are caused by cachexia, according to the National Cancer Institute).

Available evidence suggests that chemotherapy (i.e. the use of cytotoxic and anti-proliferative drugs) may play a key role in the development and sustainment of cachexia, says this study

Some solutions

Physical  activity
This 2019 study, published in the American Journal of Lifestyle Medicine concluded: Muscle metabolic health and mass are dramatically affected by physical activity and exercise. Physical activity and exercise are already thought to be beneficial during cancer treatment and survival and hold clear potential as a nonpharmacological treatment for muscle wasting conditions.
See Physical Exercise

Endurance training
This study says: Chronic endurance exercise prevents/attenuates the symptoms of cancer cachexia in animal models. Therefore, we propose that endurance exercise training may present a low-cost, safe alternative for sustained inflammation in cancer patients, provided that cardiovascular status is compatible with the load of exercise prescribed.

Review published in Applied Physiology, Nutrition, and Metabolism recommends patients to maintain as much physical activity as possible, given their particular impediments, during cancer treatment and recovery. The recommendation for healthy individuals is of at least 150 min of moderate-intensity or 75 min of vigorous-intensity activity each week, or an equivalent combination, preferably distributed throughout the week.

Cannabinoids
A type of chemical in marijuana that…may help treat the symptoms of cancer or the side effects of cancer treatment. Source: National Cancer Institute.

Study published Current Oncology says: Cannabis is useful in combatting anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, and depression. Cannabis might be less potent than other available antiemetics, but for some patients, it is the only agent that works, and it is the only antiemetic that also increases appetite.

This Institute of Medicine report concluded: For patients, such as those with AIDS or undergoing chemotherapy, who suffer simultaneously from severe pain, nausea, and appetite loss, cannabinoid drugs might offer broad spectrum relief not found in any other single medication…The therapeutic effects of cannabinoids are best established for THC, which is generally one of the two most abundant of the cannabinoids in marijuana.

Melatonin (MLT)
A hormone made by the pineal gland. Melatonin helps control the body’s sleep cycle, and is an antioxidant. It is also made in the laboratory and sold as a supplement. Source: National Cancer Institute.

Study published in European Journal of Cancer states: … this study shows that MLT may counteract weight loss that occurs with progressing cancer…

This study says:…the melatonin group had less-frequent myelosuppression, neuropathy, and cachexia.

Study: a randomized study was carried out in patients with metastatic solid tumors comparing a combination of low-dose IL-2 plus melatonin with best supportive care. In the treated group, the percentage of patients with improved performance status, as well as overall survival, was significantly higher than the controls.

The following excerpts are taken from Holland-Frei Cancer Medicine. 6th edition.
…a randomized study was carried out in patients with metastatic solid tumors comparing a combination of low-dose IL-2 plus melatonin with best supportive care. In the treated group, the percentage of patients with improved performance status, as well as overall survival, was significantly higher than the controls.
See Melatonin page

Omega 3 Fatty Acids
This study says: The potential impact of an essential fatty acid deficit is exemplified by data showing that survival is reduced by about half (approximately 8 months shorter) in cancer patients who have EPA below the range observed in an age matched healthy control group. There is evidence to suggest improvement in muscle health when essential fatty acid supply is maintained.

Several human studies have been conducted using fish oil (EPA+DHA), or EPA alone either as part of an oral nutritional supplement or in purified form in an attempt to reduce weight and/or muscle loss in patients with advanced cancers. Studies using patients in advanced cancer stages report that supplementation with > 2g per day of EPA stabilizes weight loss, attenuates lean tissue wasting, and increases survival in patients with advanced cancer.

Study published in Current Problems in Cancer says: patients with the lowest n-3 fatty acids in plasma PL experience muscle loss whereas those with the highest n-3 fatty acids gain muscle over the course of chemotherapy.

Study published in GUT states: In cancers where high inflammatory stress is usual, protein rich supplements containing n-3 polyunsaturated fatty acids and high levels of antioxidant vitamins can reverse severe weight loss.

[cancerireland.ie note:
The 3 major antioxidant vitamins are beta- carotene, vitamins C 
and vitamin E.]

Pomegranate (study)
In cancers where high inflammatory stress is usual, protein rich supplements containing n-3 polyunsaturated fatty acids and high levels of antioxidant vitamins can reverse severe weight loss (study)

Study published in Current Problems in Cancer says: COX-2 expression is increased in cachexia…Pomengranate juice resulted in the highest level of COX-2 suppression (79%) compared to treatment with single constituents. The effects are attributed to synergistic activity of the various pomegranate components necessary for anti-inflammatory and anti-carcinogenic activity.

Hydrazine Sulfate
A substance that has been studied as a treatment for cancer and as a treatment for cachexia (body wasting) associated with advanced cancer.

This study says: In 38 patients with glioblastomas, Sehydrin (Hydrazine Sulfate) administration resulted in at least tumor stabilization and tumor regression in 27 (71%).

This study states: There is good evidence that hydrazine sulfate inhibits gluconeogenesis. Therefore, it may play a role in reducing the severity of cachexia and in improving the quality of life of cancer patients.

(For more on hydrazine sulfate, see Ralph Moss’ book, The Cancer Industry.)

Low carbohydrate diet
Study published in BMC Medicine says: a switch to a low carbohydrate/ketogenic diet has been shown to prevent cachexia in patients undergoing chemotherapy, suggesting this dietary approach may be a suitable alternative for cancer patients at risk of cachexia, sarcopenia, and weight loss.

AHCC
This study evaluated fifty patients diagnosed with adenocarcinoma and malnutrition, during radio-chemotherapy. All patients were given a food therapy and a dose of AHCC of 1.5 g/day. Results: There was no progression of cancer malnutrition/cachexia in 80% of the subjects… Conclusions: The use of AHCC during chemotherapy helps to prevent cases of cachexia and sarcopenia…

Arginine, L‐glutamine, and Hydroxy methyl butyrate
This Study Review says: …we selected five studies that were suitable for our systematic review. The results of the studies shows that this combination can improve fat free mass, weight and immune function in cachexia and morbid weight loss patients. Supplementation with a combination of Arginine, Glutamine, and HMB [Hydroxy methyl butyrate] may improve cachexia and morbid weight loss in cancer patients.

Dr. Coy diet
Since malignant cancer cells metabolise blood sugar into lactic acid, the Coy diet uses very minimal amounts of carbohydrates and sugars. In doing so, the cancer cells are cut off from their main energy supply, glucose, and lose strength, which weakens cancer cells, so that treatments are more effective. The diet contains foods rich in energy that cannot be used by TKTL1-positive cells. This energy will then be at the disposal of the healthy cells and may prevent the threatening loss of weight.

L-Carnitine (LC)
This study says: We therefore tested whether oral L-Carnitine supplementation has a clinical benefit in patients with advanced pancreatic cancer and found that L-Carnitine can reduce malnutrition, increase bodyweight and improve body composition.

In cancers where high inflammatory stress is usual, protein rich supplements containing n-3 polyunsaturated fatty acids and high levels of antioxidant vitamins can reverse severe weight loss (study)
Note: The 3 major antioxidant vitamins are beta-carotene, vitamins C and vitamin E.

More options

The following excerpts are taken from
Holland-Frei Cancer Medicine. 6th edition.
(Ohnuma T. Treatment of Cachexia. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003. Available from:https: //www.ncbi.nlm.nih.gov/books/NBK13978/)

Metoclopramide
In advanced cancer patients with delayed gastric emptying or gastroparesis, oral administration of a prokinetic agent, metoclopramide, 10 mg orally 4 times daily before meals and at bedtime, was shown to be effective in stimulating appetite and relieving other dyspeptic symptoms associated with anorexia. A controlled-release preparation appears to be more effective than immediate-release drug… 

Megestrol Acetate
This progestational agent is frequently used in the treatment of patients with metastatic breast cancer. It is generally well tolerated, except that it may cause undesirable weight gain. The addition of megestrol acetate to chemotherapy for patients with melanoma resulted in a high objective response and prolonged median survival as compared to historical controls with chemotherapy alone.

Thalidomide
In a preliminary study, 72 cancer patients with anorexia and weight loss were given thalidomide 100 mg/d. By day 10, 50% to 70% of 37 evaluable patients reported improvements in intensity of various symptoms including anorexia, nausea, fatigue, and sense of well-being.

Eicosapentaenoic acid
Patients with pancreas cancer treated with supplements of fish oil capsules (EPA and docosahexaenoic acid) showed body weight gain accompanied by significant reduction in acute-phase protein production and by stabilization of resting energy expenditure. While nutritional supplement alone did not attenuate the development of weight loss in cachectic patients, nutritional supplement enriched with EPA resulted in significant weight gain. A randomized controlled study was carried out to investigate the effects of dietary EPA plus vitamin E on the immune systems and survival of well-nourished and of malnourished cancer patients… EPA prolonged the survival of both groups of patients. 

Indomethacin and Ibuprofen
These agents are inhibitors of prostaglandin synthesis. In clinical trials, indomethacin reduced fever and granulocytosis, and was claimed to have improved the well-being of cancer patients. In cachectic cancer patients, ibuprofen was reported to decrease C-reactive protein, to produce body weight gain, and to improve survival.

GHRP-2
Daily subcutaneous injections of a more stable synthetic ghrelin-receptor agonist GHRP-2 (growth hormone releasing peptide-2) produced dose-dependent increases in food intake and body weight. Ghrelin receptor agonists may offer a treatment option for syndromes such as anorexia nervosa, cancer cachexia, or acquired immunodeficiency syndrome (AIDS) wasting.

Clenbuterol
Clenbuterol is a β₂-adrenoceptor agonist. It prevented muscle protein wasting in tumor-bearing animals and increased muscle mass and function in healthy animals. There was no change in food intake or tumor growth.

Using Antioxidants during chemo

Many oncologists advise against taking supplemental antioxidants during chemotherapy. Many integrative oncologists and practitioners, on the other hand, believe that antioxidants taken during treatment not only alleviate some of the treatment side effects but also enhance the efficacy of the treatment.

The latter view is supported by this 2018 Study Review published in the Saudi Pharmaceutical Journal. It encompasses a total of 174 peer-reviewed original articles comprising 93 clinical trials with a cumulative number of 18,208 patients, 56 animal studies and 35 in vitro studies.

The authors say their data suggests that antioxidant has superior potential of ameliorating chemotherapeutic induced toxicity. Antioxidant supplementation during chemotherapy also promises higher therapeutic efficiency and increased survival times in patients.

Page last updated January 2026