Cancer Cachexia, also known as muscle wasting, is often seen in end-stage cancer. It is a complex metabolic syndrome, which accounts for up to 40% of all cancer-related deaths. The current standard of care focuses on palliation of symptoms and reduction of distress of patients and families rather than a cure.
Until this day, health professionals’ primary response is often focused on getting more calories into cancer patients. This approach, unfortunately, is often insufficient (source). Several experimental studies have suggested systemic inflammation plays an important role (source) and some anti-inflammatory therapies have offered moderate benefit on the condition (study). Oxidative stress has also be singled as an important contributing factor to cancer cachexia (study).
In this article, I will cover a few natural and holistic therapies that one should consider to improve the quality of life of cancer patients who have cachexia, and help manage the condition.
The traditional model of cachexia management has generally been to increase the calories intake of the patient. And despite the fact that a higher calories intake does not solve all symptoms, this approach shouldn’t be underestimated. In some cases, solid foods are an issue, which calls for a dedicated approach. In other cases, constipation is a problem that can be encountered. In any of those cases, a properly designed nutritional plan can bring some improvements. Of course, decreasing all the cancer promoting foods should also be a first-line intervention.
A relatively new approach is that of using the ketogenic diet, which is the subject of numerous studies. Despite some real concerns related to accelerated weight loss from the diet, those concerns do not seem to be substantiated. There is unfortunately only few studies directly addressing the subject specifically, including two on mouse models (study, study) and one on test tube cells (study). The diet has however shown great promise as an adjuvant cancer therapy.
What is clear, though, is that inflammation is implicated in the progression of the disease primarily through a class of molecules called cytokines (study, study). Several studies have also shown that the ketogenic diet is able to decrease this type of inflammation (study, study, study).
As they have a known effect on inflammation, supplementation with omega 3 fatty acids (in particular EPA & DHA) has been the subject of many studies, and although the evidence may be conflictual in the case of cancer cachexia, several studies seems to show a consistent positive effect (systematic review, study, systematic review).
Furthermore, the latest frontier of natural health, the microbiome, also has a proven link to inflammation. And it comes at no surprise that the latest results from research labs seem to point to probiotics as another potential calming factor for cancer cachexia (study, study, study).
Onco-hypnosis is the use of hypnosis as adjuvant therapy in cancer care.
Emotional issues, apprehension & anxiety, pain while eating, nausea and vomiting are all contributing factors of the condition. In all of those cases, hypnotherapy can help – see my previous post here.
Interestingly, a pilot study has been done on the hypnosis and inflammatory cytokine Interleukin-6, and indicated that hypnosis might have a positive effect (study). This is very limited evidence, however evidence none the less, and is related to the growing field of psychoneuroimmunology.
Change of lifestyle is another very important holistic set of tools to help prevent or alleviate the symptoms of cancer cachexia. Here are a few factors that ought to receive particular attention.
There are many, many different ways you can move your body. And while a marathon is certainly neither feasible nor desirable for patients who have this disease, any movement is better than none and will send signals to your body to preserve muscles. In fact, studies targeting cachectic patients have demonstrated that, even in advanced disease, peripheral muscles have the capacity to respond to exercise training. In addition, moderate exercise is known to reduce inflammation, glucose utilisation and increase mitochondria concentration in tissues (all are important elements of a metabolic therapy for cancer). (study, study)
It has been shown that stress induces immune dysregulation and inflammation (source), with negative outcomes in the case of a cancer diagnostic (source) and worsening of cachexia symptoms (source). However this goes both ways, as muscle wasting itself is a stark reminder of the seriousness of the condition and getting closer to the end of life. Other elements of its emotional impact include a sense of failure, a sense of helplessness, conflict with family members and social isolation. I have written a review of 8 simple stress management techniques that you can apply today. Other managements techniques can include yoga, breathing techniques, meditation, hypnotherapy, massage, etc. And in my opinion, one of the best stress-relief activity is to spend some time with supportive family and friends.
Extracts from the Cannabis plant or Hemp have been the subject of numerous scientific studies and many passionate debates. In particular in the case of cancer cachexia, the molecule that show the best promise is Δ9 tetrahydrocannabinol (THC), currently illegal in the UK and several other countries. There are also indications that THC is better tolerated when used together with Cannabidiol (CBD) and other cannabinoids compounds. Cannabis extract seems be doubly effective by both decreasing inflammation and increasing feelings of hunger (study, review, study). Unfortunately, there is a lack of reliable randomized controlled trials, and the pharmacokinetics of cannabinoids is not well studied (study).
Remember to always act within the laws of your country, as some have banned THC components, and others have outlawed all cannabis products.