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Symptom control in palliative care--Part II: cachexia/anorexia and fatigue.

Cachexia may occur in up to 80% of patients with advanced cancer.1 This complex metabolic syndrome, characterized by profound loss of lean body mass, is the main cause of death in 20% of patients. Cachexia (involuntary loss of more than 10% of premorbid weight) is a marker for poor prognosis2 and is associated with anorexia (loss of appetite), asthenia and changes in body image. Cancer cachexia tends to occur in patients with solid tumors, in children, and in elderly patients. Cachexia is also common in acquired immune deficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF)3–6 and other chronic illnesses, such as dementia, tuberculosis, malaria,7 chronic kidney disease, liver disease,8 and rheumatoid arthritis.