Metabolic System

Abstract

Cancer cachexia can be described as a syndrome characterized by weight loss, anorexia, muscle loss and atrophy, asthenia (general weakness including physical and mental fatigue), and anemia that occurs in cancer patients. A recent cachexia consensus conference agreed on a definition for cachexia: “Cachexia is a complex metabolic syndrome associated with underlying illness and characterised by loss of muscle with or without loss of fat mass” (Evans et al. 2008). Weight loss or the failure to gain weight are common adverse effects of cancer in children. Lange et al. (2005) found that 10.9% of 768 children with acute myelogenous leukemia (AML) were underweight at diagnosis, with the BMI ≤ 10th percentile. Picton et al. (1995) studied the nutritional status of 25 children with leukemia and 42 children with solid tumor malignancy. Nutritional status was assessed using weight-for-height index, triceps skinfold thickness, and mid-upper arm circumference. Table 17.1 shows the rates of cachexia seen in children in this study. Undernutrition has also been found to be sig-nificant (around 7%) in newly diagnosed children with acute lymphoblastic leukemia (ALL) (Reilly et al. 1999). In adults, a cachectic state at diagnosis is associated with a poor prognosis, but in children this association is debatable and may be of more importance in developing countries when associated with socioeconomic status and in social groups with relevant nutritional deficits (Rogers et al. 2005; Weir et al. 1998; Viana et al. 1994; Reilly et al. 1994). However, Lange et al. (2005) concluded that treatment-related complications significantly reduced survival rates in underweight (and overweight) children with AML (Lange et al. 2005). No significant differences were observed between underweight (or overweight) and children's gender, ethnicity, and race.