Progressive loss of weight and muscle mass is a common complication in many patients with advanced cancer.
At IVOQA (Viamed Institute of Advanced Surgical Oncology), we address this challenge through a multidisciplinary approach, combining specialised clinical care with innovative therapeutic strategies aimed at preserving the patient’s functional status and physical strength throughout the cancer journey.
This content has been prepared with the collaboration and review of Dr. Delia Cortés, Director of IVOQA, who has contributed her clinical expertise to ensure the accuracy and quality of the published information.
What is cancer cachexia and why does it occur?
Cancer cachexia is a complex metabolic syndrome characterised by severe and involuntary loss of muscle mass and body weight, triggered by the inflammatory response generated by the tumour itself.
This process profoundly alters the normal functioning of the body’s cells. It is not simply a matter of losing interest in food, but rather a destructive reorganisation of the body’s energy metabolism driven by the disease.
The difference between ordinary malnutrition and cancer cachexia
Unlike ordinary malnutrition —where the body uses its fat reserves to survive and the condition can be corrected simply by eating more— cachexia directly breaks down skeletal muscle. Chemical substances released by the tumour (inflammatory cytokines) cause a state of hypermetabolism. This means that the body breaks down proteins at an accelerated rate, making it impossible to stop weight loss through conventional nutrition alone.
Which types of cancer are most commonly associated with cachexia?
This metabolic disorder has a particularly high incidence in cancers of the digestive and respiratory systems. It is frequently associated with complex cancers of the pancreas, stomach, colon, liver and lung. These areas coincide with the fields of expertise of our advanced surgical oncology team, where early intervention is crucial to protect the patient.
Main symptoms: how can cancer cachexia be identified?
The symptoms of cancer cachexia include rapid weight loss, a visible reduction in muscle volume, extreme fatigue and a profound loss of appetite that does not improve with conventional nutritional supplements.
Identifying the initial signs allows our medical team to intervene before physical deterioration becomes severe. Patients and caregivers should pay close attention to the following warning signs:
- Involuntary loss of muscle mass (sarcopenia): a noticeable reduction in muscle volume in the arms and legs, weakness when getting up from a chair or loss of strength when holding everyday objects.
- Cancer-related anorexia and early satiety: complete loss of interest in food or feeling completely full after eating only two or three mouthfuls.
- Extreme fatigue and loss of adipose tissue: chronic tiredness that does not improve after sleeping, accompanied by loss of the fat layers beneath the skin, resulting in a gaunt appearance or very prominent cheekbones.
- Metabolic alterations: signs of systemic inflammation in blood tests, such as persistently elevated C-reactive protein (CRP) combined with very low albumin levels.
Why can cachexia compromise the success of cancer treatment?
Cachexia can compromise the success of cancer treatment because it weakens the body’s physiological reserves, significantly reducing the patient’s tolerance to systemic therapies and major surgery. Patients with sarcopenia have a higher rate of complications, including suture dehiscence following digestive surgery, respiratory problems such as pneumonia and longer hospital stays.
Protecting nutritional status is not a cosmetic issue; it is a therapeutic necessity to ensure that the main treatment plan can be completed successfully. For this reason, an important part of our prehabilitation programme focuses on nutritional optimisation and the recovery of body weight and muscle mass.
Reduced tolerance to chemotherapy and radiotherapy
When a patient experiences severe muscle loss, their ability to process and eliminate cancer drugs decreases. This significantly increases chemotherapy toxicity, sometimes forcing specialists to reduce the required doses or delay planned treatment cycles, which can reduce the effectiveness of treatment against the tumour.
Impact on postoperative complications and oncological surgery
A body weakened by tumour-induced hypermetabolism may have significant difficulty healing tissues after highly complex surgery. The risk of hospital-acquired infections, failure of digestive sutures and prolonged stays in the intensive care unit increases, potentially compromising the outcomes of cytoreductive surgery.
New treatments and medical management of cachexia at IVOQA
The advanced approach to cachexia at IVOQA combines innovative metabolic modulators, personalised clinical nutrition and adapted therapeutic exercise to help prevent muscle deterioration.
At Viamed Santa Elena University Hospital in Madrid, we have moved away from the outdated idea that physical deterioration is inevitable. We apply an active support protocol structured around the latest advances in medical care:
Emerging pharmacological therapies and metabolic modulators
We use the latest biotechnological advances to help reduce molecular inflammation. We incorporate specific anti-inflammatory drugs and new-generation appetite stimulants aimed at increasing lean body mass and blocking the chemical signals responsible for muscle protein breakdown.
Specialised and personalised nutritional support
Our nutritionists move beyond generic recommendations. We design personalised high-protein nutritional plans carefully adapted to each patient’s swallowing and digestive capacity, using advanced enteral or parenteral nutrition when necessary to ensure an adequate calorie intake. In some cases, hospital admission may be required to improve the patient’s condition through intravenous nutrition.
Prehabilitation programmes and adapted therapeutic exercise
Through IVOQA’s Physiotherapy and Functional Training Unit, we demonstrate that prescribed physical exercise can be a powerful therapeutic tool against cachexia. Adapted strength training is the only tool capable of stimulating the development of new muscle fibres, helping to reverse atrophy and restore the patient’s physical independence.
The Multidisciplinary Committee: a key element in the management of cachexia
At our centres, decisions are made jointly. A unified tumour board —in which medical oncologists, general surgeons, endocrinologists and nutritionists work closely together— reviews each patient’s laboratory results and physical progress on a weekly basis in order to adjust therapies quickly when necessary.
Cachexia clinical trial at IVOQA
At IVOQA, in collaboration with FutureMeds, we participate in the VINCTIT clinical trial, an international study evaluating a new therapeutic strategy for the treatment of cancer-associated cachexia, a common complication in patients with advanced disease characterised by progressive loss of weight and muscle mass.
The study evaluates the efficacy and safety of visugromab, an investigational drug designed to block the GDF-15 protein, which is involved in loss of appetite and nutritional deterioration in these patients.
In addition, VINCTIT incorporates digital monitoring tools that allow more precise follow-up of patients’ clinical progress. The trial is open to patients with certain advanced tumours, regardless of whether they have previously been treated at our hospital or have private medical insurance.
For further information, please contact ivoqa@viamedsalud.com
Frequently asked questions about cancer cachexia
