Cachexia and Sarcopenia With Bladder Cancer

Unintended weight loss can be a common side effect of cancer and cancer treatment. For many people, this is not a problem. But for some, it begins to affect their quality of life. It can even be dangerous.

Two common conditions can cause people with bladder cancer to lose fat and muscle mass. These conditions are called cachexia and sarcopenia. While they are different, they can be related to each other.^1,2

What is cachexia?

Cachexia is a common condition that occurs in people with advanced illnesses. It is a metabolic disorder, meaning it affects your metabolism. Your metabolism turns the food you eat into energy. This energy is used to fuel all bodily functions, including breathing, thinking, and moving.¹

Doctors think cachexia happens because of the body’s reaction to inflammation. Your body begins to use fat and muscle (along with the food you eat) for energy. As a result, you lose weight and muscle mass. Cachexia can occur with many illnesses, including advanced cancers.¹

Unfortunately, cachexia is not well understood, and there is no simple definition of it. Usually, doctors define it as a loss of 5 to 10 percent of body weight that is not intentional. But many doctors think this definition is too broad for such a complex condition.^1,3

What are the symptoms of cachexia?

Cachexia is not simply weight loss due to not eating enough food. People with cachexia experience extreme tiredness or fatigue. They also often lose strength. These symptoms can lower their appetite. In this way, cachexia may become a vicious cycle of losing weight and muscle mass.^1,3

Cachexia can affect mental health as well. It often causes a drastic change in appearance. This can lead to mental health issues for both the person with cachexia and their caregivers.^1,3

What is sarcopenia?

On the surface, sarcopenia is like cachexia because it involves the loss of muscle mass. But sarcopenia is usually caused by aging rather than illness. Most people who have sarcopenia are over the age of 60.⁴

What are the symptoms of sarcopenia?

Sarcopenia leads to weakness and reduced muscle function. These effects, in turn, can lead to falls, broken bones, and hospitalizations.⁴

Sarcopenia involves a thinning of the muscles, but it does not always involve weight loss. Doctors look at many factors to diagnose sarcopenia. These factors include:⁴

• How well you can stand up from a chair
• How well you can walk up and down stairs
• How fast you can walk short distances
• How strong your hands can grip objects

Sometimes doctors will also order imaging tests to help them diagnose sarcopenia. For people with bladder cancer, diagnosing sarcopenia is important because the condition is strongly linked to worse cancer outcomes.^2,4

How are cachexia and sarcopenia related?

Sometimes, sarcopenia is caused by cachexia. In people with cancer, including bladder cancer, cachexia causes a loss of fat and muscle mass. This can then lead to sarcopenia and the weakness and decreased function that goes along with it.²

How are these conditions treated?

People with bladder cancer should visit their doctor as soon as possible to learn about treating their sarcopenia or cachexia. Rebuilding muscle mass can help increase the likelihood of successful cancer treatment.²

If you have sarcopenia caused by aging, the best treatment option is to change your diet and exercise habits. You can focus on resistance training and weight-bearing exercises that increase muscle mass. You also can eat a balanced diet that includes enough protein.⁴

Cachexia is harder to treat. In the past, there were not many studies looking at cachexia. But this is starting to change. There have been promising recent studies on new drugs to treat cachexia.³

Some of these drugs work by changing how the cells in the body talk to each other. Others work by changing the hormones involved with hunger. Researchers also are looking at how diet and exercise can treat or even prevent cachexia.³

Talk to your doctor if you have weight or muscle loss that concerns you. And, as always, consult your doctor before changing your diet and exercise routine. They can give you recommendations for treatment based on your specific conditions.