Cancer Cachexia and Nutrition

breakfast-ceramic-plate-close-up-676560If you have read my story, you will know that cancer is a part of my family’s recent past.  Obviously, there are many things that a person going through chemotherapy has to worry about.  One problem that always arises is the form of malnutrition that accompanies cancer treatment, known as cachexia.

Cachexia is a form of muscle wasting.  Basically, even with food coming in (or not), your body starts to catabolize muscle tissue for fuel.  This results in rapid weight loss,  a higher rate of chemo toxicity, faster tumor progression, poor surgical outcome, physical impairment, and shorter survival rate.  Once cachexia starts happening, it is very challenging to improve health and makes recovery from chemotherapy even more difficult.  Usually, the advice given is to simply eat more, but this approach is not always effective.

The problem with cachexia is that It affects our appetite through means of inflammation, and increased energy expenditure leading to decreased hunger, loss of skeletal tissue, decrease in protein synthesis, and an increase in protein degradation.   Luckily, efforts are being put into researching what people can eat that will not only increase their appetite, but work to decrease inflammation and increase protein synthesis. When my wife was recovering from chemotherapy, we discovered the Primal diet.  I think it helped tremendously with recovery and gaining muscle mass back.  Many of the nutrients I’m about to list below are contained in abundance in a primal/keto aligned diet that focuses on an optimal ratio of omega-3’s to omega-6 fats, BCAA’s,  L-Carnitine, and ketones like BHB.


Specifically, we are talking about EPA and DHA, the fatty acids that are found in fish oils.  These fatty acids are well know to produce anti-inflammatory affects.  In those with cancer,  Inflammation is the biggest problem that needs solved.  It’s been shown that taking at least 1.5 g/day of fish oil is associated with clinical, biological, and quality of life parameters.

In this study on weight loss in pancreatic cancer patients, an EPA enriched supplement was given to patients twice a day.

  • Patients had significant weight gain after 3 and 7 weeks.
  • Dietary intake increased by almost 400 calories a day.
  • Resting energy expenditure fell significantly.
  • Performance and appetite greatly improved after three weeks.

Taking some quality cod liver oil like Green Pastures fermented stuff everyday would be optimal, along with eating some of the fattier wild fish like salmon and sardines.


BCAA’s are the amino acids valine, isoleucine, and leucine.  These three amino acids are found in skeletal muscle and are an important source of energy that provide protein synthesis and anti-inflammatory effects.  Studies are being done on it’s proficiency at stimulating muscle synthesis and lowering the risk of cancer anorexia.

The densest form of BCAA’s in food can be found in eggs, chicken, fish, and beef.  All foods that are very common on a primal eating plan.  To get some extra in a quality BCAA supplement isn’t out of the question.


L-Carnitine is an amino acid that is vital for mitochondrial performance.  It transports long-chain fatty acids into the mitochondria to be burned for fuel, and also transports waste buildup out of the mitochondria.  It is essential for a healthy metabolism and optimal burning of fatty-acids.  Unfortunatly, a side effect of chemotherapy is a deficiency in Carnitine.  Carnitine supplementation has been shown to help in several ways.

L-Carnitine is found most densely in red meat.  Basically the redder the meat the more carnitine you will find.   Supplements are also around.


Being in a state of ketosis is to signal a profound shift in our metabolic processes.  Instead of our cells running on a mix of glucose and fatty acids, ketones are generated by the liver to replace a lack of glucose for fuel.  The therapeutic effects of ketones are being studied intensely as treatment for a host of illness, as I detailed here.

We know that a ketogenic diet may help treat or augment conventional treatments for cancer.  We know that a ketogenic diet reduces inflammation but what about it’s affect on cachexia?

This study in a dish showed that cachexia is caused by the massive energy needs of cancer cells.  In the same study, mice with pancreatic cancer were fed a ketogenic diet and then compared to normal diet fed mice with the same cancer.  It turns out the ketogenic mice had a 45% increase in muscle weight and a 20% increase in body mass.

Although there is a lack of human studies on cachexia specifically, a ketogenic diet has been shown to dramatically decrease inflammation and energy expenditure.  These are two hallmarks of cachexia, and I wouldn’t dismiss it simply because their aren’t concrete studies yet on cachexia alone.  Later on, ill post about how to get started with a ketogenic diet.  In addition to a ketogenic diet exogenous ketones like BHB salts or esters may be taken to increase blood levels of ketones.

That’s it for today! Leave a comment below with any thoughts and questions.



Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s