ELNEC 4: Symptom Management in Palliative Care Practice Test

Cancer cachexia is driven by systemic inflammation and metabolic changes that cause ongoing loss of lean body mass and fat, even when caloric intake is adequate. This is different from simple starvation, where weight loss mainly reflects insufficient calories and can improve with increased intake. In cachexia, inflammatory signals and altered energy metabolism lead to a persistent catabolic state, so simply eating more calories often doesn’t reverse the muscle wasting and can be impractical or unsafe in advanced illness.

In palliative care, the focus shifts to relieving distress and preserving function and quality of life. That means addressing symptoms such as fatigue, appetite loss, early satiety, and weakness, supporting activity as tolerated, and using a multimodal approach to comfort and comfort-related goals rather than pursuing aggressive nutritional rehabilitation.

So the best answer highlights that cachexia involves systemic inflammation and metabolic changes and that the recommended palliative focus is symptom relief and activity as tolerated.