Which of the following is characteristic of cachexia in pediatric oncology patients?

• A. Progressive wasting of lean tissue and body fat
• B. Gradual weight loss
• C. Decrease in energy expenditure
• D. Maintenance of lean body mass at the expense of body fat

Answer: (A)

Cachexia is a catabolic state where there is progressive loss of both lean body mass and adipose tissue driven by cancer-related inflammation and metabolic changes, not simply by not eating. In pediatric oncology, this ongoing wasting cannot be fully reversed by nutrition alone and often accompanies growth impairment and functional decline. The hallmark is the loss of muscle with fat, reflecting a systemic catabolic process. Gradual weight loss can occur with insufficient intake but does not capture the characteristic body-composition wasting seen in cachexia. A decrease in energy expenditure is not typical of cachexia, which is often associated with increased or at least preserved metabolic stress. Maintaining lean mass at the expense of fat is the opposite pattern of cachexia, which involves loss of both tissues.