Cancer Anorexia-Cachexia Syndrome Current Issues in Research and Management Akio Inui, MD, PhD Cachexia is among the most debilitating and life-threatening aspects of cancer. Associated with anorexia, fat and muscle tissue wasting, psychological distress, and a lower quality of life, cachexia arises from a complex interaction between the cancer and the host. This process includes cytokine production, release of lipid-mobilizing and proteolysis-inducing factors, and alterations in intermediary metabolism. Cachexia should be suspected in patients with cancer if an involuntary weight loss of greater than five percent of premorbid weight occurs within a six-month period. The two major options for pharmacological therapy have been either progestational agents, such as megestrol acetate, or corticosteroids. However, knowledge of the mechanisms of cancer anorexia-cachexia syndrome has led to, and continues to lead to, effective therapeutic interventions for several aspects of the syndrome. These include antiserotonergic drugs, gastroprokinetic agents, branched-chain amino acids, eicosapentanoic acid, cannabinoids, melatonin, and thalidomide—all of which act on the feeding-regulatory circuitry to increase appetite and inhibit tumor-derived catabolic factors to antagonize tissue wasting and/or host cytokine release. Because weight loss shortens the survival time of cancer patients and decreases performance status, effective therapy would extend patient survival and improve quality of life. (CA Cancer J Clin 2002;52:72-91.) Dr. Inui is Associate Professor, Division of Diabetes, Digestive, and Kidney Diseases, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. The author is indebted to Prof. Masato Kasuga and Prof. Shigeaki Baba, both of Kobe University Graduate School of Medicine, Kobe, Japan, for many stimulating discussions. The work was supported by grants from the Ministry of Education, Science, Sports, and Culture of Japan. Cancer J, 4/02 Cancer J, 4/02 Cancer J, 4/02 Cancer J, 4/02 Question on Study of Fish Oil, & Cachexia EPA, Protein, Amino Acids w/Cachexia Cancer J, 4/02 Excerpts from article on Cancer Anorexia-Cachexia Excerpts from Cancer J, 4/02 Cancer Anorexia-Cachexia Excerpted from Cancer J, 4/02 Excerpts from Cancer J, 4/02 CA Cancer J Clin 2002;52:72-91 Nature Reviews Cancer, 11/02 Definition of cancer cachexia Abstract #B198 Frontiers in Cancer Prevention Res, 2003 J Pain Symptom Manage, 1/04 Associated Press article 4/09/02 EPA Halts Cachexia Weight Loss Fish Oil and Wasting (Cachexia) Nutrition Intervention in Cancer Cachexia Cancer Anorexia-Cachexia Syndrome - Summary & Fish Oil J Clin Onc, 1990 Placebo-controlled Trial Hydrazine Sulfate NSCLC Randomized Placebo-controlled Hydrazine Sulfate Colon Ca Cancer & Leukemia Group B Study of Hydrazine Sulfate Alternative Cancer Cures: "Unproven" or "Disproved"? J Am Dietetic Assoc, 6/04 Nippon Ronen Igakkai Zasshi, 9/04 AACR 2005 Abstract #5770 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.