Skip to main content
SpringerLink
Log in

The Role of Appetite Stimulants for Cancer-Related Weight Loss

  • Chapter
Cachexia and Wasting: A Modern Approach

Abstract

Involuntary weight loss and its end-stage manifestation, the anorexia and cachexia syndrome, is a frequent complication of cancer. The incidence of weight loss varies both with the primary site of the malignancy and its stage. At presentation, 15–48% of cancer patients report weight loss, while more than 80% of those with advanced disease note involuntary weight loss [1]. A weight loss of as little as 5% from premorbid weight predicts a poor prognosis, particularly among patients with lymphoma, lung, breast or gastrointestinal malignancies. Weight loss of less than 5% adversely impacts survival, with the greatest effect seen in those patients with good performance status [1]. Involuntary weight loss adversely affects quality of life as well [2] [4].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Dewys WD, Begg C, Lavin PT et al (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med 69:491–497

    Article  PubMed  CAS  Google Scholar 

  2. MacDonald N, Baracos VE, Plata-Salaman CR, Tisdale MJ (2000) Cachexia-anorexia workshop. Vancouver, British Columbia, Canada. November 7-9-1997. Nutrition 16:1006–1020

    Google Scholar 

  3. Kotler DP (2000) Cachexia. Ann Int Med 133:622–634

    PubMed  CAS  Google Scholar 

  4. Nixon DW, Lawson DH, Kutner M et al (1981) Hyperalimentation of the cancer patient with protein-calorie under-nutrition. Cancer Res 41:2038–2045

    PubMed  CAS  Google Scholar 

  5. Bruera E, Fainsinger RL (1993) Clinical management of cachexia and anorexia. In: Doyle D, Hanks G, MacDonald N (eds) Oxford textbook of palliative medicine. Oxford Medical Publications, London, pp 330–337

    Google Scholar 

  6. Kardinal C, Loprinzi C, Shaid DS et al ( 1980) A controlled trial of cyproheptadine in cancer patients with anorexia. Cancer 65:2657–2662

    Article  Google Scholar 

  7. Moertel C, Schulte A, Reitemeier R (1974) Corticosteroid therapy of preterminal gastrointestinal cancer. Cancer 33:1607–1609

    Article  PubMed  CAS  Google Scholar 

  8. Wilcox JC, Corr J, Shaw J (1984) Prednisone as an appetite stimulant in patients with cancer. BMJ 288:27

    Google Scholar 

  9. Bruera E, Roca E, Cedaro L et al (1985) Action of oral methylprednisolone in terminal cancer patients: a prospective randomized double-blind study. Cancer Treat Rep 69:751–754

    PubMed  CAS  Google Scholar 

  10. Robustelli Delia Cuna GR, Pellegrini A, Piazzi M ( 1989) Effect of methylprednisolone sodium succinate on quality of life in pre-terminal cancer patients: a placebo controlled, multi-center study. Eur J Cancer Clin Oncol 25:1817–1821

    Article  Google Scholar 

  11. Popiela T, Lucchi R, Giongo F ( 1989) Methylprednisolone as palliative therapy for female terminal cancer patients. Eur J Cancer Clin Oncol 25:1923–1929

    Google Scholar 

  12. Stiefel FC, Breitbart WS, Holland JC (1989) Corticosteroids in cancer: neuropsychiatric complications. Cancer Invest 7:479–491

    PubMed  CAS  Google Scholar 

  13. Sallan SE, Cronin C, Zelan M, Zinberg NE (1976) Antiemetics in patients receiving chemotherapy for cancer: a randomized comparison of delta-9 tetrahydrocannabinol and prochlorperazine. N Engl J Med 302:135–138

    Article  Google Scholar 

  14. Wadleigh R, Spaulding M, Lembersky B et al (1990) Dronabinol enhancement of appetite in cancer patients. Proc Am Soc Clin Oncol 9:331 (Abs 1280)

    Google Scholar 

  15. Nelson K, Walsh D, Deeter P, Sheehan F (1994) A phase II study of delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. J Palliat Care 10:14–18

    PubMed  CAS  Google Scholar 

  16. Gorter R, Seefrid M, Volberding P (1992) Dronabinol effects on weight in patients with HIV infection. AIDS 6:127–128

    Article  PubMed  CAS  Google Scholar 

  17. Beal JE, Olson R, Laubernstein L et al (1995) Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. J Pain Symptom Manage 10:89–97

    Article  PubMed  CAS  Google Scholar 

  18. Gregory EJ, Cohen SC, Oives DW (1985) Megestrol acetate therapy for advanced breast cancer. J Clin Oncol 3:155–160

    PubMed  CAS  Google Scholar 

  19. Tchekmedyian NS, Tait A, Mandy M, Aisner J (1987) High dose megestrol acetate: a possible treatment for cachexia. JAMA 9:1195–1998

    Article  Google Scholar 

  20. Loprinzi CL, Ellison NM, Schaid DJ et al (1990) Controlled trial of megestrol acetate for the treatment of cancer anorexia and cachexia. J Natl Cancer Inst 82:1127–1132

    Article  PubMed  CAS  Google Scholar 

  21. Bruera E, MacMillan K, Kuehn N et al ( 1990) A controlled trial of megestrol acetate on appetite, calorie intake, nutritional status and other symptoms in patients with advanced cancer. Cancer 66:1279–1282

    Article  PubMed  CAS  Google Scholar 

  22. Tchekmedyian NS, Tait N, Moody M et al (1986) Appetite stimulation with megestrol acetate in cachectic cancer patients. Semin Oncol 13:37–43

    PubMed  CAS  Google Scholar 

  23. Loprinzi CL, Michalak JC, Schaid DJ et al (1993) Phase III evaluation of four doses of megestrol acetate as therapy for patients with cancer anorexia and/or cachexia. J Clin Oncol 11:762–767

    PubMed  CAS  Google Scholar 

  24. Loprinzi CL, Schaid DJ, Dose AM et al (1993) Bodycomposition changes in patients who gain weight while receiving megestrol acetate. J Clin Oncol 11:152–154

    PubMed  CAS  Google Scholar 

  25. Mann M, Koller E, Murgo A et al (1997) Glucocorticoidlike activity of megestrol. Arch Intern Med 157:1651–1656

    Article  PubMed  CAS  Google Scholar 

  26. Loprinzi CL, Jensen MD, Jian NS, Schaid DJ (1992) Effect of megestrol acetate on the human pituitary-adrenal axis. Mayo Clin Proc 67:1160–1162

    PubMed  CAS  Google Scholar 

  27. Lang I, Zielinski CC, Tempi H et al (1990) Medroxyprogesterone acetate lowers plasma corticotropin and cortisol but does not suppress anterior pituitary responsiveness to human corticotropin releasing factor. Cancer 66:1949–1953

    Article  PubMed  CAS  Google Scholar 

  28. Engelson ES, Pi-Sunyer FX, Kotler DP (1995) Effects of megestrol acetate therapy on body composition and circulating testosterone concentration in patients with AIDS. AIDS 9:1107–1108

    PubMed  CAS  Google Scholar 

  29. Graham KK, Mikolich DJ, Fisher AE et al (1994) Pharmacologic evaluation of megestrol acetate oral suspension in cachectic AIDS patients. J Acquir Immune Defic Syndr 7:580–586

    PubMed  CAS  Google Scholar 

  30. Von Roenn JH, Armstrong D, Kotier DP et al (1994) Megestrol acetate in patients with AIDS-related cachexia. Ann Int Med 121:393–399

    Google Scholar 

  31. Jatoi A, Windschitl HE, Loprinzi CL et al (2002) Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol 20:567–573

    Article  PubMed  CAS  Google Scholar 

  32. Timpone JG, Wright DJ, Li N et al (1997) The safety and pharmacokinetics of single-agent and combination therapy with megestrol acetate and dronabinol for the treatment of HIV wasting syndrome. AIDS Res Hum Retroviruses 13:305–315

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Hematology/Oncology, The Feinberg School of Medicine of Northwestern University and the Robert H. Lurie Comprehensive Cancer Center, Palliative Care and Home Hospice Program, Northwestern Memorial Hospital, Chicago, IL, USA

    Jamie H. Von Roenn

Authors
  1. Jamie H. Von Roenn
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Medical Oncology, University of Cagliari, Cagliari, Italy

    Giovanni Mantovani

  2. Department of Clinical Cardiology, Imperial College, NHLI, London, UK

    Stefan D. Anker

  3. Department of Cardiology Charité, Applied Cachexia Research, Campus Virchow-Klinikum, Berlin, Germany

    Stefan D. Anker

  4. Department of Behavioral Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

    Akio Inui

  5. GRECC, VA Medical Center and Division of Geriatric Medicine, Saint Louis University, St. Louis, MO, USA

    John E. Morley

  6. Department of Clinical Medicine, University of Rome, La Sapienza, Rome, Italy

    Filippo Rossi Fanelli

  7. Department of Infectious Diseases, IRCCS S.Matteo Polyclinic, University of Pavia, Pavia, Italy

    Daniele Scevola

  8. Bone Marrow and Blood Stem Cell Transplantation Program, Center for Lymphoma and Myeloma, New York Presbyterian Hospital/Weill Medical Center, New York, NY, USA

    Michael W. Schuster

  9. Department of Medicine-Geriatrics, University of New York at Stony Brook VAMC, Northport, NY, USA

    Shing-Shing Yeh

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag Italia

About this chapter

Cite this chapter

Von Roenn, J.H. (2006). The Role of Appetite Stimulants for Cancer-Related Weight Loss. In: Mantovani, G., et al. Cachexia and Wasting: A Modern Approach. Springer, Milano. https://doi.org/10.1007/978-88-470-0552-5_56

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-0552-5_56

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0471-9

  • Online ISBN: 978-88-470-0552-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation