Advertisement

An Update on Therapeutics: The Cancer Anorexia/Weight Loss Syndrome in Advanced Cancer Patients

  • Aminah Jatoi
  • Karin F. Giordano
  • Phuong L. Nguyen

Abstract

Experienced oncologists acknowledge that the cancer anorexia/weight loss syndrome predicts a shorter survival for patients with advanced, incurable disease. Several powerful, well-conducted studies have borne out this clinical impression. DeWys et al. focused on weight loss in a multiinstitutional, retrospective review of 3047 cancer patients and observed that loss of more than 5% of premorbid weight predicted an early demise [1]. This prognostic effect occurred independently of tumour stage, tumour histology and patient performance status. Weight loss was also associated with a trend towards lower chemotherapy response rates.

Keywords

Clin Oncol Creatine Supplementation Anabolic Androgenic Steroid Advanced Cancer Patient North Central Cancer Treatment Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    DeWys WD, Begg C, Lavin PT et al (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am JMed 69:491–497Google Scholar
  2. 2.
    Chang VT (2000) The value of symptoms in prognosis of cancer patients. Topics in palliative care, Volume 4. Oxford University Press, OxfordGoogle Scholar
  3. 3.
    Walsh D, Donnelly S, Rybicki L (2000) The symptoms of advanced cancer: relation to age, gender, and performance status in 1000 patients. Support Care Cancer 8:175–179PubMedCrossRefGoogle Scholar
  4. 4.
    Finkelstein DM, Cassileth BR, Bonomi PD et al (1988) A pilot study of the functional living indexcancer (FLIC) scale for the assessment of quality of life for metastatic lung cancer patients. Am J Clin Oncol 11:630–633PubMedCrossRefGoogle Scholar
  5. 5.
    Sarna L, Lindsey AM, Dean H et al (1994) Weight change and lung cancer: relationships with symptom distress, functional status, and smoking. Res Nurs Health 17:371–379PubMedCrossRefGoogle Scholar
  6. 6.
    Ovesen L, Allingstrup L, Hannibal J et al (1993) Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: a prospective, randomized study. J Clin Oncol 11:2043–2049PubMedGoogle Scholar
  7. 7.
    Anonymous (1989) Parenteral nutrition in patients receiving cancer chemotherapy. Ann Intern Med 110:734–736Google Scholar
  8. 8.
    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 82:1127–1132PubMedCrossRefGoogle Scholar
  9. 9.
    Todorov P, Cariuk P, McDevitt T et al (1996) Characterization of a cancer cachectic factor. Nature 379:739–742PubMedCrossRefGoogle Scholar
  10. 10.
    Falconer JS, Fearon KC, Plester CE (1994) Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer. Ann Surg 219:325–331PubMedCrossRefGoogle Scholar
  11. 11.
    Hellerstein MK, Meydani SNetal (1989) Interleukinl-induced anorexia in the rat. Influence of prostaglandins. J Clin Invest 84:228–235PubMedCrossRefGoogle Scholar
  12. 12.
    Fong Y, Moldawer LL, Marano M et al (1989) Cachectin/TNF or IL-1 alpha induces cachexia with redistribution of body proteins. Am J Physiol 256:R659–R665PubMedGoogle Scholar
  13. 13.
    Greenberg AS, Nordan RP, Mclntosh J et al (1992) Interleukin 6 reduces lipoprotein lipase activity in adipose tissue of mice in vivo and in 3T3-L1 adipocytes: a possible role for interleukin 6 in cancer cachexia. Cancer Res 52:4113–4116PubMedGoogle Scholar
  14. 14.
    Torelli GF, Meguid MM, Moldawer LL et al (1999) Use of recombinant human soluble TNF receptor in anorectic tumor-bearing rats. Am J Physiol 277:R850–R855PubMedGoogle Scholar
  15. 15.
    Jatoi A, Loprinzi CL, Sloan JA et al (2001) Neuropeptide Y, leptin, and cholecystokinin 8 in patients with advanced cancer and anorexia: a North Central Cancer Treatment Group exploratory investigation. Cancer 92:629–633PubMedCrossRefGoogle Scholar
  16. 16.
    Lissoni P, Chilelli M, Villa S et al (2003) Five years survival in metastatic non-small cell lung cancer patients treated with chemotherapy alone or ehemotherapy and melatonin: a randomized trial. J Pineal Res 35:12–15PubMedCrossRefGoogle Scholar
  17. 17.
    Braczkowski R, Zubelewicz B, Romanowski W et al (1995) Modulation of tumor necrosis factor-alpha toxicity by the pineal hormone melatonin in metastatic solid tumor patients. Ann NY Acad Sci 768:334–336PubMedCrossRefGoogle Scholar
  18. 18.
    Lissoni P, Paolorossi F, Ardizzoia A et al (1997) A randomized study of chemotherapy with cisplatin plus etoposide versus chemoendocrine therapy with cisplatin, etoposide and the pineal hormone melatonin as a first-line treatment of advanced non-small cell lung cancer in patients with a poor clinical state. J Pineal Res 23:15–19PubMedCrossRefGoogle Scholar
  19. 19.
    Von Roenn JH, Tchekmedyian S, Ke-Ning Setal (2002) Oxandralone in cancer-related weight loss: improvement in weight, body cell mass, performance status, and quality of life. Proc Soc Clin Oncol #1450Google Scholar
  20. 20.
    Loprinzi CL, Kugler JW, Sloan JA et al (1999) Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol 17:3299–3306PubMedGoogle Scholar
  21. 21.
    Moreira AL, Sampaio EP, Zmuidzinas A et al (1993) Thalidomide exerts its inhibitory effects on tumor necrosis factor by enhancing mRNA degradation. J Exp Med 177:1675–1680PubMedCrossRefGoogle Scholar
  22. 22.
    Bruera E, Neumann CM, Pituskin E et al (1999) Thalidomide in patients with cachexia due to terminal cancer: preliminary report. Ann Oncol 10:857–859PubMedCrossRefGoogle Scholar
  23. 23.
    Mahmoud FA, Walsh D, Davis S et al (2003) A dose titration study of thalidomide in cancer anorexia. Proc Am Soc Clin Oncol #3170Google Scholar
  24. 24.
    Boasberg P, O’Day S, Weisberg M et al (2000) Thalidomide induced cessation of weight loss and improved sleep in advanced cancer patients with cachexia. Proceedings of the American Society of Clinical Oncology, 2396Google Scholar
  25. 25.
    Khan ZH, Simpson EJ, Cole AT et al (2003) Oesophageal cancer and cachexia: the effect of short-term treatment with thalidomide on weight loss and lean body mass. Aliment Pharmacol Ther 17:677–682PubMedCrossRefGoogle Scholar
  26. 26.
    Jatoi A, Sideras K, Nguyen PL (2006) Tumor necrosis factor alpha as a treatment target for the cancer anorexia/weight loss syndrome. Supportive Cancer Therapy (in press)Google Scholar
  27. 27.
    Lundholm K, Gelin J, Hyltander A et al (1994) Antiinflammatory treatment may prolong survival in undernourished patients with metastatic solid tumors. Cancer Res 54:5602–5606PubMedGoogle Scholar
  28. 28.
    Lundholm K, Daneryd P, Korner U et al (2004) Evidence that long-term COX-treatment improves energy homeostasis and body composition in cancer patients with progressive cachexia. Int J Oncol 24:505–512PubMedGoogle Scholar
  29. 29.
    Agteresch HJ, Rietveld T, Kerkhofs LG et al (2002) Beneficial effects of adenosine triphosphate on nutritional status in advanced lung cancer patients: a randomized clinical trial. J Clin Oncol 20:371–378PubMedCrossRefGoogle Scholar
  30. 30.
    Juhn MS, Tarnopolsky M (1998) Potential side effects of oral creatine supplementation: a critical review. Clin J Sport Med 8:298–304PubMedGoogle Scholar
  31. 31.
    Juhn MS, Tarnopolsky M (1998) Oral creatine supplementation and athletic performance: a critical review. Clin J Sport Med 8:286–297PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2006

Authors and Affiliations

  • Aminah Jatoi
    • 1
  • Karin F. Giordano
    • 1
  • Phuong L. Nguyen
    • 2
  1. 1.Department of OncologyMayo ClinicRochesterUSA
  2. 2.Department of Laboratory Medicine and PathologyMayo ClinicRochesterUSA

Personalised recommendations