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Cachexia-anorexia cancer

Cong Ming-Hua, Zou Bao-Hua, Yu Lei
Anorexia cancer cachexia syndrome is prevalent in advanced cancer patients, which is featured by anorexia, decreased dietary intake, body weight loss (skeletal muscle mass loss), and unable to be reversed by routine nutritional support therapy. Up to now, the main mechanisms involved in cancer cachexia include excessive systemic inflammation, which is represented by increased plasma levels of IL-1, IL-6, TNF-alpha, tumor-induced factors, such as PIF and LMF. These factors eventually act on orexigenic and anorexigenic neurons located in hypothalamus or protein and lipid metabolism of peripheral tissues, which lead to anorexia, decreased dietary intake, enhanced basic metabolism rate and hyper catabolism...
October 18, 2016: Current Pharmaceutical Biotechnology
Willian das Neves, Christiano Robles Rodrigues Alves, Ney Robson de Almeida, Fátima Lúcia Rodrigues Guimarães, Paulo Rizzo Ramires, Patricia Chakur Brum, Antonio Herbert Lancha
AIMS: Resistance exercise training (RET) has been adopted as non-pharmacological anti-catabolic strategy. However, the role of RET to counteract cancer cachexia is still speculative. This study aimed to verify whether short-term RET would counteract skeletal muscle wasting in a severe cancer cachexia rat model. MAIN METHODS: Wistar rats were randomly allocated into four experimental groups; 1) untrained control rats (control), 2) rats submitted to RET (control+RET), 3) untrained rats injected with Walker 256 tumor cells in the bone marrow (tumor) and 4) rats injected with Walker 256 tumor cells in the bone marrow and submitted to RET (tumor+RET)...
October 15, 2016: Life Sciences
Marie François, Kuniko Takagi, Romain Legrand, Nicolas Lucas, Stephanie Beutheu, Christine Bôle-Feysot, Aurore Cravezic, Naouel Tennoune, Jean-Claude do Rego, Moïse Coëffier, Akio Inui, Pierre Déchelotte, Sergueï O Fetissov
BACKGROUND AND AIMS: Cancer chemotherapy is commonly accompanied by mucositis, anorexia, weight loss, and anxiety independently from cancer-induced anorexia-cachexia, further aggravating clinical outcome. Ghrelin is a peptide hormone produced in gastric mucosa that reaches the brain to stimulate appetite. In plasma, ghrelin is protected from degradation by ghrelin-reactive immunoglobulins (Ig). To analyze possible involvement of ghrelin in the chemotherapy-induced anorexia and anxiety, gastric ghrelin expression, plasma levels of ghrelin, and ghrelin-reactive IgG were studied in rats treated with methotrexate (MTX)...
2016: Frontiers in Nutrition
Simone Gärtner, Janine Krüger, Ali A Aghdassi, Antje Steveling, Peter Simon, Markus M Lerch, Julia Mayerle
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related mortality in both genders. More than 80% of patients suffer from significant weight loss at diagnosis and over time develop severe cachexia. Early nutritional support is therefore essential. SUMMARY: This review evaluates the different nutritional therapies, such as enteral nutrition, parenteral nutrition and special nutritional supplements, on nutritional status, quality of life and survival...
May 2016: Gastrointestinal Tumors
Ju-Hyun Jeon, Chong-Kwan Cho, So-Jung Park, Hwi-Joong Kang, Kyungmin Kim, In-Chul Jung, Young-Il Kim, Suk-Hoon Lee, Hwa-Seung Yoo
Objective The aim of this study was to determine the feasibility, acceptability, and safety of using moxibustion for treating anorexia and improving quality of life in patients with metastatic cancer. Methods We conducted a randomized sham-controlled trial of moxibustion. Sixteen patients with metastatic cancer were recruited from Daejeon, South Korea. The patients were randomly placed into a true or a sham moxibustion group and received 10 true or sham moxibustion treatments administered to the abdomen (CV12, CV8, CV4) and legs (ST36) over a 2-week period...
June 22, 2016: Integrative Cancer Therapies
Meng-Chuan Chen, Wen-Lin Hsu, Pa-An Hwang, Yen-Lin Chen, Tz-Chong Chou
Cancer cachexia is characterized by anorexia, skeletal muscle atrophy, and systemic inflammation. Fucoidan extracted from brown algae exhibits anti-inflammatory and anticancer activities. However, whether fucoidan ameliorates tumour and chemotherapy-induced muscle atrophy and -related cachectic symptoms remains unknown. Compared with mice with bladder cancer treated with chemotherapy alone (TGC group), those treated with a combination of low molecular weight fucoidan (LMWF) and chemotherapy drugs such as gemcitabine and cisplatin (TGCF) showed a significant reduction of body weight loss, muscle atrophy, and intestinal injury and dysfunction...
June 13, 2016: Oncotarget
Koji Amano, Isseki Maeda, Tatsuya Morita, Yoshiro Okajima, Takashi Hama, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita
BACKGROUND: A number of advanced cancer patients are suffering from physical and psychosocial burdens because of cancer cachexia, and these burdens also greatly impact on their family members and relationships between patients and family members. It is necessary to consider the psychosocial impact of cancer cachexia on family members of advanced cancer patients. METHODS: A cross-sectional anonymous nationwide survey was conducted involving 925 bereaved family members of cancer patients who had been admitted to 133 inpatient hospices throughout Japan...
February 15, 2016: Journal of Cachexia, Sarcopenia and Muscle
Edson Alves de Lima Junior, Alex Shimura Yamashita, Gustavo Duarte Pimentel, Luís G O De Sousa, Ronaldo Vagner T Santos, Cinara Ludvig Gonçalves, Emilio Luiz Streck, Fábio Santos de Lira, Jose Cesar Rosa Neto
BACKGROUND: Cancer is considered the second leading cause of death in the world, and for the treatment of this disease, pharmacological intervention strategies are frequently based on chemotherapy. Doxorubicin (DOX) is one of the most widely used chemotherapeutic agents in clinical practice for treating a number of solid tumours. The treatment with DOX mimics some effects of cancer cachexia, such as anorexia, asthenia, decreases in fat and skeletal muscle mass and fatigue. We observed that treatment with DOX increased the systemic insulin resistance and caused a massive increase in glucose levels in serum...
February 15, 2016: Journal of Cachexia, Sarcopenia and Muscle
Chunhoo Cheon, Sunju Park, Yu Lee Park, Ching-Wen Huang, Youme Ko, Bo-Hyoung Jang, Yong-Cheol Shin, Seong-Gyu Ko
INTRODUCTION: Cancer-related anorexia is the loss of appetite or desire to eat in patients with cancer. Although treatments for cancer-related anorexia do exist, patients have sought complementary and alternative medicine including herbal remedies, due to safety concerns. Sipjeondaebo-tang is one among other popular herbal medicines that are beneficial to management of anorexia in Korea. The purpose of this study is to examine the feasibility for a full randomised clinical trial of Sipjeondaebo-tang for cancer-related anorexia...
2016: BMJ Open
Tito Borner, Laura Loi, Claudio Pietra, Claudio Giuliano, Thomas A Lutz, Thomas Riediger
The gastric hormone ghrelin positively affects energy balance by increasing food intake and reducing energy expenditure. Ghrelin mimetics are a possible treatment against cancer anorexia-cachexia syndrome (CACS). This study aimed to characterize the action of the nonpeptidergic ghrelin receptor agonist HM01 on neuronal function, energy homeostasis and muscle mass in healthy rats and to evaluate its possible usefulness for the treatment of CACS in a rat tumor model. Using extracellular single-unit recordings, we tested whether HM01 mimics the effects of ghrelin on neuronal activity in the arcuate nucleus (Arc)...
July 1, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Joanne K Taylor, Neil Pendleton
BACKGROUND: Cachexia describes a complex pathological syndrome of muscle wasting, anorexia and weight loss. Progesterone therapies have been shown to improve appetite and promote weight gain in patients with cachexia; however, research has focused heavily on patients with cancer, and its effectiveness in other diseases remains unclear. AIMS: This systematic review aimed to present the evidence available for progesterone therapy as a treatment for non-cancer cachexia...
September 2016: BMJ Supportive & Palliative Care
Koichi Takayama, Shinji Atagi, Fumio Imamura, Hiroshi Tanaka, Koichi Minato, Toshiyuki Harada, Nobuyuki Katakami, Takuma Yokoyama, Kozo Yoshimori, Yuichi Takiguchi, Osamu Hataji, Yuichiro Takeda, Keisuke Aoe, Young Hak Kim, Soichiro Yokota, Hiroshi Tabeta, Keisuke Tomii, Yasuo Ohashi, Kenji Eguchi, Koshiro Watanabe
PURPOSE: Although cancer cachexia is mainly characterized by persistent loss of body weight (BW), usually in response to a malignancy, the pathophysiology of cachexia remains unresolved. To elucidate the relationship between the loss of BW and other related clinical factors, we conducted a nationwide, multi-institutional, prospective, observational study in patients with advanced non-small cell lung cancer (NSCLC). METHODS: Treatment-naïve stage IV NSCLC patients with an Eastern Cooperative Oncology Group performance status (PS) of 0-2 were eligible...
August 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Jennifer S Temel, Amy P Abernethy, David C Currow, John Friend, Elizabeth M Duus, Ying Yan, Kenneth C Fearon
BACKGROUND: Patients with advanced cancer frequently experience anorexia and cachexia, which are associated with reduced food intake, altered body composition, and decreased functionality. We assessed anamorelin, a novel ghrelin-receptor agonist, on cachexia in patients with advanced non-small-cell lung cancer and cachexia. METHODS: ROMANA 1 and ROMANA 2 were randomised, double-blind, placebo-controlled phase 3 trials done at 93 sites in 19 countries. Patients with inoperable stage III or IV non-small-cell lung cancer and cachexia (defined as ≥5% weight loss within 6 months or body-mass index <20 kg/m(2)) were randomly assigned 2:1 to anamorelin 100 mg orally once daily or placebo, with a computer-generated randomisation algorithm stratified by geographical region, cancer treatment status, and weight loss over the previous 6 months...
April 2016: Lancet Oncology
Sriram Yennurajalingam, Janet L Williams, Gary Chisholm, Eduardo Bruera
OBJECTIVE: Advanced cancer patients frequently experience debilitating symptoms that occur in clusters, but few pharmacological studies have targeted symptom clusters. Our objective was to examine the effects of dexamethasone on symptom clusters in patients with advanced cancer. METHODS: We reviewed the data from a previous randomized clinical trial to determine the effects of dexamethasone on cancer symptoms. Symptom clusters were identified according to baseline symptoms by using principal component analysis...
March 2016: Oncologist
Stephanie E Reuter, Jennifer H Martin
Anorexia can affect up to 90 % of people with advanced cancer. It is a complex symptom associated with changes in taste, lack of hunger at mealtimes and lack of food enjoyment. Associated weight loss is part of the physical decline that occurs as cancer worsens. Weight loss can also occur from cachexia, the increased metabolism of energy due to raised inflammatory cytokines, liver metastases and other factors seen in several advanced cancers. Independent of anorexia, although frequently associated (where it is referred to as the cachexia-anorexia syndrome), it accounts for a significant amount of morbidity and deaths in people with cancer...
July 2016: Clinical Pharmacokinetics
Jonathan R Burgos, Britt-Marie Iresjö, Ulrika Smedh
The aim of the present study was to explore central and peripheral host responses to an anorexia-cachexia producing tumor. We focused on neuroendocrine anorexigenic signals in the hypothalamus, brainstem, pituitary and from the tumor per se. Expression of mRNA for corticotropin-releasing hormone (CRH), cocaine- and amphetamine-regulated transcript (CART), nesfatin-1, thyrotropin (TSH) and the TSH receptor were explored. In addition, we examined changes in plasma TSH, CART peptides (CARTp) and serum amyloid P component (SAP)...
April 2016: Oncology Reports
Rosanna Tarricone, Giada Ricca, Barbara Nyanzi-Wakholi, Antonieta Medina-Lara
INTRODUCTION: Cancer anorexia-cachexia syndrome (CACS) negatively impacts patients' quality of life (QoL) and increases the burden on healthcare resources. OBJECTIVES: To review published CACS data regarding health-related QOL (HRQoL) and its economic impact on the healthcare system. METHODS: Searches were conducted in MEDLINE, EMBASE, DARE, and NHS EED databases. RESULTS: A total of 458 HRQoL and 189 healthcare resources utilisation abstracts were screened, and 42 and 2 full-text articles were included, respectively...
March 2016: Critical Reviews in Oncology/hematology
David Hui
BACKGROUND: Prognosis is a key driver of clinical decision-making. However, available prognostication tools have limited accuracy and variable levels of validation. METHODS: Principles of survival prediction and literature on clinician prediction of survival, prognostic factors, and prognostic models were reviewed, with a focus on patients with advanced cancer and a survival rate of a few months or less. RESULTS: The 4 principles of survival prediction are (a) prognostication is a process instead of an event, (b) prognostic factors may evolve over the course of the disease, (c) prognostic accuracy for a given prognostic factor/ tool varies by the definition of accuracy, the patient population, and the time frame of prediction, and (d) the exact timing of death cannot be predicted with certainty...
October 2015: Cancer Control: Journal of the Moffitt Cancer Center
Chukwuemeka Charles Ezeoke, John E Morley
Anorexia is commonly present in persons with cancer and a major component of cancer cachexia. There are multiple causes of anorexia in cancer. Peripherally, these can be due to (i) substances released from or by the tumour, e.g. pro-inflammatory cytokines, lactate, and parathormone-related peptide; (ii) tumours causing dysphagia or altering gut function; (iii) tumours altering nutrients, e.g. zinc deficiency; (iv) tumours causing hypoxia; (v) increased peripheral tryptophan leading to increased central serotonin; or (vi) alterations of release of peripheral hormones that alter feeding, e...
December 2015: Journal of Cachexia, Sarcopenia and Muscle
Stefan D Anker, Andrew J S Coats, John E Morley
A major component of the cancer anorexia-cachexia syndrome is a decline in food intake. Up until now none of the drugs that improve appetite also improve skeletal muscle. Recent studies have suggested that the oral ghrelin-analog, anamorelin, increased food intake and muscle mass. Unfortunately, it does not increase muscle power. Its regulatory future is uncertain, although it has important clinical effects.
December 2015: Journal of Cachexia, Sarcopenia and Muscle
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