J Korean Oncol Nurs.  2011 Feb;11(1):20-25.

Recent Advances in Cancer Cachexia

• Choi SG

Abstract

PURPOSE
The study was aimed to review and understand the meaning of cancer cachexia.
METHODS
Using the keywords "cachexia" and "cancer cachexia" 30 oncology research published from 1974 to 2009 were selected for the review.
RESULTS
The mechanism of cancer cachexia has not been fully understood, but various pathogenesis appears to be involved in the development cachexia including altered metabolism of carbohydrate, lipid, and protein associated with cytokines and hormone. As a result, muscle strength, food intake and resting energy expenditure (REE) are reduced. Most medications for the treatment of cachexia show debating results except some drugs such as megace. Supportive care including nutritional education, nursing care, and social support are found another effective treatment options.
CONCLUSION
The results of this study would help oncology nurses to understand the mechanism of cancer cachexia and its management.

Keyword

Cachexia; Cytokines

MeSH Terms

Cachexia
Cytokines
Eating
Education, Nursing
Energy Metabolism
Megestrol Acetate
Muscle Strength
Cytokines
Megestrol Acetate

Reference

1. Larkin M. Thwarting the dwindling progression of cachexia. Lancet. 1998. 351:1336.

2. Bruera E. Anorexia, cachexia and nutrition. BMJ. 1997. 315:1219–1222.

3. Slaviero KA, Read JA, Clarke SJ, Rivory LP. Baseline nutritional assessment in advanced cancer patients receiving palliative chemotherapy. Nutr Cancer. 2003. 46:148–157.

4. Wisse BE, Frayo RS, Schwartz MW, Cummings DE. Reversal of cancer anorexia by blockade of central melanocortin receptors in rats. Endocrinology. 2001. 142:3292–3301.

5. Pedersen BK. Exercise immunology. 1997. New York: Chapman & Hall.

6. Perboni S, Inui A. Anorexia in cancer: role of feedeing-regulatory peptides. Phil Trans R Soc B. 2006. 361:1281–1289.

7. Sütö G, Király A, Taché Y. IL-1b inhibits gastric emptying in rats: mediation through prostaglandin and corticotropin-releasing factor. Gastroenterology. 1994. 106:1568–1575.

8. Nelson KA, Walsh D, Sheehan FA. The cancer anorexia-cachexia syndrome. J Clin Oncol. 1994. 12:213–225.

9. Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature. 1998. 395:763–770.

10. Shellock FG, Riedinger MS, Fishbein MC. Brwon adipose tissue in cancer patients: possible cause of cancer-induced cachexia. J Cancer Res Clin Oncol. 1986. 111:82–85.

11. Sanchis D, Busquets S, Alvarez B, Ricquier D, Lopez-Soriano FJ, Argiles JM. Skeletal muscle UCP2 and UCP3 gene expression in a rat cancer cachexia model. FEBS Lett. 1998. 436:415–418.

12. Tisdale MJ. Metabolic abnormalities in cachexia and anorexia. Nutrition. 2000. 16:1013–1014.

13. Tisdale MJ. Cancer anorexia and cachexia. Nutrition. 2001. 17:438–442.

14. Tisdale MJ. Protein loss in cancer cachexia. Science. 2000. 289:2293–2294.

15. Bozzetti F, Mariani L. Defining and classifying cancer cachexia: a proposal by the SCRINIO Working Group. JPEN J Parenter Enteral Nutr. 2009. 33:361–367.

16. Evans WJ, Morley JE, Argilés J, Bales C, Varacos V, Guttridge D, et al. Cachexia: a new definition. Clin Nutr. 2008. 27:793–799.

17. Body JJ. The syndrome of anorexia-cachexia. Curr Opin Oncol. 1999. 11:255–260.

18. Moertel CG, Schutt AJ, Reitemeier RJ, Hahn RG. Corticosteroid therapy of preterminal gastrointestinal cancer. Cancer. 1974. 33:1607–1609.

19. Popiela T, Lucchi R, Giongo F. Methylprednisolone as palliative therapy for female terminal cancer patients. Eur J Cancer Clin Oncol. 1989. 25:1823–1829.

20. Inui A. Feeding and body-weight regulation by hypothalamic neuropeptides-mediation of the actions of leptin. Trends Neurosci. 1999. 22:62–67.

21. Loprinzi CL, Schaid DJ, Dose AM, Burnham NL, Jensen MD. Body-composition changes in patients who gain weight while receiving megestrol acetate. J Clin Oncol. 1993. 11:152–154.

22. Loprinzi CL, Michalak JC, Schaid DJ, Mailliard JA, Athmann LM, Goldberg RM, et al. Phase III evaluation of four doses of megestrol acetate as therapy for patients with cancer anorexia and/or cachexia. J Clin Oncol. 1993. 11:762–767.

23. Lai V, George J, Richey L, Kim HJ, Cannon T, Shores C, et al. Results of a pilot study of the effects of celecoxib on cancer cachexia in patients with cancer of the head, neck, and gastrointestinal tract. Head Neck. 2008. 30:67–74.

24. Edelman MJ, Gandara DR, Meyers FJ, Ishii R, O'Mahony M, Uhrich M, et al. Serotonergic blockade in the treatment of the cancer anorexia-cachexia syndrome. Cancer. 1999. 86:684–688.

25. Fearon KC, Von Meyenfeldt MF, Moses AG, Van Geenen R, Roy A, Gouma DJ, et al. Effect of a protein and energy dense N-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut. 2003. 52:1479–1486.

26. Nelson KA, Walsh D, Sheehan FA. The cancer anorexia-cachexia syndrome. J Clin Oncol. 1994. 12:213–225.

27. Lissoni P, Paolorossi F, Tancini G, Barni S, Ardizzoia A, Brivio F, et al. Is there a role for melatonin in the treatment of neoplastic cachexia? Eur J Cancer. 1996. 32A:1340–1343.

28. Gordon JN, Trebble TM, Ellis RD, Duncan HD, Johns T, Goggin PM. Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial. Gut. 2005. 54:540–545.

29. Lesser GJ, Case D, Ottery F, McQuellon R, Choksi JK, Sanders G, et al. A phase III randomized study comparing the effects of oxandrolone (Ox) and megestrol acetate (Meg) on lean body mass (LBM), weight (wt) and quality of life (QOL) in patients with solid tumors and weight loss receiving chemotherapy. J Clin Oncol. 2008. 26:505s.

30. Reid J, McKenna H, Fitzsimons D, McCance T. The experience of cancer cachexia:A qualitative study of advanced cancer patients and their family members. Int J Nurs Stud. 2009. 46:606–616.