Anorexia and cachexia in advanced cancer patients.
Cachexia is a frequent and devastating complication of advanced cancer. Current understanding of the pathophysiology of this syndrome implicates tumour induced metabolic changes and immune responses. Clinical manifestation include anorexia, chronic nausea, asthenia and change in body image. Aggressive nutritional intervention has not been shown to be of benefit. Patients and families should be counselled about the goals of nutritional intake. In selected cases, enteral nutrition may be appropriate. Pharmacological management should first be directed at correcting nausea. Agents of potential usefulness in the treatment of anorexia include corticosteroids, megestrol acetate, cyproheptadine, hydrazine sulphate and dronabinol. Future research should further address pathophysiology, symptomatic and metabolic effects of interventions and interactions with other syndromes of terminal cancer.
Vigano
A
A
Palliative Care Program, Edmonton General Hospital, Canada.
Watanabe
S
S
Bruera
E
E
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D000855:Anorexia / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002100:Cachexia / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy; D002186:Cannabinoids / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D018849:Controlled Clinical Trials as Topic; D003533:Cyproheptadine / Q000627:therapeutic use; D004750:Enteral Nutrition; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D006834:Hydrazines / Q000627:therapeutic use; D051379:Mice; D009369:Neoplasms / Q000150:complications*; D009747:Nutritional Physiological Phenomena; D010288:Parenteral Nutrition; D011372:Progestins / Q000627:therapeutic use; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012106:Research; D013727:Terminal Care
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D002186:Cannabinoids; D005765:Gastrointestinal Agents; D006834:Hydrazines; D011372:Progestins; C029424:hydrazine; D003533:Cyproheptadine