Current management of cancer-associated anorexia and weight loss.
Loss of appetite and weight predict a poor prognosis for cancer patients. Although caloric supplementation might benefit subgroups of patients--specifically, perioperative, severely malnourished cancer patients, stem cell and bone marrow transplant patients and head and neck cancer patients--its use remains controversial and is not recommended for the majority of patients with cancer-associated weight loss.  Most patients with advanced cancer, anorexia, and/or weight loss do not appear to benefit from nutritional supplementation.  Instead, discussions with patients and families about realistic eating goals ans, at time armacologic interventions with progestational agents or corticosteroids--both of which are aimed at palliating anorexia--provide clinical benefit.  Other phamalogic interventions such as eicosapentaenoic acid, thalidomide (Thalomid), adenosine triphosphate and nonsteriodal anti-inflammatory agents focus on the fact that cancer-assciated weight loss is an enitty dintinct for simple starvation  These interventions promise to replenish lean tissue but require further investigation before they can be recommndedas standard clinical practice.
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Division of Medical Oncology Mayo Clinic, Rochester, Minnesota, USA. Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA. w-small@northwestern.edu
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D000465:Algorithms; D000855:Anorexia / Q000209:etiology / Q000628:therapy*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D018529:Nutritional Support / Q000379:methods; D015431:Weight Loss / Q000187:drug effects* / Q000502:physiology