[Tumour anorexia--tumour cachexia in case of gastrointestinal tumours: standards and visions].
The development of progressive malnutrition or cachexia is frequent in patients with gastrointestinal cancer - especially in patients with a carcinoma of the pancreas. The cachexia syndrome which is characterised by loss of body weight, negative nitrogen balance and fatigue significantly affects patients' quality of life, morbidity and survival. Because the currently established therapeutical strategies are often disappointing many physicians tended to develop a therapeutical nihilism. Cancer anorexia and cachexia are two distinct syndromes which may have synergistic effects in a patient. This review highlights the growing understanding of the multidimensional pathophysiological background. An algorithm of the current treatment strategies is given. In addition, we discuss new anabolic and anticatabolic agents (e.g. eicosapentanoic acid) and the results from first clinical trials.
Ockenga
J
J
Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie, Humboldt Universität, Charité, Berlin, Germany. johann.ockenga@charite.de
Pirlich
M
M
Gastell
S
S
Lochs
H
H
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000465:Algorithms; D000855:Anorexia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D001835:Body Weight; D002100:Cachexia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D003927:Diet, Diabetic; D013759:Dronabinol / Q000627:therapeutic use; D002149:Energy Intake; D005440:Fluid Therapy; D005770:Gastrointestinal Neoplasms / Q000150:complications*; D006801:Humans; D019290:Megestrol Acetate / Q000627:therapeutic use; D009747:Nutritional Physiological Phenomena; D010190:Pancreatic Neoplasms / Q000150:complications*; D010289:Parenteral Nutrition, Total; D010431:Pentoxifylline / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D010919:Placebos; D011379:Prognosis; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013577:Syndrome; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D016861:Cyclooxygenase Inhibitors; D010726:Phosphodiesterase Inhibitors; D010919:Placebos; D011619:Psychotropic Drugs; D013759:Dronabinol; D010431:Pentoxifylline; D019290:Megestrol Acetate