Components of the anorexia-cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia.
BACKGROUND
Cancer-related anorexia is traditionally considered part of a complex but ill-defined anorexia-cachexia syndrome in which anorexia is intimately associated with other gastrointestinal (GI) symptoms and weight loss. We surveyed cancer patients with anorexia to learn more about the relationship between anorexia and these symptoms.


METHODS
A 22-item GI questionnaire assessed the severity of anorexia and the prevalence of concurrent GI symptoms, including taste changes, food aversions, altered sense of smell, and diurnal food intake changes. The relationship between anorexia severity and anticancer therapy and prior menstrual or pregnancy-related appetite changes was also assessed.


RESULTS
Ninety-five of 101 patients with anorexia surveyed had complete data. Seventy-eight percent of them had moderate or severe anorexia. Abnormal diurnal appetite variation, taste changes, and food aversions were present in over 50% of all those with anorexia. Judged by the numerical rating scale, the worse the anorexia, the more prevalent were early satiety, constipation, vomiting, and food aversions. Those with more severe anorexia had greater weight loss, and worse performance status. Anorexia severity did not correlate with that during prior menses/pregnancy or antitumor therapy.


CONCLUSIONS
Evaluation of multiple other GI symptoms is important in understanding the total experience of cancer anorexia. Early satiety, taste changes, food aversions, and altered sense of smell are important accompanying GI symptoms. Most validated anorexia tools do not assess these commonly associated GI symptoms. Future research should develop a comprehensive anorexia symptom questionnaire.
Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, M-76, Cleveland, OH 44195, USA.
Tugba
T
Yavuzsen
Declan
D
Walsh
Mellar P
MP
Davis
Jordanka
J
Kirkova
Tao
T
Jin
Susan
S
LeGrand
Ruth
R
Lagman
Lesley
L
Bicanovsky
Bassam
B
Estfan
Bushra
B
Cheema
Abdo
A
Haddad
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000209:etiology / Q000503:physiopathology*; D002100:Cachexia / Q000209:etiology / Q000503:physiopathology*; D004435:Eating; D005260:Female; D005518:Food Preferences; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012528:Satiety Response; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013577:Syndrome; D013651:Taste Disorders / Q000209:etiology; D015431:Weight Loss; D055815:Young Adult