title: Cancer cachexia and anabolic interventions: a case report.
abstract: BACKGROUND
  Standard-of-care (SOC) cancer treatments are primarily aimed at reducing size and progression of a tumor. There is a need for successful supplemental anabolic therapies to combat cancer cachexia in addition to these SOC treatment modalities. Anabolic interventions, including testosterone and amino acid supplements, may be beneficial in reducing and/or reversing muscle wasting in these patient populations.
  
  
  METHODS
  A 48-year-old Caucasian female with recurrent cervical cancer was scheduled to receive three 21-day cycles of cisplatin and topetecan chemotherapy. She qualified, consented, and enrolled into a blinded interventional pilot study where she received daily whey protein (10 g, three times per day with meals) and a weekly injection of testosterone enanthate (100 mg intramuscular) before and during the SOC chemotherapy treatment period. Body composition, serum inflammatory markers, mixed muscle protein synthesis and breakdown rates, physical function, fatigue, and quality of life were assessed before and after the intervention period.
  
  
  RESULTS
  Body composition, as assessed by an increase in body weight and lean body mass and reduction in fat mass; physical function; fatigue; and quality of life each improved across the entire intervention period despite general increases in inflammatory markers and no improvements in muscle protein turnover towards the end of the intervention.
  
  
  CONCLUSIONS
  Concomitant treatment of oral amino acids and testosterone may be a viable therapeutic option for fighting cachexia and improving body composition and quality of life during chemotherapeutic treatment of recurrent cervical cancer. These positive outcomes may be attainable over time despite overall poor inflammatory status.
authors.affiliation: Department of Internal Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, 77555-0569, USA.
authors.forename: Edgar L
authors.initials: EL
authors.lastname: Dillon
authors.forename: Gurjot
authors.initials: G
authors.lastname: Basra
authors.forename: Astrid M
authors.initials: AM
authors.lastname: Horstman
authors.forename: Shanon L
authors.initials: SL
authors.lastname: Casperson
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Randolph
authors.forename: William J
authors.initials: WJ
authors.lastname: Durham
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Urban
authors.forename: Concepcion
authors.initials: C
authors.lastname: Diaz-Arrastia
authors.forename: Lyuba
authors.initials: L
authors.lastname: Levine
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Hatch
authors.forename: Maurice
authors.initials: M
authors.lastname: Willis
authors.forename: Gwyn
authors.initials: G
authors.lastname: Richardson
authors.forename: Melinda
authors.initials: M
authors.lastname: Sheffield-Moore