title: Cancer and systemic inflammation: treat the tumour and treat the host.
abstract: Determinants of cancer progression and survival are multifactorial and host responses are increasingly appreciated to have a major role. Indeed, the development and maintenance of a systemic inflammatory response has been consistently observed to confer poorer outcome, in both early and advanced stage disease. For patients, cancer-associated symptoms are of particular importance resulting in a marked impact on day-to-day quality of life and are also associated with poorer outcome. These symptoms are now recognised to cluster with one another with anorexia, weight loss and physical function forming a recognised cluster whereas fatigue, pain and depression forming another. Importantly, it has become apparent that these symptom clusters are associated with presence of a systemic inflammatory response in the patient with cancer. Given the understanding of the above, there is now a need to intervene to moderate systemic inflammatory responses, where present. In this context the rationale for therapeutic intervention using nonselective anti-inflammatory agents is clear and compelling and likely to become a part of routine clinical practice in the near future. The published literature on therapeutic intervention using anti-inflammatory agents for cancer-associated symptoms was reviewed. There are important parallels with the development of useful treatments for the systemic inflammatory response in patients with rheumatological disease and cardiovascular disease.
authors.affiliation: Academic Unit of Surgery, School of Medicine - University of Glasgow, Royal Infirmary, Glasgow G31 2ER, UK.
authors.forename: C S D
authors.initials: CS
authors.lastname: Roxburgh
authors.affiliation: Academic Unit of Surgery, School of Medicine - University of Glasgow, Royal Infirmary, Glasgow G31 2ER, UK.
authors.forename: D C
authors.initials: DC
authors.lastname: McMillan
mesh_terms: D006801:Humans; D007249:Inflammation / Q000473:pathology*; D009369:Neoplasms / Q000473:pathology* / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis