tailieunhanh - Cancer Anorexia-Cachexia Syndrome: Current Issues in Research and Management

The cancer registry is an essential part of any rational programme of can- cer control. Its data can be used in a wide variety of areas of cancer control ranging from etiological research, through primary and secondary preven- tion to health-care planning and patient care. Although most cancer reg- istries are not obliged to do more than provide the basis for such uses of the data, they possess the potential for developing and supporting important research programmes making use of the information they collect | Cancer Anorexia-Cachexia Syndrome Cancer Anorexia-Cachexia Syndrome Current Issues in Research and Management Dr. Inui is Associate Professor Division of Diabetes Digestive and Kidney Diseases Department of Clinical Molecular Medicine Kobe University Graduate School of Medicine Kobe Japan. The author is indebted to Prof. Masato Kasuga and Prof. Shigeaki Baba both of Kobe University Graduate School of Medicine Kobe Japan for many stimulating discussions. The work was supported by grants from the Ministry of Education Science Sports and Culture of Japan. This article is also available online at . Akio Inui MD PhD ABSTRACT Cachexia is among the most debilitating and life-threatening aspects of cancer. Associated with anorexia fat and muscle tissue wasting psychological distress and a lower quality of life cachexia arises from a complex interaction between the cancer and the host. This process includes cytokine production release of lipid-mobilizing and proteolysis-inducing factors and alterations in intermediary metabolism. Cachexia should be suspected in patients with cancer if an involuntary weight loss of greater than five percent of premorbid weight occurs within a six-month period. The two major options for pharmacological therapy have been either progestational agents such as megestrol acetate or corticosteroids. However knowledge of the mechanisms of cancer anorexia-cachexia syndrome has led to and continues to lead to effective therapeutic interventions for several aspects of the syndrome. These include antiserotonergic drugs gastroprokinetic agents branched-chain amino acids eicosapentanoic acid cannabinoids melatonin and thalidomide all of which act on the feeding-regulatory circuitry to increase appetite and inhibit tumor-derived catabolic factors to antagonize tissue wasting and or host cytokine release. Because weight loss shortens the survival time of cancer patients and decreases performance status effective therapy would extend patient .