Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Cancer Anorexia (CA)

  • Chapter
  • First Online:
Nutritional Management of Cancer Treatment Effects

Abstract

Anorexia can be defined as a lack of appetite or loss of desire to eat resulting in the involuntary decline in food intake contributing to malnutrition. Although cancer cachexia and cancer anorexia have been used synonymously in research literature, there are distinct differences between the two symptoms observed in cancer patient populations. In cancer anorexia, without cachexia, metabolism is almost normal, and nutritional deficits and symptom management can be achieved. If a patient with cancer anorexia continues to develop or demonstrate persistent metabolic disturbances, it is likely that this patient is cachectic and should be screened, staged, and treated for cancer cachexia with anorexia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kumar NB, Kazi A, Smith T, Crocker T, Yu D, Reich RR, Reddy K, Hastings S, Exterman M, Balducci L, Dalton K, Bepler G (2010) Cancer cachexia: traditional therapies and novel molecular mechanism-based approaches to treatment. Curr Treat Options Oncol 11(3–4):107–117, Review

    Article  PubMed  Google Scholar 

  2. Gupta SC, Kim JH, Kannappan R, Reuter S, Dougherty PM, Aggarwal BB (2011) Role of nuclear factor κB-mediated inflammatory pathways in cancer-related symptoms and their regulation by nutritional agents. Exp Biol Med (Maywood) 236(6):658–671, Epub 2011 May 12. Review

    Article  CAS  Google Scholar 

  3. Tisdale MJ (2008) Catabolic mediators of cancer cachexia. Curr Opin Support Palliat Care 2(4):256–261, PMID: 19069310

    Article  PubMed  Google Scholar 

  4. Deans C, Wigmore SJ (2005) Systemic inflammation, cachexia and prognosis in patients with cancer. Curr Opin Clin Nutr Metab Care 8(3):265–269, PMID: 15809528

    Article  PubMed  CAS  Google Scholar 

  5. Tisdale MJ (2001) Loss of skeletal muscle in cancer: biochemical mechanisms. Front Biosci 6:164–174, PMID: 11171557

    Article  Google Scholar 

  6. Fearon KC, Von Meyenfeldt MF, Moses AG, Van Geenen R, Roy A, Gouma DJ, Giacosa A, Van Gossum A, Bauer J, Barber MD, Aaronson NK, Voss AC, Tisdale MJ (2003) Effect of a protein and energy dense N-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 52(10):1479–1486, PMCID: PMC1773823

    Article  PubMed  CAS  Google Scholar 

  7. Tisdale MJ (1999) Wasting in cancer. J Nutr 129(1S Suppl):243S–246S, Review. PMID: 9915907

    PubMed  CAS  Google Scholar 

  8. Morley JE (2002) Pathophysiology of anorexia. Clin Geriatr Med 18(4):661–673, v. Review. PMID: 12608495

    Article  PubMed  Google Scholar 

  9. Shoemaker LK, Estfan B, Induru R, Walsh TD (2011) Symptom management: an important part of cancer care. Cleve Clin J Med 78(1):25–34

    Article  PubMed  Google Scholar 

  10. Von Roenn JH (1994) Randomized trials of megestrol acetate for AIDS-associated anorexia and cachexia. Oncology 51(Suppl 1):19–24

    Article  Google Scholar 

  11. Khalid U, Spiro A, Baldwin C, Sharma B, McGough C, Norman AR, Eisen T, O’Brien ME, Cunningham D, Andreyev HJ (2007) Symptoms and weight loss in patients with gastrointestinal and lung cancer at presentation. Support Care Cancer 15(1):39–46

    Article  PubMed  CAS  Google Scholar 

  12. Van Cutsem E, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 9(Suppl 2):S51–S63

    Article  PubMed  Google Scholar 

  13. Schmitz KH, Holtzman J, Courneya KS, Mâsse LC, Duval S, Kane R (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 14:1588–1595

    Article  PubMed  Google Scholar 

  14. Copland L, Liedman B, Rothenberg E, Bosaeus I (2007) Effects of nutritional support long time after total gastrectomy. Clin Nutr 26:605–613

    Article  PubMed  Google Scholar 

  15. Braga M, Molinari M, Zuliani W, Foppa L, Gianotti L, Radaelli G, Cristallo M, Di Carlo V (1996) Surgical treatment of gastric adenocarcinoma: impact on survival and quality of life. A prospective ten year study. Hepatogastroenterology 43:187–193

    PubMed  CAS  Google Scholar 

  16. Hyltander A, Bosaeus I, Svedlund J, Liedman B, Hugosson I, Wallengren O, Olsson U, Johnsson E, Kostic S, Henningsson A et al (2005) Supportive nutrition on recovery of metabolism, nutritional state, health-related quality of life, and exercise capacity after major surgery: a randomized study. Clin Gastroenterol Hepatol 3:466–474

    Article  PubMed  Google Scholar 

  17. Liedman B, Andersson H, Berglund B, Bosaeus I, Hugosson I, Olbe L, Lundell L (1996) Food intake after gastrectomy for gastric carcinoma: the role of a gastric reservoir. Br J Surg 83:1138–1143

    Article  PubMed  CAS  Google Scholar 

  18. Takahashi S, Maeta M, Mizusawa K, Kaneko T, Naka T, Ashida K, Tsujitani S, Kaibara N (1998) Long-term postoperative analysis of nutritional status after limited gastrectomy for early gastric cancer. Hepatogastroenterology 45:889–894

    PubMed  CAS  Google Scholar 

  19. García-Peris P, Parón L, Velasco C, de la Cuerda C, Camblor M, Bretón I, Herencia H, Verdaguer J, Navarro C, Clave P (2007) Long-term prevalence of oropharyngeal dysphagia in head and neck cancer patients: impact on quality of life. Clin Nutr 26(6):710–717, Epub 2007 Oct 22

    Article  PubMed  Google Scholar 

  20. Couch M, Lai V, Cannon T, Guttridge D, Zanation A, George J, Hayes DN, Zeisel S, Shores C (2007) Cancer cachexia syndrome in head and neck cancer patients: part I. Diagnosis, impact on quality of life and survival, and treatment. Head Neck 29(4):401–411, PMID: 17285641

    Article  PubMed  Google Scholar 

  21. Malone FR, Leisenring WM, Storer BE, Lawler R, Stern JM, Aker SN, Bouvier ME, Martin PJ, Batchelder AL, Schoch HG, McDonald GB (2007) Prolonged anorexia and elevated plasma cytokine levels following myeloablative allogeneic hematopoietic cell transplant. Bone Marrow Transplant 40(8):765–772, Epub 2007 Aug 13

    Article  PubMed  CAS  Google Scholar 

  22. Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, Cohen MH, Douglass HO Jr, Engstrom PF, Ezdinli EZ, Horton J, Johnson GJ, Moertel CG, Oken MM, Perlina C, Rosenbaum C, Silverstein MN, Skeel RT, Sponzo RW, Tormey DC (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69:491–497, PMID: 7424938

    Article  PubMed  CAS  Google Scholar 

  23. Ross PJ, Ashley S, Norton A, Priest K, Waters JS, Eisen T, Smith IE, O’Brien ME (2004) Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers? Br J Cancer 90:1905–1911

    Article  PubMed  CAS  Google Scholar 

  24. Vallas B, Lauque S, Andrieu S, Nurhashemi F, Folland Y, Baumgartner R, Garry P (2001) Nutrition assessment in the elderly. Curr Opin Clin Nutr Metab Care 4(1):5–8

    Article  Google Scholar 

  25. Morley JE (2003) Anorexia and weight loss in older persons. J Gerontol A Biol Sci Med Sci 58(2):131–137

    Article  PubMed  Google Scholar 

  26. Ockenga J, Valentini L (2005) Review article: anorexia and cachexia in gastrointestinal cancer. Aliment Pharmacol Ther 22(7):583–594, Review

    Article  PubMed  CAS  Google Scholar 

  27. Capra S, Ferguson M, Ried K (2001) Cancer: impact of nutrition intervention outcome–­nutrition issues for patients. Nutrition 17:769–772

    Article  PubMed  CAS  Google Scholar 

  28. Sink J, Kademani D (2011) Maxillofacial oncology at the University of Minnesota: treating the epidemic of oral cancer. Northwest Dent 90(3):13–16, 38

    PubMed  Google Scholar 

  29. Arias F, Manterola A, Domínguez MA, Martínez E, Villafranca E, Romero P, Vera R (2004) Acute dysphagia of oncological origin. Therapeutic management. An Sist Sanit Navar 27(Suppl 3):109–115

    PubMed  Google Scholar 

  30. Davis MP, Walsh D, Lagman R, Yavuzsen T (2006) Early satiety in cancer patients: a common and important but underrecognized symptom. Support Care Cancer 14(7):693–698, Epub 2006 Apr 20. Review

    Article  PubMed  Google Scholar 

  31. Ryu SW, Kim IH (2010) Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol 16(26):3310–3317

    Article  PubMed  Google Scholar 

  32. Schwartz MW, Woods SC, Porte D Jr, Seeley RJ, Baskin DG (2000) Central nervous system control of food intake. Nature 404:661–671

    PubMed  CAS  Google Scholar 

  33. Plata-Salaman CR (1996) Anorexia during acute and chronic disease. Nutrition 12:69–78

    Article  PubMed  CAS  Google Scholar 

  34. Laviano A, Meguid MM, Rossi-Fanelli F (2003) Cancer anorexia: clinical implications, pathogenesis, and therapeutic strategies. Lancet Oncol 4:686–694

    Article  PubMed  CAS  Google Scholar 

  35. Mantovani G, Macciò A, Esu S, Lai P, Santona MC, Massa E, Dessì D, Melis G, Del Giacco S (1997) Medroxyprogesterone acetate reduces the production of cytokines and serotonin involved in anorexia/cachexia and emesis by peripheral blood mononuclear cells of cancer patients. Biochem Soc Trans 25(2):296S

    PubMed  CAS  Google Scholar 

  36. Barrett GL, Naim T, Trieu J (2011) Leptin-derived peptides that stimulate food intake and increase body weight following peripheral administration. Regul Pept 170(1–3):24–30, Epub 2011 May 24

    Article  PubMed  CAS  Google Scholar 

  37. Opara EI, Laviano A, Meguid MM, Yang ZJ (1995) Correlation between food intake and CSF IL-1 alpha in anorectic tumor bearing rats. Neuroreport 6:750–752

    Article  PubMed  CAS  Google Scholar 

  38. Laviano A, Gleason JR, Meguid MM, Yang ZJ, Cangiano C, Rossi Fanelli F (2000) Effects of intra-VMN mianserin and IL-1ra on meal number in anorectic tumor-bearing rats. J Invest Med 48:40–48

    CAS  Google Scholar 

  39. Wood LJ, Nail LM, Perrin NA, Elsea CR, Fischer A, Druker BJ (2006) The cancer chemotherapy drug etoposide (VP-16) induces proinflammatory cytokine production and sickness behavior-like symptoms in a mouse model of cancer chemotherapy-related symptoms. Biol Res Nurs 8:157–169

    Article  PubMed  CAS  Google Scholar 

  40. Wang W, Lonnroth C, Svanberg E, Lundholm K (2001) Cytokine and cyclooxygenase-2 protein in brain areas of tumor-bearing mice with prostanoid-related anorexia. Cancer Res 61:4707–4715

    PubMed  CAS  Google Scholar 

  41. Hopkinson JB (2010) The emotional aspects of cancer anorexia. Curr Opin Support Palliat Care 4(4):254–258, Review

    Article  PubMed  Google Scholar 

  42. Hopkinson JB, Brown JC, Okamoto I, Addington-Hall JM (2012) The effectiveness of ­patient-family carer (couple) intervention for the management of symptoms and other ­health-related problems in people affected by cancer: a systematic literature search and ­narrative review. J Pain Symptom Manage 43(1):111–142, Epub 2011 Jun 30

    Google Scholar 

  43. Thomas DR (2009) Anorexia: aetiology, epidemiology and management in older people. Drugs Aging 26(7):557–570

    Article  PubMed  CAS  Google Scholar 

  44. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495, Epub 2011 Feb 4. Review

    Article  PubMed  Google Scholar 

  45. Dy SM, Lorenz KA, O’Neill SM, Asch SM, Walling AM, Tisnado D, Antonio AL, Malin JL (2010) Cancer Quality-ASSIST supportive oncology quality indicator set: feasibility, reliability, and validity testing. Cancer 116(13):3267–3275

    Article  PubMed  Google Scholar 

  46. Townsend D, Accurso-Massana C, Lechman C, Duder S, Chasen M (2010) Cancer nutrition rehabilitation program: the role of social work. Curr Oncol 17(6):12–17

    Article  PubMed  CAS  Google Scholar 

  47. Ramic E, Pranjic N, Batic-Mujanovic O, Karic E, Alibasic E, Alic A (2011) The effect of loneliness on malnutrition in elderly population. Med Arh 65(2):92–95

    PubMed  Google Scholar 

  48. McQuestion M, Fitch M, Howell D (2011) The changed meaning of food: physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 15(2):145–151

    Article  PubMed  Google Scholar 

  49. Snyder CF, Garrett-Mayer E, Blackford AL, Brahmer JR, Carducci MA, Pili R, Stearns V, Wolff AC, Dy SM, Wu AW (2009) Concordance of cancer patients’ function, symptoms, and supportive care needs. Qual Life Res 18(8):991–998, Epub 2009 Aug 6

    Article  PubMed  Google Scholar 

  50. Jiménez A, Madero R, Alonso A, Martínez-Marín V, Vilches Y, Martínez B, Feliu M, Díaz L, Espinosa E, Feliu J (2011) Symptom clusters in advanced cancer. J Pain Symptom Manage 42(1):24–31, Epub 2011 Mar 12

    Article  PubMed  Google Scholar 

  51. Kirkova J, Aktas A, Walsh D, Davis MP (2011) Cancer symptom clusters: clinical and research methodology. J Palliat Med 14(10):1149–1166, Epub 2011 Aug 23

    Article  PubMed  Google Scholar 

  52. Laviano A, Seelaender M, Sanchez-Lara K, Gioulbasanis I, Molfino A, Rossi Fanelli F (2011) Beyond anorexia -cachexia. Nutrition and modulation of cancer patients’ metabolism: supplementary, complementary or alternative anti-neoplastic therapy? Eur J Pharmacol 668(Suppl 1):S87–S90, Epub 2011 Jul 27

    Google Scholar 

  53. Paccagnella A, Morassutti I, Rosti G (2011) Nutritional intervention for improving treatment tolerance in cancer patients. Curr Opin Oncol 23(4):322–330

    Article  PubMed  CAS  Google Scholar 

  54. Del Fabbro E, Hui D, Dalal S, Dev R, Noorhuddin Z, Bruera E (2011) Clinical outcomes and contributors to weight loss in a cancer cachexia clinic. J Palliat Med 14(9):1004–1008 [Epub ahead of print]

    Article  PubMed  Google Scholar 

  55. Baker A, Wooten LA, Malloy M (2011) Nutritional considerations after gastrectomy and esophagectomy for malignancy. Curr Treat Options Oncol 12(1):85–95, Review. Erratum in: Curr Treat Options Oncol. 2011 Mar;12(1):109

    Article  PubMed  Google Scholar 

  56. Inui A (2005) Recent development in research and management of cancer anorexia-cachexia syndrome. Gan To Kagaku Ryoho 32(6):743–749, Review

    PubMed  CAS  Google Scholar 

  57. Ovesen L, Allingstrup L, Hannibal J, Mortensen EL, Hansen OP (1993) Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: a prospective, randomized study. J Clin Oncol 11:2043–2049, PMID: 8410128

    PubMed  CAS  Google Scholar 

  58. Berenstein EG, Ortiz Z (2005) Megestrol acetate for the treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev (2):CD004310

    Google Scholar 

  59. Leśniak W, Bała M, Jaeschke R, Krzakowski M (2008) Effects of megestrol acetate in patients with cancer anorexia-cachexia syndrome–a systematic review and meta-analysis. Pol Arch Med Wewn 118(11):636–644

    PubMed  Google Scholar 

  60. Yeh SS, Lovitt S, Schuster MW (2009) Usage of megestrol acetate in the treatment of anorexia-cachexia syndrome in the elderly. J Nutr Health Aging 13(5):448–454

    Article  PubMed  CAS  Google Scholar 

  61. Busquets S, Serpe R, Sirisi S, Toledo M, Coutinho J, Martínez R, Orpí M, López-Soriano FJ, Argilés JM (2010) Megestrol acetate: its impact on muscle protein metabolism supports its use in cancer cachexia. Clin Nutr 29(6):733–737

    Article  PubMed  CAS  Google Scholar 

  62. Desport JC, Gory-Dalabaere G, Blanc-Vincent MP, Bachmann P, Béal J, Benamouzig R, Colomb V, Kere D, Melchior JC, Nitenberg G, Raynard B, Schneider S, Senesse P, FNCLCC (2003) Standards, options and recommendations for the use of appetite stimulants in oncology (2000). Br J Cancer 89(Suppl 1):S98–S100, PMID: 12915909

    Article  PubMed  Google Scholar 

  63. Karcic E, Philpot C, Morley JE (2002) Treating malnutrition with megestrol acetate: literature review and review of our experience. J Nutr Health Aging 6(3):191–200, Review. PMID: 12152625

    PubMed  CAS  Google Scholar 

  64. Morley JE (2002) Orexigenic and anabolic agents. Clin Geriatr Med 18(4):853–866, Review. PMID: 12608509

    Article  PubMed  Google Scholar 

  65. Donnelly S, Walsh TD (1995) Low-dose megestrol acetate for appetite stimulation in advanced cancer. J Pain Symptom Manage 10:182–183

    Article  PubMed  CAS  Google Scholar 

  66. Mulligan K, Zackin R, Von Roenn JH et al (2007) ACTG 313 study team. Testosterone supplementation of megestrol therapy does not enhance lean tissue accrual in men with human immunodeficiency virus-associated weight loss: a randomized, double-blind, placebo-controlled, multicenter trial. J Clin Endocrinol Metab 92:563–570, Abstract

    Article  PubMed  CAS  Google Scholar 

  67. Navari RM, Brenner MC (2010) Treatment of cancer-related anorexia with olanzapine and megestrol acetate: a randomized trial. Support Care Cancer 18:951–956

    Article  PubMed  Google Scholar 

  68. Walsh D, Kirkova J, Davis MP (2005) The efficacy and tolerability of long-term use of dronabinol in cancer-related anorexia: a case series. J Pain Symptom Manage 30:493–495

    Article  PubMed  Google Scholar 

  69. Cannabis-In-Cachexia-Study-Group, Strasser F, Luftner D, Possinger K et al (2006) Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol 24:3394–3400

    Article  PubMed  CAS  Google Scholar 

  70. Kumar NB, Hopkins K (2007) A retrospective study of Nutritional supplementation and appetite stimulants in the treatment of cancer cachexia. Abstract. In: Proceedings of research day, Moffitt Cancer Center, Tampa, Fl, USA 2007

    Google Scholar 

  71. Jatoi A, Windschitl HE, Loprinzi CL et al (2002) Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol 20:567–573

    Article  PubMed  CAS  Google Scholar 

  72. Fearon KC (2008) Cancer cachexia: developing multimodal therapy for a multidimensional problem. Eur J Cancer 44(8):1124–1132, Epub 2008 Mar 28. PMID: 183475115

    Article  PubMed  CAS  Google Scholar 

  73. Walsh D, Nelson KA, Mahmoud FA (2003) Established and potential therapeutic applications of cannabinoids in oncology. Support Care Cancer 11(3):137–143, Epub 2002 Aug 21. Review. PMID: 12618922

    PubMed  Google Scholar 

  74. Al-Majid S, Waters H (2008) The biological mechanisms of cancer-related skeletal muscle wasting: the role of progressive resistance exercise. Biol Res Nurs 10(1):7–20

    Article  PubMed  Google Scholar 

  75. Al-Majid S, McCarthy DO (2001) Cancer-induced fatigue and skeletal muscle wasting: the role of exercise. Biol Res Nurs 2(3):186–197

    Article  PubMed  CAS  Google Scholar 

  76. Lowe SS (2011) Physical activity and palliative cancer care. Recent Results Cancer Res 186:349–365

    Article  PubMed  Google Scholar 

  77. Penna F, Busquets S, Pin F, Toledo M, Baccino FM, López-Soriano FJ, Costelli P, Argilés JM (2011) Combined approach to counteract experimental cancer cachexia: eicosapentaenoic acid and training exercise. J Cachex Sarcopenia Muscle 2(2):95–104, Epub 2011 May 11

    Article  Google Scholar 

  78. Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT (1993) The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ 306(6890):1440–1444

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of South Florida, Heather Oak Place, 33647, Tampa, Florida, USA

    Nagi B. Kumar Ph.D

Authors
  1. Nagi B. Kumar Ph.D
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nagi B. Kumar Ph.D .

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Kumar, N.B. (2012). Cancer Anorexia (CA). In: Nutritional Management of Cancer Treatment Effects. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27233-2_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-27233-2_3

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27232-5

  • Online ISBN: 978-3-642-27233-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation