home
RSS
September 22nd, 2010
08:35 AM ET

Is the inability of cancer patients to eat a concern?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Steve Snodgrass, Bowling Green, Kentucky

I wanted to see what your experts thought about cancer/chemotherapy patients and protein malnutrition. I have read it leads to as many as 45 to 50 percent of cancer deaths. Is the inability of cancer patients to eat of major concern to cancer health care providers? Thank you.

Expert Answer

You ask an important question about a devastating problem.

Cachexia is a condition in which the body consumes excess energy. There is accelerated loss of fat stores and then consumption of proteins such as skeletal muscle. Cachexia is best known as a disease of cancer patients, but it is seen in patients with chronic infection, AIDS, heart failure, rheumatoid diseases and chronic obstructive pulmonary disease. Nearly half of patients with cancer that has spread to organs other the original site of disease (metastatic disease) have cachexia.

Loss of appetite or anorexia is often associated with cachexia, especially cachexia of malignancy. Contrary to what many think, this is not a disease caused by starvation. The loss in weight and body mass is driven by a metabolic disease manifested by increased energy consumption. As a result aggressive feeding and caloric replacement are not adequate treatments. Extremely aggressive efforts are to be discouraged. There are studies to suggest that forced tube feeding or intravenous feeding (known as hyperalimentation) can actually increase risk of infection and death.

Cachectic patients generally do not respond well to anti-cancer therapies. In one National Cancer Institute sponsored study, weight loss of greater than 5% from baseline was a predictor of poor outcome independent of cancer stage, type of cancer and patient performance status. Performance status is a rating of a patient's ability to walk and independently care for ones activities of daily living such as dressing oneself or hygiene.

Studies demonstrate that cachexia is the direct cause of death in a small number of cancer patients (1 to 2 percent). This is akin to the body running out of fuel or extreme malnutrition. More commonly the person has lost a great deal of immune function and becomes susceptible to infection or cachexia can lead to metabolic disorders that can cause heart rhythm disturbances. There are no good estimates as to how often this occurs.

Cancer cachexia appears to be caused by chemicals given off by the tumor or by the patient's immune system that is trying to combat the tumor. These chemicals are called cytokines. Some cytokines have also been found to cause depression which can also of course cause loss of appetite which worsens the condition. When there is effective treatment of the cancer, symptoms of cachexia decrease.

A number of agents have been studied, not as treatment of the cancer, but as a treatment of the condition known as cachexia of malignancy. These include melatonin, thalidomide, cannabinoids, and androgenic steroids. Only the corticosteroids, such as dexamethasone, and the progestational agents, such megesterol acetate, have proven of benefit in treatment of the loss of appetite. While a number of studies show corticosteroids and progestational agents cause an increase in appetite and even weight gain, these studies have not shown that they improve quality of live or survival.


soundoff (640 Responses)
  1. injectable for ed

    ed medications injectable https://alprostadildrugs.com/ alprostadil gel online

    April 15, 2021 at 04:30 | Report abuse | Reply
  2. canadian diet pills

    canadian weight loss pills https://canadapillstorex.com/ canadian pharmacies ed pills

    April 15, 2021 at 07:03 | Report abuse | Reply
  3. Catalina

    you answer question but not your contact information unless you choose to do so you will have control over when the dialogue ends you can choose to take a pro bono case from the website but that is entirely up to you all we

    https://sites.google.com/view/essay-writing-price/

    April 15, 2021 at 07:24 | Report abuse | Reply
  4. Stuart Madziar

    You made some decent points there. I looked over the internet for the issue and found most people will go in addition to with your website.

    https://www.pearltrees.com/justinarone215/item353135772

    April 15, 2021 at 07:46 | Report abuse | Reply
  5. dina

    I’m not sure where you are getting your information, but great topic. I needs to spend some time learning much more or understanding more. Thanks for magnificent information I was looking for this info for my mission.

    http://kaosdistro61526.blogsuperapp.com/3825856/13-kaos-distro-terbaik-di-pasar-saat-ini

    April 15, 2021 at 10:03 | Report abuse | Reply
  6. dysfunction

    erectile disorder causes https://canadaerectiledysfunctionpills.com/ erectile aid pump

    April 15, 2021 at 13:00 | Report abuse | Reply
  7. 카지노사이트추천

    Iím impressed, I must say. Seldom do I come across a blog thatís equally educative and interesting, and let me tell you, you have hit the nail on the head. The issue is something that not enough men and women are speaking intelligently about. I am very happy I stumbled across this in my search for something regarding this.

    http://iedc.com/helix3/index.php?option=com_k2&view=itemlist&task=user&id=562189

    April 15, 2021 at 13:18 | Report abuse | Reply
  8. vardenafil sublingual generic

    generic vardenafil 20mg https://vegavardenafil.com/ vardenafil sublingual generic

    April 15, 2021 at 14:07 | Report abuse | Reply
  9. 우리카지노계열

    Excellent post. I am dealing with many of these issues as well..

    http://www.bsaa.edu.ru/bitrix/rk.php?goto=https://www.blackplanet.com/perchdaniel13/message/22968930

    April 15, 2021 at 16:47 | Report abuse | Reply
  10. YuuSZRKEwx

    buy a business plan uk uwo essay writing help cheap term paper writing service do my accounting assignment cheap

    April 15, 2021 at 17:07 | Report abuse | Reply
  11. how to get free gems in episode choose your story

    Yes! Finally something about get free gems on episode.

    April 15, 2021 at 17:28 | Report abuse | Reply
  12. episode hack free passes and gems

    Greetings, I do believe your web site may be having web
    browser compatibility problems. Whenever I look at your
    site in Safari, it looks fine but when opening in I.E., it has some overlapping
    issues. I just wanted to provide you with a quick heads up!
    Apart from that, wonderful blog!

    April 15, 2021 at 21:48 | Report abuse | Reply
  13. 카지노사이트추천

    This is a topic that's close to my heart... Many thanks! Exactly where are your contact details though?

    https://pbase.com/topics/routerclub01/the_joys_of_playing_poker

    April 15, 2021 at 23:57 | Report abuse | Reply
  14. https://magic-mushrooms-online.com/product-category/magic-mushroom-growing-kits/

    Your manner of addressin this topic is both terrific as well as inspiring.

    https://magic-mushrooms-online.com/product-category/magic-mushroom-growing-kits/

    April 16, 2021 at 03:38 | Report abuse | Reply
  15. Thalia Rodrigus

    Have you ever thought about publishing an ebook or guest authoring on other websites? I have a blog based upon on the same information you discuss and would really like to have you share some stories/information. I know my audience would value your work. If you are even remotely interested, feel free to send me an email.

    https://penzu.com/public/c990ec2a

    April 16, 2021 at 05:23 | Report abuse | Reply
  16. zithromax z-pak price without insurance

    z pack indications https://zithromaxes.com/ zithromax and uti

    April 16, 2021 at 06:12 | Report abuse | Reply
  17. pfizer viagra canada pharmistry

    viagra canada purchase https://canadaviagrastore.com/ organic viagra in canada

    April 16, 2021 at 15:17 | Report abuse | Reply
  18. 우리카지노

    I quite like reading through an article that can make men and women think. Also, thanks for allowing me to comment!

    https://pastebin.pl/view/22578ac7

    April 16, 2021 at 23:48 | Report abuse | Reply
  19. pfizer viagra canada pharmacy

    do you need a prescription for viagra in canada https://canadaviagrastore.com/ pfizer viagra canada pharmistry

    April 17, 2021 at 00:45 | Report abuse | Reply
  20. xCUJqGFhfi

    proquest dissertation and thesis order form pay essay online order a paper essay help with math algebra 2

    April 17, 2021 at 00:49 | Report abuse | Reply
  21. canadian pharmacy cialis without prescription

    cialis viagra combination canadian pharmacy https://canadacialisstore.com/ canadian pharmacy cialis no prescription

    April 17, 2021 at 01:00 | Report abuse | Reply
  22. alprostadil gel

    where to buy alprostadil gel https://alprostadildrugs.com/ caverject suppository

    April 17, 2021 at 01:20 | Report abuse | Reply
  23. 우리카지노계열

    This website was... how do you say it? Relevant!! Finally I have found something that helped me. Thanks a lot!

    http://bookmarkloves.com/story7240759/tx-holdem-poker

    April 17, 2021 at 02:08 | Report abuse | Reply
  24. online erectile dysfunction prescription

    is erectile dysfunction a va disability rates https://canadaerectiledysfunctionpills.com/ erectile pills that work

    April 17, 2021 at 09:42 | Report abuse | Reply
  25. 메이저사이트

    https://www.yelp.co.uk/user_details?userid=vpZDVgweZ5SyUlId4wQIQg

    April 17, 2021 at 14:45 | Report abuse | Reply
  26. https://magic-mushrooms-online.com/

    Just bookmarked this post as I have actually found it rather practical.

    https://magic-mushrooms-online.com/

    April 17, 2021 at 15:31 | Report abuse | Reply
  27. https://magic-mushrooms-online.com/product-category/magic-mushroom-spores/

    I like the way you have ended this blog post ...

    https://magic-mushrooms-online.com/product-category/magic-mushroom-spores/

    April 17, 2021 at 16:19 | Report abuse | Reply
  28. bottle cage sepeda

    I could not resist commenting. Well written!

    April 17, 2021 at 17:33 | Report abuse | Reply
  29. is it safe to order cialis from canadian pharmacy

    canadian generic cialis safe https://canadacialisstore.com/ cialis canadian

    April 18, 2021 at 01:34 | Report abuse | Reply
  30. vardenafil grapefruit interaction

    vardenafil 20 mg tablets https://vegavardenafil.com/ vardenafil 40 mg

    April 18, 2021 at 07:38 | Report abuse | Reply
  31. 40 mg tadalafil

    what is tadalafil https://elitadalafill.com/ order tadalafil

    April 18, 2021 at 15:09 | Report abuse | Reply
  32. 먹튀검증업체

    Way cool! Some extremely valid points! I appreciate you writing this write-up plus the rest of the site is extremely good.

    https://spinalhub.win/wiki/South_Korea_Betting_on_Casino_Gambling_Web_Sites

    April 18, 2021 at 23:29 | Report abuse | Reply
  33. 카지노사이트

    This is a topic which is close to my heart... Take care! Exactly where are your contact details though?

    http://www.wxedu.com.cn/home.php?mod=space&uid=689637

    April 19, 2021 at 04:33 | Report abuse | Reply
  34. API 5L line pipe specification

    Steel Pipe – Seamless Pipe – ERW Pipe – Galvanized Pipe | Stainless Steel Pipe, Nickel Alloy Pipe, A106B, Tube

    https://menwiki.men/wiki/The_Boiler_Tube_Used_For_Vapor_Power_Plant

    April 19, 2021 at 08:56 | Report abuse | Reply
  35. 카지노사이트

    I needed to thank you for this very good read!! I absolutely loved every little bit of it. I have you saved as a favorite to look at new things you postÖ

    https://pbase.com/topics/honeynail2/how_to_maximize_your_chances

    April 19, 2021 at 16:28 | Report abuse | Reply
  36. 먹튀검증

    https://pastebin.pl/view/3ede280c

    April 19, 2021 at 19:36 | Report abuse | Reply
  37. EilqVbWFjo

    help me write my business plan essay pay equality picture of person doing homework tco writing service reviews

    April 19, 2021 at 22:20 | Report abuse | Reply
  38. 우리카지노

    This site was... how do I say it? Relevant!! Finally I have found something that helped me. Cheers!

    https://orlandotechnologygroup.com/members/baccarat9beetamount37/activity/159946/

    April 20, 2021 at 04:54 | Report abuse | Reply
  39. alprostadil suppository for sale

    alprostadil https://alprostadildrugs.com/ alprostadil side

    April 20, 2021 at 05:58 | Report abuse | Reply
  40. prices of sildenafil

    purchase sildenafil pills https://eunicesildenafilcitrate.com/ cheapest sildenafil australia

    April 20, 2021 at 17:21 | Report abuse | Reply
  41. 먹튀사이트

    http://www.indiaserver.com/cgi-bin/news/out.cgi?url=http://lorenzoklls751.simplesite.com/448630501

    April 20, 2021 at 17:55 | Report abuse | Reply
  42. 먹튀검증

    Iím amazed, I must say. Rarely do I encounter a blog thatís equally educative and entertaining, and without a doubt, you've hit the nail on the head. The issue is something that too few people are speaking intelligently about. Now i'm very happy I found this during my search for something concerning this.

    http://bookmarkextent.com/story9358353/trent-et-quarante-s-volte-chicago-rumba

    April 20, 2021 at 21:09 | Report abuse | Reply
  43. generic drug for viagra in canada

    canada 20 viagra https://canadaviagrastore.com/ what is the price of generic viagra in canada

    April 21, 2021 at 02:30 | Report abuse | Reply
  44. canadian generic pills

    canadian customs pills vitamins https://canadapillstorex.com/ canadian diet pills

    April 21, 2021 at 05:47 | Report abuse | Reply
  45. staxyn (vardenafil)

    warnings for vardenafil https://vegavardenafil.com/ how does vardenafil work

    April 21, 2021 at 06:27 | Report abuse | Reply
  46. what is tadalafil

    buy tadalafil https://elitadalafill.com/ tadalafil 40 mg daily

    April 21, 2021 at 06:45 | Report abuse | Reply
  47. do you need prescription for canadian prescription of cialis in usa

    buy generic cialis, canadian https://canadacialisstore.com/ canadian pharmacy for cialis

    April 21, 2021 at 09:14 | Report abuse | Reply
  48. fQCzcHOEMl

    essay writing companies essay writing service in the uk can you pay someone to do your essay three things i enjoy doing essay

    April 21, 2021 at 11:37 | Report abuse | Reply
  49. 먹튀검증

    bookmarked!!, I really like your site!

    https://pattern-wiki.win/wiki/How_to_locate_Cheap_Slots_At_Home

    April 21, 2021 at 13:00 | Report abuse | Reply
  50. vardenafil prices india

    vardenafil how to take https://vegavardenafil.com/ buy vardenafil

    April 21, 2021 at 14:05 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13

Post a comment


 

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

Advertisement
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.