Cancer Anorexia/Weight Loss Syndrome


Characterized by weight loss, impaired appetite, declining function and decreased survival.

Defined as weight loss of at least 5% in 12 months or less in the presence of an underlying illness +3 of the following criteria: decreased muscle strength, fatigue, anorexia, low fat free mass index, abnormal biochemistry with inflammatory marker increase, anemia, and low serum albumin,

Occurs in 80% of patients with incurable solid tumor cancers.

Associated with poor quality of life and decreased survival and is often undertreated.

Of 352 patients, 87% has weight loss, 71% has weight loss of more than 10% of pre-illness weight, suggesting that weight loss is common in patients with incurable cancer (Sarhill).

Associated with a tendency to die sooner than patients who maintain appetite and weight.

This syndrome negative impacts quality of life a predicts for a poor prognosis.

Individuals with a weight loss of 6% or greater over preceding 6 months have s shortened survival than patients who maintain their weight (Dewys).

Interleukin-1 (IL-1) beta is a supposed mediator of the syndrome.

Cytokine tumor necrosis factor-α (TNF- α) suspected as a key mediator of this syndrome.

Ubiquitin-proteasome system responsible for approximately 80% of muscle wasting in cancer patients.

Etanercept, a TNF inhibitor, did not improve this syndrome in a clinical trial.

Prevalence of malnutrition occurs in 9-80% of all cancer patients (Capra S).

In as many as 20% of cancer patients malnutrition is the primary cause of morbidity rather than malignancy (Newell S).

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