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Cachexia (Pronounced Kuh-Kek-See-Uh)
#1
Cachexia is often seen in end-stage cancer, and in that context is called "cancer cachexia."



In patients with congestive heart failure, there is also a cachectic syndrome. Also, a cachexia co-morbidity is seen in patients that have any of the range of illnesses classified as "COPD" (chronic obstructive pulmonary disease), particularly emphysema. Some severe cases of schizophrenia can present this condition where it is named vesanic cachexia (from vesania, a Latin term for insanity).<sup>[</sup><sup>citation needed</sup><sup>]</sup>



It also can be observed in such parasitic diseases as african trypanosomiasis (Sleeping sickness).<sup>[</sup><sup>citation needed</sup><sup>]</sup>



In each of these settings there is full-body wasting, which hits the skeletal muscle especially hard, resulting in muscle atrophy and great muscle loss. However, when presenting comorbidly with malabsorbtion syndrome, (as seen, for example, in Crohn's Disease or Celiac Disease) simply consuming more food is not sufficient to reverse wasting and the malabsorbtion must be treated before the patient will be able to stabilize body mass.<sup>[5]</sup>



Cachexia not only worsens survival for people with cancer, but it interferes with quality of life. People with cachexia are less able to tolerate treatments, such as chemotherapy, and often have more side effects. For those who have surgery, postoperative complications are more common. Cachexia also worsens cancer fatigue, one of the most annoying symptoms of cancer.





Mechanism

The exact mechanism in which these diseases cause cachexia is poorly understood, but there is probably a role for inflammatory cytokines such as tumor necrosis factor-alpha (TNF-), which is also nicknamed cachexin (also spelled cachectin) for this reason, Interferon gamma (IFN), and Interleukin 6 (IL-6), as well as the tumor-secreted proteolysis inducing factor (PIF).



Related malnutrition syndromes are kwashiorkor and marasmus, although these do not always have an underlying causative illness; they are most often symptomatic of severe malnutrition.



Those suffering from the eating disorder anorexia nervosa appear to have high plasma levels of ghrelin. Ghrelin levels are also high in patients who have cancer-induced cachexia.<sup>[6]</sup>





Treatment

Currently, there are no widely accepted drugs to treat cachexia and there are no FDA-approved drugs to treat cancer cachexia.



Cachexia may be treated by steroids such as corticosteroids or drugs that mimic progesterone, which increase appetite, may reverse weight loss, but have no evidence of reversing muscle loss.<sup>[7]</sup> Medical marijuana has been allowed for the treatment of cachexia in some US states such as Nevada, Michigan, Washington, Oregon, California, Colorado, New Mexico, and Arizona.<sup>[7]</sup><sup>[8]</sup>







Evaluation

There are several ways that cachexia can be evaluated. Some of these measures include:
  • Body mass index (BMI) -- Body mass index describes not only relative body weight, but can give more information about a healthy weight. BMI is calculated using a formula of height and weight.
  • Lean muscle mass -- Measuring body composition can help determine the ratio of lean muscle mass to body fat. Tests used to do this may include skin folds and bioimpedance.
  • Food intake diaries -- Keeping a food diary is an important activity when looking to prevent or cope with cachexia. At the same time, it's important to keep in mind that the malnutrition of cachexia can occur even with an adequate intake of calories.
  • Blood tests -- Some lab tests that are useful in evaluating cachexia include white blood cell counts (WBC), serum albumin, transferin levels, uric acid, and inflammatory markers, such as C-reactive protein (CRP).




Omega-3 fatty acids

A 2007 systematic review of n-3 fatty acids and cachexia found seventeen studies, eight of which were high-quality. It concluded that there was evidence that oral n-3 fatty acid supplements benefit cancer patients, improving appetite, weight and quality of life.<sup>[9]</sup> A 2009 trial found that a supplement of eicosapentaenoic acid helped cancer patients retain muscle mass.<sup>[10]</sup>



<sup>source</sup>

<sup></sup>

<sup></sup>

Medical Marijuana and Cachexia



Watch this video







http://www.youtube.com/watch?v=har8I0Lqsd4





What Is Cachexia?

Cachexia is any general reduction in vitality and strength of body and mind resulting from a debilitating chronic disease.





Medical Marijuana and Cachexia

Cachexia is a wasting syndrome that causes weakness and a loss of weight, fat, and muscle, which affects patients with advanced cancer, AIDS, and some other major chronic progressive diseases. Cachexia and anorexia, or a lack of appetite, often occur together.



Currently, there is no widely accepted drug to treat cachexia. Patients are often treated with steroids and/or nutritional supplements that provide easy-to-absorb nutrients. A 2009 trial found that a supplement of eicosapentaenoic acid helped cancer patients retain muscle mass. Scientists are also studying how human growth hormone treatments can help wasting syndrome patients. However, it is extremely expensive and could cost over $40,000 per year to use.



In order to manage cachexia, patients must reduce nausea and vomiting in order to increase food intake. And according to scientific and anecdotal evidence, using medical marijuana is a safe, effective way to do so. The National Cancer Institute is in the process of evaluating the effects of THC for treatment-related and cancer-related anorexia and cachexia. Many marijuana states include cachexia on their list of qualifying conditions. Additionally, marijuana side effects are typically mild and are classified as "low risk," with euphoric mood changes among the most frequent side effects.



If you or someone you know is looking to find relief from cachexia, MarijuanaDoctors.com can help. We can connect you with hundreds of quality marijuana doctors across the country in all legal marijuana states. Book an appointment today and let us help improve your quality of life!









Source







<strong>Cannabinoids and Cachexia</strong>



[Cannabinoids in the treatment of the cachexia-anorexia syndrome in palliative care patients].

Nauck F, Klaschik E.

Loss of appetite and cachexia are frequent symptoms in palliative care patients. However, therapeutic regimens often prove ineffective, and the quality of life of many patients is significantly impaired by these symptoms. Causes and pathophysiology of anorexia and cachexia are complex and must be identified and treated. Symptomatic pharmacological therapy aims at metabolic, neuroendocrinological and catabolic changes. Prokinetic drugs, corticosteroids and gestagenes are used for symptomatic therapy. Recently, the use of cannabinoids for treatment of loss of appetite and cachexia has become the focus of interest. In cancer patients, cannabinoids proved more effective than placebo but less than gestagenes. Compared to placebo, higher efficacy of cannabinoids could be demonstrated in patients with AIDS as well as in patients with Morbus Alzheimer. However, side effects, such as dizziness, tiredness and daze led to discontinuation of the cannabinoid therapy in some patients.



Cancer cachexia and cannabinoids.

Gorter RW.

Anorexia and cachexia are diagnosed in more than two-thirds of all cancer patients with advanced disease, and are independent risk factors for morbidity and mortality. Anorexia, nausea and vomiting often are described as more significant inhibiting factors for quality of life of cancer patients than even intense pain. In 1986, delta-9-tetrahydrocannabinol (THC), the main effective constituent of cannabis, was licensed as an anti-emetic drug in cancer patients receiving chemotherapy. In addition, in clinical studies THC has shown significant stimulation of appetite and increase of body weight in HIV-positive and cancer patients. The appetite-stimulating effect of cannabis itself has also been well documented in many anecdotal cases. There are strong indications that cannabis is better tolerated than THC alone, because cannabis contains several additional cannabinoids, like cannabidiol (CBD), which antagonize the psychotropic actions of THC, but do not inhibit the appetite-stimulating effect. Therefore, we intend to compare the therapeutic effects of whole-plant extracts of cannabis to those of THC (dronabinol) alone in controlled studies.





Abstract and key points

Cannabinoids are components isolated from Cannabis sativa and Cannabis indica plants (hemp).

The antiemetic efficacy of cannabis in chemotherapy-induced nausea/vomiting has been established in a systematic review.

The use of cannabinoids for anorexia-cachexia-syndrome in advanced cancer is not supported by the evidence from randomised controlled trials.

Several randomised controlled trials indicate a mild analgesic effect of cannabinoids in cancer patients.

Dose-limitating central nervous and cardiovascular adverse effects have frequently been observed in clinical studies.

Cannabinoids are components isolated from Cannabis sativa and Cannabis indica plants (hemp). This summary deals with cannabinoid products for medical use. Medical cannabinoids are claimed to alleviate nausea and vomiting in chemo-/radiotherapy and in palliative care. They are also recommended for the treatment of anorexia and cachexia in patients with advanced cancer and for the control of chronic tumor pain. The pharmacokinetics of cannabinoids have been intensively investigated and cannabinoid effects in humans have been linked to their agonist activity at two cannabinoid receptors.

The antiemetic efficacy of cannabinoids in chemotherapy-induced nausea/vomiting has been established in a systematic review. If cannabinoids can offer improvements over modern antiemetic medication, especially serotonin antagonists, in preventing acute or delayed chemotherapy induced nausea and vomiting is still unclear. Only anecdotal evidence is available to support the use of medical cannabinoids against radiotherapy-related nausea and nausea in palliative care patients.

The use of cannabinoids for anorexia-cachexia-syndrome in advanced cancer is not supported by the evidence from randomised controlled trials.

Several randomised controlled trials also indicate a mild analgesic effect of cannabinoids in cancer patients. Insufficient evidence is available to support the introduction of cannabinoids into widespread clinical use as analgesics.

The main limitation of cannabinoids is seen in the high frequency of serious adverse effects on the central nervous system and the cardiovascular system. Known absolute and relative contraindications and pharmacological interactions should be carefully considered. Medical cannabinoids are subject to country-specific prohibitory legislation.

Considering the availability of well-investigated and established medications for chemotherapy-induced nausea and chronic pain, a first-line use of medical cannabinoids is not recommended. Medical cannabinoids might be beneficial in individual cases as adjuncts to other antiemetic or analgesic medication when standard treatment fails in symptom control. Potential hazards and toxicities should be considered.





Case notes

"It affected everything I did," says Addario, who is alive and well nine years later in San Carlos, Calif. "I literally could not get up and down the stairs."



There is a name for what Addario experienced: cachexia. It is the muscle wasting and weight loss that are so often cancer's sidekick.



Doctors and patients have long assumed cachexia is an integral part of cancer, and it's rarely discussed. "Ninety percent of oncologists completely ignore the cachexia because there's no known therapy," says Alfred Goldberg, a professor of cell biology who studies protein and muscle breakdown at Harvard Medical School in Boston.



But that could soon change as two potential cachexia treatments are now in Phase 3 clinical trials. If studies continue to go well, the drugs could become available for lung cancer patients within the next two to three years.



The main goal of both medications is to give people more muscle strength as they fight cancer. But they may do even more, scientists hope.



"It's not clear that if you treat cachexia you will prolong life," says Dr. Egidio Del Fabbro, a palliative care physician at the University of Texas M.D. Anderson Cancer Center in Houston, but "we suspect it will." Del Fabbro is not involved with either of the companies developing the drugs,GTx Inc. of Memphis, Tenn., and Helsinn Therapeutics Inc. of Bridgewater, N.J.



Cachexia (pronounced kuh-KEK-see-uh) is commonly defined as the unintentional loss of 5% or more of a person's weight within a six-month period. Crucially, it's muscle that slides off one's frame, often with fat as well. It's associated with advanced cancers as well as HIV, heart failure and kidney disease. In layman's terms, it means "the patient looks awful, they look weak, they've lost much of their body mass," Goldberg says.



Cachexia is especially prevalent in pancreatic and lung cancers. People with the condition also tend to lose their appetites, but eating more does not help because the body's metabolism is operating at a higher-than-normal rate, says Vickie Baracos, a metabolism researcher at the University of Alberta in Edmonton.



"The controls are not operating properly," she says. "It's sort of like having your thermostat turned up and the window left open at the same time."



Given current rates of obesity, muscle wasting is sometimes hidden behind a layer of fat. "You can have somebody who technically looks obese, but they have the muscle mass of a concentration camp victim," says Dr. Mitchell Steiner, a urologic oncologist who co-founded GTx and now serves as the company's chief executive.









MORE



Introduction

Cannabis sativa has been cultivated for more than 5000 y both to obtain fibers for manufacturing of textiles and to provide a variety of extracts for medicinal and recreational use. To the present, marijuana and other psychoactive derivatives of Cannabis sativa represent the most widely illegal drug consumed in the Western world. However, despite the social problems related to the abuse of these substances, scientific and social communities have recently started to be aware of the therapeutic potentials of cannabinoids and of new synthetic compounds interfering with the endogenous cannabinoid system.

Since 300 AD, it was observed that Cannabis can stimulate hunger and increase appetite, particularly for sweet and palatable food.

However, only a few years ago this phenomenon was seriously taken into consideration in research. After the discovery of cannabinoid receptors and their endogenous ligands (endocannabinoids), the existence of an endogenous cannabinoid system has been proposed, providing a physiological basis for the biological effects induced by marijuana and its derivatives. The importance of this system is also underlined by the finding of a high degree of evolutionary conservation across species, emphasizing the fundamental physiological role played by cannabinoids in brain function.

The endogenous cannabinoid system

Cannabinoid research was largely neglected at the beginning of the 20th century, partly because of the political antimarijuana attitude, which officially started in the United States with the Harrison Act in 1914, leading to full prohibition 20 years later. During the 1960s, the sudden increase of the recreational use of Cannabis stimulated the public concern about its negative effects on the health of the consumers. On the other hand, this renewed interest initiated a series of scientific investigations into the numerous chemical constituents of Cannabis and their mechanisms of action, finally leading to the identification of the structure of 9-tetrahydrocannabinol ( 9-THC), the main psychoactive ingredient of marijuana. However, the definitive breakthrough concerning the importance of this system was given by the discovery of cannabinoid receptors and their endogenous ligands.

Cannabinoid receptors

In 1990, the first cannabinoid receptor (CB1) was cloned, followed 3 y later by the characterization of a second cannabinoid receptor (CB2).

Cannabinoid receptors belong to the G protein-coupled receptor superfamily and, to the present, include CB1, CB2 and a splice variant of the CB1 (for a review see Howlett et al). There is important pharmacological and physiological evidence suggesting the existence of other cannabinoid receptor subtypes that have not yet been cloned. Typically, the activation of cannabinoid receptors modulates adenylate-cyclase, potassium and calcium channels and signal-regulated kinases. Moreover, cannabinoid receptors are able to crosstalk with other neurotransmitter receptor systems, for example, recruiting by this way other intracellular signal transduction pathways. Given its wide distribution in the central nervous system (CNS) CB1 was considered as the 'brain-type' cannabinoid receptor, whereas CB2, mainly expressed in immune cells, was considered as its 'peripheral' counterpart. However, this classification does not hold true anymore as many studies show exp<b></b>ression of CB1 also in peripheral tissues. On the other hand, CB2 was also localized in brain-derived immune cells.

In the CNS, CB1 is predominantly expressed presynaptically, modulating the release of neurotransmitters, including -aminobutyric acid (GABA), dopamine, noradrenaline, glutamate and serotonin.

9-THC-mediated behavioral effects include ataxia, analgesia, hypothermia, euphoria, short-term memory deficits and other cognitive impairments. They are mediated by CB1 as suggested by the exp<b></b>ression of this receptor in brain areas implicated in these functions and by the lack of these effects in CB1-deficient mice.

Endogenous cannabinoids

The presence of specific receptors mediating the actions of marijuana and its derivatives strongly stimulated the search for endogenous ligands for cannabinoid receptors. The first endogenous cannabinoid, arachidonoyl ethanolamide, was identified from the porcine brain in 1992 and was named anandamide, from the Sanskrit word 'ananda' that means internal bliss. Anandamide is able to reproduce most of the typical behavioral effects of 9-THC in rodents and shares the same G protein-mediated actions on adenylate cyclase and Ca2+ channels with 9-THC (for a review see Di Marzo et al). This substance binds both to CB1 and CB2, with a higher affinity to CB1 and is present at highest concentration in hippocampus, cortex, thalamus and cerebellum of different species including humans.

Since the discovery of this ligand, other polyunsaturated fatty acid derivatives, acting as functional agonists of cannabinoid receptors, have been characterized and collectively termed endocannabinoids. As an example, Noladin ether is the most recent ether-type endocannabinoid identified only 1 y ago. Among these compounds, 2-arachidonoylglycerol (2-AG), identified in canine gut in a search for endogenous ligands selective for CB2, displays a lower affinity for CB1; nevertheless, it represents the most abundant endocannabinoid in the brain. In contrast to classical neurotransmitters, endocannabinoids do not appear to be stored in the interior of synaptic vesicles, because of the high lipophilicity of these ligands. In fact, phospholipid molecules within the cellular membrane were shown to serve as precursors and storage depots for anandamide synthesis. Anandamide is produced from such membrane phospholipids (eg N-arachidonoyl phosphatidyl ethanolamine), after cleavage of the phosphodiester bond by an as-yet-unidentified phospholipase D that is activated by Ca2+ ions. Endocannabinoids, like 'classical' neurotransmitters, are released from neurons following membrane depolarization and Ca2+ influx into the cells, are inactivated by a reuptake mechanism, involving facilitated transport by an as-yet-unisolated anandamide membrane transporter, and hydrolyzed by the enzyme fatty acid amide hydrolase in neurons and astrocytes.







Cannabis Treatment: Anorexia and Cachexia

An appetite enhancing effect of THC is observed with daily divided doses totalling 5 mg. When required, the daily dose may be increased to 20 mg. In a long-term study of 94 AIDS patients, the appetite-stimulating effect of THC continued for months, confirming the appetite enhancement noted in a shorter 6 week study. THC doubled appetite on a visual analogue scale in comparison to placebo. Patients tended to retain a stable body weight over the course of seven months. A positive influence on body weight was also reported in 15 patients with Alzheimers disease who were previously refusing food. source



Covers body composition and muscle loss in both normal lifespan progression and disease conditions, offering research results and clinical innovation.




  • The first scientific journal dedicated to research on cachexia and sarcopenia
  • Presents research on both typical ageing progression and disease-related changes
  • Covers both research and clinical topics
Changes in body composition, especially in skeletal muscle, are key elements in the ageing process and in the pathophysiology of chronic illness. The Journal of Cachexia, Sarcopenia and Muscle presents research on these debilitating conditions, and on body composition and physiological and pathophysiological changes during the lifespan, and in response to disease.









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Coverage includes research on the functional importance of fat tissue and mechanisms leading to lipolysis, and studies on mechanisms of muscle wasting, as well as better screening and evaluation options and enhanced biomarkers through validated complementary investigations.



The Journal is a reliable resource on clinical care, including patients suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis and sepsis.



The Journal of Cachexia, Sarcopenia and Muscle benefits physicians, biochemists, biologists, dieticians, pharmacologists, and students.



Related subjects Family & Geriatric Medicine - Internal Medicine - Molecular Medicine - Oncology & Hematology - Pharmaceutical Science









Understanding Cachexia



Symptoms, Signs, Causes, and Treatments

By Lynne Eldridge MD, About.com Guide



Updated April 03, 2012



About.com Health's Disease and Condition content is reviewed by the Medical Review Board



My link



Cachexia is a syndrome that is characterized by symptoms of unintentional weight loss, progressive muscle wasting, and a loss of appetite. Present in at least 50% of people with advanced cancer, it's estimated that it contributes directly to 20% of cancer deaths.



Even though the symptoms and signs of cachexia are usually noticed late in the course of cancer, we're learning that the process leading to muscle wasting begins very early on after a diagnosis of cancer. In such, cachexia is often present before any weight loss occurs.



Cachexia is sometimes referred to as a paraneoplastic syndrome, which simply means symptoms that are caused by substances made by a cancer or by the body's reaction to cancer. It might seem like cachexia should be easily treated at first glance, but effective treatments are lacking. This is because cachexia is more than just a lack of calories in the body.





Cancer Cachexia

Cachexia is seen frequently with cancer, but is also seen with diseases such as AIDS/HIV, heart failure, emphysema, and kidney failure. With regard to cancer, it is seen most frequently with lung cancer, pancreatic cancer, and stomach cancer. Cachexia not only worsens survival for people with cancer, but it interferes with quality of life. People with cachexia are less able to tolerate treatments, such as chemotherapy, and often have more side effects. For those who have surgery, postoperative complications are more common. Cachexia also worsens cancer fatigue, one of the most annoying symptoms of cancer. read more here











Signs and Symptoms

The major symptoms of cachexia include:
  • Involuntary (unintentional) weight loss -- Weight loss with cachexia is involuntary, meaning that it occurs without trying. Yet it goes further than unintentional weight loss. Weight loss may occur even though you are getting an adequate amount of calories in your diet, and if calorie intake outweighs output of energy.
  • Skeletal muscle wasting -- Muscle wasting is a hallmark of cachexia and occurs along with loss of fat. It can also be fairly insidious. In people who are overweight at the time of their diagnosis, significant loss of muscle mass can occur without an obvious outward appearance of weight loss.
  • Anorexia/loss of appetite -- Loss of appetite is another symptom of cachexia, and again, this symptom is somewhat different than ordinary "loss of appetite" symptoms. With cachexia, it is not simply a decreased desire for food, but more of a loss of a desire to eat.
  • Lowered quality of life -- Muscle wasting can diminish your ability to walk and participate in activities that would ordinarily be enjoyable.


What Causes Cachexia?

Cachexia may be caused by "tumor factors" -- substances manufactured and secreted by a tumor, or by the "host response." Host response simply means the body's response to a tumor. The response of the immune system to cancer and other causes of cachexia is being studied to try and understand the underlying factors behind cachexia. Cachexia is dominated by catabolic metabolism. If you think of normal metabolism being the building of tissue and muscle (anabolic metabolism), the opposite is true with cachexia, which is the breakdown of normal bodily processes.





Evaluation

There are several ways that cachexia can be evaluated. Some of these measures include:




  • Body mass index (BMI) -- Body mass index describes not only relative body weight, but can give more information about a healthy weight. BMI is calculated using a formula of height and weight.
  • Lean muscle mass -- Measuring body composition can help determine the ratio of lean muscle mass to body fat. Tests used to do this may include skin folds and bioimpedance.
  • Food intake diaries -- Keeping a food diary is an important activity when looking to prevent or cope with cachexia. At the same time, it's important to keep in mind that the malnutrition of cachexia can occur even with an adequate intake of calories.
  • Blood tests -- Some lab tests that are useful in evaluating cachexia include white blood cell counts (WBC), serum albumin, transferin levels, uric acid, and inflammatory markers, such as C-reactive protein (CRP).




Tackling the Conundrum of Cachexia in Cancer

Source http://www.cancer.go...in/110111/page5











By some estimates, nearly one-third of cancer deaths can be attributed to a wasting syndrome called cachexia that can be devastating for patients and their families. Characterized by a dramatic loss of skeletal muscle mass and often accompanied by substantial weight loss, cachexia (pronounced kuh-KEK-see-uh) is a form of metabolic mutiny in which the body overzealously breaks down skeletal muscle and adipose tissue, which stores fat. Patients suffering from cachexia are often so frail and weak that walking can be a Herculean task.



Cachexia occurs in many cancers, usually at the advanced stages of disease. It is most commonly seen in a subset of cancers, led by pancreatic and gastric cancer, but also lung, esophageal, colorectal, and head and neck cancer.



Despite cachexia's impact on mortality and data strongly suggesting that it hinders treatment responses and patients' ability to tolerate treatment, researchers who study muscle wasting say it has not received the attention it deserves. No effective therapies have been developed to prevent or hamper its progression. Even for patients who are able to eatappetite suppression or anorexia is a common cachexia symptomimproved nutrition often offers no respite.



There really is an enormous therapeutic opportunity here.



Dr. GoldbergAnd yet, over the last few years, researchers have begun to better understand the underlying biology of cancer-related cachexia. Findings from several studies point to potentially powerful therapeutic approaches, and a number of clinical trials of investigational drugs and drugs approved for other uses have been conducted or are under way.



"It's exciting to see several avenues of investigation coming to the forefront and trials moving forward," said Dr. Aminah Jatoi, a medical oncologist at the Mayo Clinic Comprehensive Cancer Center.



"It's important that oncologists be aware of these trials and offer participation to their patients," said Dr. Jatoi, a member of an international group of clinicians and researchers who earlier this year published a consensus statement to more precisely define cancer-related cachexia. The publication also provided a preliminary classification system for the conditionakin in some respects to the staging system used for tumors. (See the sidebar.)



Cachexia isn't limited to cancer. It is commonly seen in people with AIDS and chronic forms of kidney disease and heart failure, among other conditions, as well as in those who have suffered severe trauma and burns, said Dr. Alfred Goldberg of the Harvard University School of Medicine, whose research on muscle wasting and protein degradation eventually led to the development of the cancer drug bortezomib (Velcade). With so many potential clinical applications, Dr. Goldberg said, "There really is an enormous therapeutic opportunity here."



Why and How Cachexia Happens



The consensus statement is a good beginning, according to another co-author, Dr. Mellar Davis of the Cleveland Clinic Taussig Cancer Center. But researchers still need to dig deeper into how cachexia develops in patients with cancer, Dr. Davis continued, and how its course is influenced by everything from nutrition and physical activity to disease-specific factors, such as reduced testosterone levels caused by cancer therapy or opioids to treat pain.



Multiple factors are clearly at play in cachexia development and progression, Dr. Goldberg explained. He believes that at its core cachexia is "more of a host response that's evolved to fight fasting, injury, or disease," he said. During this response, the body is trying to obtain additional energy stores from muscle, in the form of amino acids, to convert into glucose to keep the brain functioning. The problem, he continued, "is that we can't turn off this response to the cancer, even when we can provide the patient with essential nutrients."



Many studies suggest that inflammation "is a unifying theme of cachexia across many diseases, including cancer," said Dr. Teresa Zimmers of the Jefferson Kimmel Cancer Center in Philadelphia.



The inflammation is caused in part by the body's immune response to the tumor, which results in the production of pro-inflammatory cytokines, explained Dr. Konstantin Salnikow, of NCI's Division of Cancer Biology (DCB). Although these cytokines can help to kill tumor cells, some also appear to tilt the body's metabolism toward catabolism, the breakdown of muscle proteins and fat.



Elevated levels of several cytokines in particular have been closely associated with cachexia and mortality in cancer patients. In NCI-supported mouse model studies, for example, Dr. Zimmers has shown that elevated levels of the cytokine IL-6 can induce cachexia. She and others have begun to unravel some of the potential mechanisms by which IL-6 may do this.



Goverments Search



Despite the incomplete understanding of the underlying biology of cancer-related cachexia, a few potential therapies are moving into early human trials.



More than one drug will likely be needed to successfully combat cachexia, particularly if it's at an advanced stage, said Dr. Barbara Spalholz, also of DCB. "We may have to hit different combinations of targets, depending on the type of cancer and other factors," she said.



The agent that appears to be the furthest along is the selective androgen receptor modulator GTx-024 (Ostarine), developed by GTx Inc., based in Memphis, TN. In August, GTx launched two phase III clinical trials of the investigational agent, dubbed POWER1 and POWER2, for the prevention or treatment of cachexia in patients with advanced non-small cell lung cancer.



More of their report here





























References_________________________________________________________________________________________________________________________________________________________________________________

1. ^ http://www.merriam-w...ionary/Cachexia

2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1169. ISBN 1-4160-2999-0.

3. ^ Lainscak M, Podbregar M, Anker SD (December 2007). "How does cachexia influence survival in cancer, heart failure and other chronic diseases?". Curr Opin Support Palliat Care 1 (4): 299305. doi:10.1097/SPC.0b013e3282f31667. PMID 18685379.

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7. ^ a b Gagnon B, Bruera E (May 1998). "A review of the drug treatment of cachexia associated with cancer". Drugs 55 (5): 67588. doi:10.2165/00003495-199855050-00005. PMID 9585863.

8. ^ Yavuzsen T., Davis M.P., Walsh D., LeGrand S., Lagman R. (November 2005). "Systematic review of the treatment of cancer-associated anorexia and weight loss". J. Clin. Oncol. 23 (33): 850011. doi:10.1200/JCO.2005.01.8010. PMID 16293879.

9. ^ Colomer R., Moreno-Nogueira J.M., Garca-Luna PP, et al. (May 2007). "N-3 fatty acids, cancer and cachexia: a systematic review of the literature". Br. J. Nutr. 97 (5): 82331. doi:10.1017/S000711450765795X. PMID 17408522.

10. ^ Ryan A.M., Reynolds J.V., Healy L, et al. (2009). "Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial". Ann. Surg. 249 (3): 35563. doi:10.1097/SLA.0b013e31819a4789. PMID 19247018.

11. ^ J.R. Rigas et al (June 2010). [http:// http://www.asco.org/...bstractID=50646 "Affect of ALD518, a humanized anti-IL-6 antibody, on lean body mass loss and symptoms in patients with advanced non-small cell lung cancer (NSCLC): Results of a phase II randomized, double-blind safety and efficacy trial"]. J Clin Oncol 28 (1534). http:// http://www.asco.org/...stractID=50646.

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#2
My Word ! Now I Know Why My Cachexia, Along With My GERD




And Hiatal Hernia Are 'Screaming' At Me Not To Even Attempt This Chemo.




6 Straight Months. My 'Gut' And My Brain And Soul Tells Me No. Especially




Now In How Emaciated I Am.




I'm now 144 lbs. 5'-9". Down From 195 At My Highest. From That To 150 It




Was Like In 6-7 Weeks. Pain Doc Was Concerned. But Hasn't Followed Up & Will Freak Now.




Man---> My Brother, Thank You Again. Never Think You Wasted A Second Now In Posting This




Fantastic Piece Of Work Up... I Keep Finding All These Hiddens 'Gems' Like This One.




Thank You-I'm VERY Grateful ! Much Peace And Love To You Both.




Most Sincerely, Brother Will






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