Cachexia-Anorexia Syndrome and Food Supplementation in Cancer Patients

Loss of appetite and weight are one of the first symptoms of a malignant disease. In rapidly advancing cancer which does not respond to therapy, severe cachexia will undoubtedly lead to death. The cancer tissue and the body itself secrete cytokines and other factors, which, combined interfere with both central and peripheral metabolic pathways causing anorexia and cachexia. Assessing nutritional state in cancer patients should be made before starting oncological treatment, but also regularly during the course of therapy. The treatment of cachexia and anorexia in cancer patients is a complex issue and includes specific treatment with a goal of reducing cancer volume, providing nutritive support and intervening with pharmaceuticals. There are different appetite-enhancing medications with the most effective being megestrol acetate, corticosteroids and cannabinoids. Eicosapentaenoic acid (EPA) on the other hand is the key in treating cachexia. Today, formulations with EPA are prepared in such ways that they can be mixed with other food and can be prepared by following many different recipes. Parenteral nutrition is also an option, but is rarely used due to its high cost and risk of infections, and should not be used in end-stage disease. Administering nutritive advice, prescribing nutritional and pharmacological support can temporarily stop weight loss and improve appetite, quality of life and social interactions of cancer patients, and allow for a longer administration of systemic anti-tumor therapy and hence probably for a longer survival.