P0005 Low testosterone levels and increased serum C reactive protein levels in cancer patients with refractory cachexia

Abstract

Background Cachexia has long been recognised as an adverse effect of cancer. Cancer cachexia (CC) has three stages of clinical relevance: precachexia, cachexia, and refractory cachexia (RC). Methods This study includes 36 patients diagnosed with CC (of whom 17 patients had RC and remaining 19 had cachexia) at the Department of Medical Oncology, Bulent Ecevit University, and 24 healthy controls, who enrolled between May 2011, and February 2013. Findings We investigated the levels of serum C reactive protein (CRP), IL-1 alfa, IL-1 beta, TNF alfa, and free and total testosterone in male patients with CC. In the group of men with refractory cachexia, serum CRP levels were significantly higher (139 mg/l versus 3.8 mg/l, p = 0.0001) and serum testosterone levels were significantly lower (170 ng/dl versus 450 ng/dl, p = 0.0001) than in the cachexia group. There were no significant differences in the serum levels of IL1 alfa, IL1 beta, TNF alfa, and serum free testosterone levels. Interpretation In RC, there has been a clinically refractory process as a result of end-stage disease. Our study revealed that CRP levels increase and testosterone levels decrease in refractory cachexia. In a pre-cachectic or cachectic patient, basal CRP levels can be followed up and increasing CRP levels and/or decreasing testosterone levels must alert to proceeding to irreversible catabolism, such as RC.