Abstract

Patients with advanced cancer frequently exhibit progressive weight loss and this is associated with a shorter survival time and reduced quality of life. Indeed, some patients appear to die of severe wasting rather than as a result of vital organ involvement by tumour (Warren, 1935; DeWys et al. 1980; Oveson et al. 1993b). Seventy of weight loss varies markedly with tumour type; for example, some patients with advanced breast cancer actually increase their weight, whereas almost all patients with pancreatic cancer become severely wasted. In a recent survey of patients with unresectable pancreatic cancer we found that 85 % of patients had unintentionally lost weight by the time of diagnosis and that near to the time of death the group as a whole had lost approximately 25 % of their pre-illness weight (Wigmore et al. 1997~). Clearly, in a proportion of individuals with pancreatic cancer such severe weight loss contributes to their demise, and thus it is patients with pancreatic cancer that we have used as a paradigm for cancer cachexia. The term cachexia is derived from the Greek words ‘kakos’, meaning ‘bad’ and ‘hexis’, meaning ‘condition’. The syndrome is characterized by anorexia, early satiety, changes in taste perception, weight loss, weakness, anaemia and oedema (Fearon & Carter, 1988). Cachexia is not exclusive to cancer, but is also seen in a variety of inflammatory conditions such as sepsis, acquired immunodeficiency syndrome and rheumatoid arthritis (Grunfeld & Feingold, 1992; Roubenoff et al. 1992; Cangiano et al. 1996).

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