Radiation Oncology/Cachexia

Treatment These medications treat the loss of appetite and weight loss but do not treat the cachexia itself. Medications: Corticosteroids: Stimulate appetite, but effect lasts only for 4-8 weeks, and does not lead to weight gain. Dronabinol (Marinol) Stimulates appetite but does not clearly lead to weight gain Megestrol (Megace) Most potent Anabolic steroids: nandrolone, fluoxymesterone, oxandrolone (increases lean tissue mass) Nutritional supplements: Boost, Ensure, etc. Boost (Website) - 240 Cal per 8 oz can. Boost Breeze - 160 Cal (8 oz). Boost Plus - 360 Cal (8 oz) Boost High Protein - 240 Cal (8 oz), 15 g protein Ensure (Website) - 250 Cal (8 oz). Ensure Plus - 350 Cal (8 oz) Ensure High Protein - 230 Cal (8 oz) ProSure - Website eicosapentaenoic acid (an omega-3 fatty acid) + protein + calories. Provides 300 Cals (17 g protein) per can. Use 2 cans per day. Does not require prescription. Juven - Website HMB (beta-hydroxy-beta-methylbutyrate), arginine and glutamine. Use: 2 servings per day (one packet per serving). Provides 150 Cal/day (75 Cal/pkg). Does not require prescription Exercise: Weight training Studies Randomized: Corticosteroids vs Megesterol Mayo, 1999 (1992-96) - 10506633 — "Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia." Loprinzi CL et al. J Clin Oncol. 1999 Oct;17(10):3299-306. 475 pts. Similar efficacy for decadron (0.75 mg qid) and megace (800 mg qd = 5x160), but differing toxicities.