TreatmentsYour healthcare providers are trained to determine the cause of your anorexia and what to do to help it. Many factors can contribute to anorexia, and they are discussed elsewhere in this Web site. However, this section discusses effective treatments that target the root cause of cancer-related anorexia. Many treatments are available to help your body use nutrients better and in a more normal way. The ONS Web site lists clinical studies conducted on this topic.
Here is the latest information on these treatments.
Most HelpfulClinical studies conducted to date on anorexia, as well as additional information from oncology experts, indicate that corticosteroids and progestins are the most helpful ways to manage anorexia.
Although corticosteroids are best known for their anti-inflammatory properties, they also are effective in stimulating appetite. In addition, progestins stimulate appetite, encourage weight gain, and help relieve nausea.
Likely to Be HelpfulOne treatment that is likely to be helpful is nutritional counseling. A registered dietitian can develop a specialized diet for you, based on the types of nutrition you need and in what quantities. The dietitian will individualize this based on your current symptoms, type of cancer, factors such as how much you can digest, and other considerations. This diet uses regular foods that can be purchased in any grocery store.
Not Enough EvidenceMany treatments fall into this category. All but one are prescription drugs-either biologic drugs or "traditional" drugs.
These drugs stimulate appetite by various means.
These treatments help reduce inflammation, which indirectly affects appetite.
Erythropoietin helps decrease metabolic stress by decreasing energy consumption related to anemia, which, in turn, helps reduce weight loss.
Not Likely to Be HelpfulCannabinoids are chemical compounds found in marijuana. They may stimulate the appetite and help relieve nausea.
Hydrazine sulfate may block the way that tumors use glucose as fuel; it also may block a chemical in the body that causes inflammation.
Melatonin regulates a hormone called leptin, which plays a role in regulating appetite and metabolism. (You may be familiar with melatonin as a natural sleep aid, but it also affects appetite. Both sleep and appetite follow circadian rhythms—natural cycles in which levels of melatonin rise and fall at certain times of the day.)
Many side effects and symptoms of cancer can contribute to anorexia (including, but not limited to)
• Physical problems with swallowing, such as those caused by mucositis
• Changes in smell, taste, or both
• Problems with elimination, such as diarrhea or constipation
• Mood imbalances, such as depression
• Sleep disturbances
• Pain
Branched-chain amino acids (BCAA)
reduces the level of a chemical in the brain, which, through a set of complex interactions, improves appetite, the body’s nutritional status, and how the body uses proteins
Cyproheptadine
stimulates appetite. Also used as an antihistamine
Ghrelin
increases appetite and hunger by helping the stomach empty its contents
Metoclopramide
decreases abnormal feelings of being “full” when you have not eaten enough to be full. Helps the stomach empty by increasing movement of food through the upper digestive tract
Eicosapentaenoic acid (EPA)
an omega-3 fatty acid (such as found in fish oil capsules). Omega-3s reduce inflammation.
Pentoxifylline
reduces inflammation
Thalidomide
affects immunity and inflammation. Also used to treat blood cancers, including multiple myeloma
Leptin
a hormone that increases the storage of body fat and suppresses appetite
Circadian rhythms
diverse yet predictable changes in physiologic variables, including sleep, appetite, temperature, and hormone secretion, over a 24-hour period
