• Title/Summary/Keyword: Cachexia

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Recent Advances in Cancer Cachexia (암성 악액질의 최신 지견)

  • Choi, Sang-Gyu
    • Asian Oncology Nursing
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    • v.11 no.1
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    • pp.20-25
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    • 2011
  • Purpose: The study was aimed to review and understand the meaning of cancer cachexia. Methods: Using the keywords "cachexia" and "cancer cachexia" 30 oncology research published from 1974 to 2009 were selected for the review. Results: The mechanism of cancer cachexia has not been fully understood, but various pathogenesis appears to be involved in the development cachexia including altered metabolism of carbohydrate, lipid, and protein associated with cytokines and hormone. As a result, muscle strength, food intake and resting energy expenditure (REE) are reduced. Most medications for the treatment of cachexia show debating results except some drugs such as megace. Supportive care including nutritional education, nursing care, and social support are found another effective treatment options. Conclusion: The results of this study would help oncology nurses to understand the mechanism of cancer cachexia and its management.

Safe Nuclear Factor-kappa B Inhibitor for Cachexia Management (악액질 완화를 위한 안전한 Nuclear Factor-kappa B 전사인자 제어 물질 발굴)

  • Park, Jeong-Soo
    • Journal of Korean Biological Nursing Science
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    • v.14 no.2
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    • pp.129-138
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    • 2012
  • Purpose: Cachexia is a complex metabolic syndrome associated with wasting of skeletal muscle which contributes to nearly one-third of all cancer deaths. Cachexia lowers the frequency of response to chemotherapy and radiation and ultimately can impact survival as well as quality of life during treatment. NF-kappa B is one of the most important molecular mediators of cachexia. In this study, therefore, possible candidates for inhibitors of NF-kappa B were searched. Methods: Amino acids that regulate cellular redox potential by adjusting the level of NAD/NADH ratio, such as aspartate, pyruvate, and isocitrate were selected. Results: Pyruvate effectively inhibited luciferase activity in TNF-stimulated 293T cells transfect with an NF-kB dependent luciferase reporter vector. Pyruvate also showed protective effect on muscle atrophy of differentiated C2C12 myocyte induced by TNF/IFN. Conclusion: We might be able to develop the nutritional management strategy for cancer cachexia patients with pyruvate supplementation.

Nutritional Support for Patients with Pancreatic Cancer (췌장암에서 영양 치료)

  • Jung, Min Kyu
    • The Korean Journal of Gastroenterology
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    • v.74 no.2
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    • pp.87-94
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    • 2019
  • Pancreatic cancer is the ninth common malignancy in South Korea. It has a dismal prognosis with a 5-year overall survival rate of less than 10%, and pancreatic cancer is associated with cancer cachexia, which is defined as the loss of muscle mass that is not reversible by conventional nutritional support. Cachexia is noted in over 85% of all pancreatic cancer patients and it is strongly related with the disease's mortality. Nearly 30% of pancreatic cancer deaths are due to cachexia rather than being due to the tumor burden. Therefore, it is crucial to discover the mechanisms behind the development of muscle wasting in pancreatic cancer patients and find novel therapeutics for targeting cachexia. This review deals with the current understanding about the development of cachexia and nutritional support in those patients suffering with pancreatic cancer.

The Cytokine-mediated Link Between Depression and Cachexia in Cancer Patients (암환자의 우울증과 카켁시아 간 시토카인 매개 연결)

  • Lim, Woo Taek
    • Journal of Korean Physical Therapy Science
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    • v.26 no.3
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    • pp.44-56
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    • 2019
  • Despite the advances in medical technology, there are limited therapeutic interventions for cancer. Currently, the main goal of treatment is to remove a tumor completely. However, recent studies have shown that mortality is highly influenced by symptoms such as depression and cachexia, not solely by cancer itself. Depression is caused by psychological stress, and cachexia involves extreme weight loss with skeletal muscle atrophy, which are widely observed in patients with cancer. Although those two appear completely different from each other, they have a common etiology: cytokines. The production of cytokines can lead to depression and cachexia, and it contributes greatly to the increase in mortality rate. A better understanding of depression and cachexia in patients with cancer will help establish efficient treatment strategies.

Effects of Therapeutic Exercise on Fatigue and Anxiety of Cachexia Patients(Case Report) (악액질(cachexia) 환자에게 적용한 운동치료가 피로와 불안에 미치는 영향(단일사례 보고))

  • An, Hyunkyu;Yoon, Junggyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.4
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    • pp.111-125
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    • 2018
  • Purpose : Cachexia, is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. Patients with cachxia shows various symptoms including fatigue, anxiety, pain, sleep disorders, and poor appetite. Medications therapy, dietary and exercise therapy, and emotional support are recommended to treat patients with cachexia. However, evidence-based research verifying the role of exercise therapy in patients with cachexia is limited. The purpose of this study was to investigate the effects of therapeutic exercise on fatigue and anxiety in patients with cachexia. Methods : Case report. A 29-year-old woman was diagnosed with cachexia. Following 2 weeks of inpatient and 4 weeks of out-patient treatment. we assessed her weight, as well as pain, fatigue, and anxiety level. As an the patient exercised for an hour 5 times a week for 2 weeks,-and during the outpatient visit, she exercised for an hour twice a week for 4 weeks. Her weight was measured using a weighting scale. Pain was assessed using the visual analog scale, and fatigue and anxiety levels were assessed using questionnaires. Results : Following 6 weeks of treatment, exercise therapy a positively affected the patient's weight, as well as pain, fatigue, and anxiety levels. We observed a weight gain of 4.5 kg, pain reduction of 5.1 points. Fatigue reduction of 43 points, anxiety reduction of total 41 points. Conclusion : Exercise therapy positively affects weight, as well as pain, fatigue, and anxiety levels in patients with cachexia. However, generalization of this observation is inappropriate based on this single case study.

The Effects of Korean Traditional Medicine Mixture on Cytokine Level, Food Intake and Nutrition Metabolism of the Cachexia Induced-Mice (혼합한약재가 악액질이 유도된 생쥐의 Cytokine분비 및 식이섭취와 영양대사에 미치는 영향)

  • 왕수경;윤은영;박정민;임종순;김승형
    • Journal of Nutrition and Health
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    • v.36 no.4
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    • pp.368-375
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    • 2003
  • Cancer cachexia, characterized by weight loss and progressive tissue wasting, has been postulated to be mediated by cytokines. This study was conducted to evaluate the effect of Korean Traditional Medicine (KTM ; mokhyang, jisil, osooyu) mixture on food intake, blood cytokines level and blood nutrients status of the cachexia induced-mice. Thirty male Balb/c mice aged 6-8 weets were blocked into 3 groups that were Normal (no colon26 cells) Control (colon 26 cells) and KTM (colon26 cells + KTM extract mixture) group. In Control and KTM groups, murine adenocarcinoma colon 26 cells were injected subcutaneously to induce cachexia. KTM mice were given 200 ul KTM extract mixture (7%) per day. Half of each groups were sacrificed at the 14 th day to see serum cytokines & nutrients and the others were fed until almost of control group died to see life span. food intake and body weight were decreased significantly in cachexia induced groups. Tumor weight of KTM group was significantly lower than control group. Serum cytokines (IL-1$\beta$ and TNF-$\alpha$) level of cachexia induced groups were increased than those of normal group, and those of KTM group were significantly lower than the level of control group. Total serum protein and serum albumin were higher in KTM group than other groups. TG and fatty acid were lower in cachexia induced groups than normal group. HDL-cholesterol in serum was increased in KTM group. Effect of oral administration of KTM extract mixture on survival time of colon26 bearing mice showed extension of the life span. Overall, this study showed that KTM (mokhyang, jisil, osooyu) extract mixture inhibited the growth of cancer cell, changed the secretion of cytokines induced by colon26 adenocarcinoma in mice, and changed nutrition metabolism.

A Study on Chinese Herb Medicine Treatment of Cancer Cachexia to Chinese Journals (암성 악액질(cancer cachexia)의 한약치료에 대한 고찰 -2000~2009년까지 중의논문을 중심으로-)

  • Song, Kwang-Kyu;Park, Mee-Yeon;Choi, Hae-Yun;Kim, Jong-Dae
    • Korean Journal of Oriental Medicine
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    • v.16 no.2
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    • pp.181-191
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    • 2010
  • Objetcives : Cancer cachexia is a common syndrome in advanced cancer patients, which is characterized by profound changes in protein, fat and carbohydrate metabolism, resulting in anorexia, weight loss, muscle wasting and poor performance status. We studied the journals of Chinese herb medicine about cancer cachexia and reported the results. Methods : This study attempted to analyze the contents of the research papers concerning the treatment of cancer cachexia presented in the journals of Chinese medicine published in China over the period between 2000 and 2009. Results & Conclusions : The principles for medical treatment were invigorating Ki(益氣), invigorating the spleen(健脾), regulating the stomach(和胃), nourishing the blood(養血), nourishing Eum(補陰), promoting the circulation of Ki(行氣), removing the phlegm(化痰), removing blood stasis(祛瘀) etc. The used herbs were Poria(茯笭), Astragali Radix(黃芪), Atractylodis Macrocephalae Rhizoma(白朮), Codonopsis Pilosulae Radix(黨蔘), Dioscoreae Rhizoma(山藥), Citri Pericarpium(陳皮), Angelicae Gigantis Radix(當歸), Coicis Pemen(薏苡仁), Paeoniae Radix Alba(白芍藥) etc. The effetcive rate of treatment with Chinese herb medicine group was comparable or even more effetcive. Chinese herb medicine group had little side effetcs. Chinese medicine herb treatment to inhibit cancer cachexia has many possibilities.

Can the Serum Level of Myostatin be Considered as an Informative Factor for Cachexia Prevention in Patients with Medullary Thyroid Cancer?

  • Hedayati, Mehdi;Nozhat, Zahra;Hannani, Masoomeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.119-123
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    • 2016
  • Thyroid cancer, the most common endocrine neoplasia, consists of four main types of carcinomas: papillary, follicular, and anaplastic, all with thyroid follicular origin, and medullary thyroid cancer (MTC) related to para-follicular cells. Cronic diseases such as diverse cancers may be associated with cachexia, especially at advanced stage. Cancer-induced cachexia is associated with diminished quality of life, functional performance, reduced response to antitumor therapy, and increased morbidity and mortality. Myostatin (Mst) is one of the outstanding molecules in the skeletal muscle loss process in cancer and it may be released by both skeletal muscle and cachexia-inducing tumors. Recently changes in serum levels of Mst have been identified as an important factor of cancer-induced cachexia. The goal of this study was to assessserum Mst levels in MTC patients. In this descriptive and case-control study, 90 participants were selected, comprising 45 MTC patients (20 males, $29{\pm}13.9years$, 25 females, $29{\pm}14.5years$) and 45 control individuals (25 males, $23.1{\pm}11.6years$, 20 females, $31.5{\pm}14.4years$). Serum Mst was determined using an ELISA kit and body mass index (BMI) was calculated by weight and height measurements. The Kolmogorov Simonov test showed a normal distribution for log transformed Mst serum levels in both case and control groups. Geometric means were 5.9 and 8.2 ng/ml respectively, and a significant difference was found according to the independent t-test results (P<0.01). There was also a significant difference mean of Mst between females in control and MTC groups, but not for the males. Pearson correlation test showed no correlation between age and BMI with Mst serum levels. The findings of this study support the hypothesis that Mst serum levels may have a potential ability for early diagnosis of cachexia in MTC patients, especially in females.

Effectiveness of comprehensive traditional Korean Medicine treatment on quality of life, anorexia and cachexia of cancer patients : Retrospective chart review (암 환자의 삶의 질, 식욕 부진과 악액질에 대한 복합 한의 치료 프로그램의 효과: 후향적 차트 리뷰)

  • Han, Wonju;Lee, Eunji;Han, Gajin;Yoon, Sang-hoon;Han, Gajin;Leem, Jungtae
    • The Journal of Korean Medicine
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    • v.40 no.2
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    • pp.119-132
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    • 2019
  • Purpose: This study was conducted to collect and analyze real world data to evaluate the effectiveness and safety of comprehensive traditional Korean Medicine treatment on quality of life, anorexia and cachexia of cancer patients. Methods: We analyzed medical records of 62 cancer patients admitted to O-I Dang Korean Medicine Hospital from February 2018 to February 2019. The primary outcome was a change score in the Anorexia/Cachexia Subscale of Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes were Functional Assessment of Cancer Therapy-General (FACT-G), Trial Outcome Index(TOI) of FAACT, 11 point Pain Intensity Numeric Rating Score (11 PI-NRS) and Patient Global Impression of Change (PGIC) and adverse event. Results: Cachexia and quality of life in cancer patients assessed by FAACT, increased by $5.59{\pm}14.83$ (p=0.004) after treatment. PI-NRS was reduced by $2.10{\pm}1.81$ (p<0.001) and TOI and FACT-G total scores were increased by $5.17{\pm}11.70$ (p=0.001) and $3.59{\pm}10.94$ (p=0.012), respectively. These results were also clinically meaningful assessed via minimal clinically important difference (MCID). There was no severe adverse event. Conclusion: These findings suggest that comprehensive traditional Korean Medicine treatment might be effective and safe strategy for improving quality of life, anorexia, cachexia and pain of cancer patients. Further advanced studies with controlled group and more participants with rigorous design are needed to ensure these findings.

Anticachexic Effects of Kwibi-tang on Non-small Cell Lung Carcinoma, NCI-H520 Xenograft Mice (귀비탕(歸脾湯)이 비소세포 폐암세포(NCI-H520) 이식 마우스에서 악액질 억제에 미치는 영향)

  • Son, Ji-young;Kim, Kyung-soon;Choi, Hae-Yun;Kim, Jong-Dae
    • Journal of Korean Traditional Oncology
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    • v.20 no.2
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    • pp.23-36
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    • 2015
  • Purpose : The object of this study was to observe anti-cachexic effects of Kwibi-tang extracts (KBTe) on non-small cell lung carcinoma (squamous epithelial carcinoma), NCI-H520, xenograft Balb/c nu-nu nude mice. Methods : Three different dosages of KBTe, 50, 100 and 200 mg/kg were orally administered once a day for 42 days from 11 days after tumor cell inoculation. Six groups, each of 8 mice per group were used in the present study. Changes on the body weight, the epididymal fat weight and serum IL-6 levels were detected with the thicknesses of deposited cervical brown adipose tissue and their mean diameters to monitor the tumor-related anticachexic effects. Results : Deceases on the body weight and gains were also demonstrated in tumor-bearing control with increases of serum IL-6 levels, decreases of epididymal fat pad weight, atrophic changes of cervical brown adipose tissues. These are means that tumor-related cachexia are induced by tumor cell inoculations in the present study. However, these tumor-related cachexia were markedly inhibited by all three different dosages of KBTe treatment as compared with tumor-bearing control. 5-FU showed somewhat deteriorated the tumor-related cachexia in the present study. Conclusion : The results obtained in this study suggest that over 50 mg/kg of KBTe showed favorable anticachexic effects on the NCI-H520 cell xenograft. However, detail mechanism studies should be conducted in future with the screening of the biological active compounds in this herb.