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Diet problems research

Research helps us to find out more about diet problems with cancer. Researchers are looking at the causes, prevention and treatments of diet problems including drug therapy, food supplements and exercise.

Researching diet problems

Why we need research

We have to fully research all treatments before they can become standard treatment for everyone. This is so that we can be sure they are safe and work better than the treatments we already use.

Research into diet problems

There is ongoing research into new ways of treating diet problems and cancer.

Doctors can only use these treatments once the researchers have completed the studies and found that it works.

Scientists have developed better drugs to help control sickness in the last 20 years. But a lot of research in nutrition and cancer has been into preventing cancer through diet. There hasn’t been much research into cachexia. This is now changing.

One trial looked at certain biomarkers in the blood. It helped researchers to see who were likely to develop cachexia. The researchers suggested that further trials are necessary.

Drug therapy: drugs that block cytokine

Scientists know that natural chemicals, such as cytokines, cause weight loss and cachexia. Knowing this, they are trying to find drugs to help block cytokines.

There are clinical trials that use thalidomide in people with cachexia. This drug got a bad name for causing birth defects in the late 1950s and early 1960s.  But it is only dangerous if taken in pregnancy.

It seems to interfere with certain cytokines in cachexia. Early trial results suggested that thalidomide improved appetite. It also helped to control sickness in people with cachexia. There is not enough information to recommend it as a treatment at the moment.

We are awaiting the results of a study where researchers have used thalidomide to see if it helps with cachexia.

Another study is looking at a new drug BYM338 to help build up muscle and help to stop weight loss.

BYM338 is a drug that blocks a substance called myostatin. Myostatin controls muscle growth. By blocking it muscle is able to grow.

We are awaiting the results of this study.

Drug therapy: drugs that improve appetite

These drugs are called appetite stimulants. Doctors use them for people with cachexia. They help some people but not others. The two drugs often used are megestrol acetate and medroxyprogesterone acetate.

Megestrol

A  research review showed that megestrol acetate increases appetite and weight gain. But it was no more effective than steroids. Both types of drugs have side effects. So we need more research to find out how much megestrol acetate improves quality of life.

Cannabinoids

Researchers are also looking at cannabinoids as appetite stimulants. These are drugs made from the cannabis plant, also known as marijuana. Some studies found that smoking cannabis or eating it could help to control sickness and pain. Also that it could increase appetite. Another phase 3 trial failed to show that cannabinoids improved appetite or quality of life. Neither did it seem to help people put on weight.  

Anamorelin

Ghrelin is an appetite regulating hormone found in the stomach lining. Anamorelin is a new drug that mimics this hormone and improves appetite.

Two large trials (ROMANA 1 and 2) showed that anamorelin increased both body mass and body weight. It was in people with advanced non small cell lung cancer and cachexia. The increase in body mass suggests an increase in muscle and strength. But these studies did not prove this. The researchers suggested that anamorelin is safe. Also that it is effective as a treatment for anorexia and cachexia.

Steroids

Steroids can help improve appetite and food intake when you have cachexia. Your sense of well being might also improve. Steroids don't tend to help you put on weight. You are more likely to gain weight from fluid retention. 

Non steroidal anti inflammatory drugs

Some scientists believe that cachexia may be because of inflammation due to cancer. This made them look at the use of non steroidal anti inflammatory drugs (NSAIDs). They wanted to see if it helps people with malnutrition. They found that the drug indomethacin might be helpful.

Another study looked at the use of the drug celecoxib, exercise and diet advice, and a nutritional supplement for people with cachexia. The study found that these treatments were safe to use in people with cachexia. The researchers want to look at these combined treatments in more detail.

Anti inflammatory drugs can be harmful. Do not take them regularly without checking with your doctor. Especially if you have a stomach ulcer, bleeding disorders or are taking drugs to thin your blood (warfarin or heparin).

Omega 3 food supplements

Researchers are looking at supplements that might help people with cachexia. One such nutrient is fish oil, which contains omega 3 fatty acids.

Increasing omega 3 in your diet

Omega 3 fatty acids are chemicals that the body needs to function in a normal way. But they are not made in the body. We have to get them from our diet.  

Foods rich in omega 3 fatty acids include oily fish like:

  • mackerel
  • salmon
  • tuna
  • sardines

They are also in several oils, including:

  • rapeseed
  • linseed
  • walnut
  • soya
  • flax

Dark green vegetables also contain a little omega 3.

Taking fish oil supplements

There are 3 fatty acids that make up omega 3: 

  • alpha linolenic acid
  • eicosapentaenoic acid 
  • docosahexaenoic acid

These fatty acids can prevent cancer in animals. This may also be the case with humans, but we have no evidence of that yet.

There is not enough evidence to support the use of omega 3 in cachexia in people with advanced cancer. People taking it did not have any severe side effects.

The side effects of these supplements are mild to moderate and include:

  • loose, fatty looking bowel motions
  • fishy tasting burps

Antioxidants and cancer prevention

Some scientists believe that antioxidant vitamins and minerals may help to prevent cancer. This is when it forms part of a healthy, balanced diet. Early stage trials suggested that they might help prevent cachexia.

In theory, antioxidants help protect body cells from damage. This damage is from oxygen particles called free radicals. But doctors don't advise antioxidants, vitamin and mineral supplements for people with cancer. There is no proof that they help. Especially not a higher dose than the Recommended Daily Allowance (RDA).

Antioxidant research

A research review did not recommend the use of the following supplements in people with cancer cachexia:

  • minerals
  • vitamins
  • proteins
  • other supplements

There were no severe side effects with taking these supplements. The researchers feel we need more research to see if supplements are safe and effective. Only then doctors can recommend it. 

In a recent study, researchers have looked at whether a supplement powder given in combination with a support programme, can help stop weight and muscle loss. We are awaiting the results of this study.

Cachexia in people with cancer is a very complex problem. Finding ways to successfully manage and control it will need a lot more research. Many scientists believe that combinations of treatments will be needed.

Exercise and cachexia

Some studies show that exercise may help with cachexia.

Researchers looked at progressive resistance exercise training (PRT). PRT makes use of a low number of muscle movements. You do it against resistance that increases. 

It may increase muscle mass and strength. It may also help with physical functioning and quality of life.

We need more research to see how well this exercise works. 

Cancer drugs for muscle wasting

Xilonix is a type of biological therapy called a monoclonal antibody. It may help to stop or slow down cancer growth. An earlier study showed that Xilonix helped people to regain some muscle mass. These people lived for longer than people who did not have an improvement in muscle mass. It also slowed the growth of cancer in some people.

Researchers are looking at how well Xilonix can reduce muscle wasting and symptoms in people with bowel cancer. They also want to see if Xilonix can improve quality of life. We are awaiting results of this study.

Last reviewed: 
20 Oct 2017
  • Emerging markers of cachexia predict survival in cancer patients

    P Mondello and others

    BMC Cancer 2014, 14:828

  • Randomized Phase III Clinical Trial of Five Different Arms of Treatment in 332 Patients with Cancer Cachexia

    G Mantovani and others

    Oncologist. 2010 February; 15(2): 200–211.

  • A systematic review on the role of fish oil for the treatment of cachexia in advanced cancer: an EPCRC cachexia guidelines project.

     A Ries and others

     Palliative Medicine. 2012 June;26(4):294-304. 

  • Cancer cachexia prevention via physical exercise: molecular mechanisms

    D Gould and others

    Journal of Cachexia Sarcopenia and Muscle. 2013 June;4(2):111-24

  • Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials
    J Temel and others
    The Lancet Oncology Volume 17, No. 4, p519–531, April 2016

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