How can cachexia be prevented in cancer patients receiving aggressive protocols involving radiation and chemotherapy?

1. Introduction
   1. This chapter is a review of the most recent literature about cachexia in cancer patient treated with chemotherapy and radiation.  Does radiation exposure increase the risk of cachexia compared to chemotherapy in patients receiving aggressive protocols? How can cachexia be prevented in cancer patients receiving aggressive protocols involving radiation and chemotherapy? What is the process by which patients receiving aggressive protocols involving radiation and chemotherapy are diagnosed, treated, and managed? Google Scholar and Carson Newman University web-based library was used to gather literature on the topic.  The incidence and current treatment of cachexia will be discussed.  A description of the onset and course of the disorder for patient’s both on radiation therapy and chemotherapy will be included.  In addition, research about its new treatment options will be examined.   Finally, the most recent research findings will be considered, results summarized, and a conclusion about the current knowledge surrounding this topic.
   2. Key Terms
2. Cachexia in Cancer Patients
   1. What is cachexia?
   2. Early Signs and Symptoms
   3. Prevention
   4. Radiation vs. Chemotherapy vs. Tumor Growth
   5. Diagnosis and Grade of Cachexia
   6. Recovery and Mortality

• Treatment for Cancer Patients Diagnosed with Cachexia
  1. Current management
  2. Pallative and Treatment of Symptoms
  3. Nutritional Support
  4. Administration of Megastrol acetate
  5. Growth hormone and anabolic steroids
  6. Metformin
  7. Physical Activity

1. Previous Research
   1. Studies available regarding cachexia caused by chemotherapy and radiation
   2. Lack of Quantitative Research Trials
   3. Inconclusive Studies
2. Conclusion

Reference

Aoyagi, T., Terracina, K. P., Raza, A., Matsubara, H., & Takabe, K. (2015). Cancer cachexia, mechanism and treatment. World journal of gastrointestinal oncology, 7(4), 17–29. https://doi.org/10.4251/wjgo.v7.i4.17

Auger, C., Knuth, C. M., Abdullahi, A., Samadi, O., Parousis, A., & Jeschke, M. G. (2019). Metformin prevents the pathological browning of subcutaneous white adipose tissue. Molecular metabolism, 29, 12-23. https://doi.org/10.1016/j.molmet.2019.08.011

Cui, W., Bennett, A., Zhang, P. et al. (2016). A non-human primate model of radiation-induced cachexia. Sci Rep 6, 23612 https://doi.org/10.1038/srep23612

Damrauer, J. S., Stadler, M. E., Acharyya, S., Baldwin, A. S., Couch, M. E., & Guttridge, D. C. (2018). Chemotherapy-induced muscle wasting: association with NF-κB and cancer cachexia. European journal of translational myology, 28(2), 7590. https://doi.org/10.4081/ejtm.2018.7590

Dev, R., Wong, A., Hui, D., & Bruera, E. (2017, January 15). The Evolving Approach to Management of Cancer Cachexia. Retrieved from https://www.cancernetwork.com/oncology-journal/evolving-approach-management-cancer-cachexia

Gorenc, M., Kozjek, N. R., & Strojan, P. (2015). Malnutrition and cachexia in patients with head and neck cancer treated with (chemo)radiotherapy. Reports of Practical Oncology & Radiotherapy, 20(4), 249–258. doi: 10.1016/j.rpor.2015.03.001

Gullett, N. P., Hebbar, G., & Ziegler, T. R. (2010). Update on clinical trials of growth factors and anabolic steroids in cachexia and wasting. The American journal of clinical nutrition, 91(4), 1143S–1147S. https://doi.org/10.3945/ajcn.2010.28608E

Joppa, M., Gogas, K., Foster, A., & Markison, S. (2007). Central infusion of the melanocortin receptor antagonist agouti-related peptide (AgRP(83-132)) prevents cachexia-related symptoms induced by radiation and colon-26 tumors in mice. Peptides, 28(3), 636–642. doi: 10.1016/j.peptides.2006.11.021

Tisdale, M. (2002). zCachexia in cancer patients. Nat Rev Cancer 2, 862–871 https://doi.org/10.1038/nrc927

Yeh, S. S., & Schuster, M. W. (2006). Megestrol acetate in cachexia and anorexia. International journal of nanomedicine, 1(4), 411–416.  doi: 10.2147/nano.2006.1.4.411