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Appetite and Cancer-Associated Anorexia: A Review

From the Harry R. Horvitz Center for Palliative Medicine, Department of Hematology/Medical Oncology; the Cleveland Clinic Foundation, and the Cleveland Clinic Taussig Cancer Center Cleveland, OH

Address reprint requests to Mellar P. Davis, MD, FCCP, Cleveland Clinic Foundation, 9500 Euclid Ave, R35, Cleveland, OH 44195; e-mail: davism6{at}ccf.org

Appetite is governed by peripheral hormones and central neurotransmitters that act on the arcuate nucleus of the hypothalamus and nucleus tactus solitarius of the brainstem. Cancer anorexia appears to be the result of an imbalance between neuropeptide-Y and pro-opiomelanocortin signals favoring pro-opiomelanocortin. Many of the appetite stimulants redress this imbalance. Most of our understanding of appetite neurophysiology and tumor-associated anorexia is derived from animals and has not been verified in humans. There have been few clinical trials and very little translational research on anorexia despite its prevalence in cancer.

A WHO project in palliative medicine.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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