Re: unexpected weight loss...what are its parameters?

From: Matti Narkia (mnng1_REMOVE_THIS_at_despammed.com)
Date: 08/03/04 

Date: Wed, 04 Aug 2004 00:16:40 +0300

2 Aug 2004 23:15:34 -0700 in article
<8aedb098.0408022215.755a9504@posting.google.com> kawika_sw@yahoo.com
(RIchard Nguyen) wrote:

>Hi..Im posing this message for the group and any MD's out there who
>would like to answer. I lost 12 pounds in 6 weeks (formal stable
>weight of 192) and went down to 181 and stayed there (179 in the
>morning)for about 4 weeks now. I was exercising and feeling good. Then
>the weight loss happened and I had insomnia and depression. I went to
>the GI man who did a CT and a abdominal ultrasound...all negative. But
>I cant seem to put back on the weight EXCEPT when I decrease or stop
>the exercise routine. So I can only gain back when I stop
>exercising..and when I do..I go back towards 181 again. Just how does
>the unexpected weight loss work? With cancer..can you go back up? Im
>thinking of getting a ERCP...even if I have to pay for it with out of
>my pocket...I need information from the group and informed individuals
>to help me make a decision.
>
I'm sure there could be many reasons for weight loss (cachexia), two
possibilities which first come to my mind are cancer and severe chronic
infection or inflammation. In both cases inflammatory cytokines TNF-alpha
(tumor necrosis factor alpha) and IL-6 (interleukin-6) have been identified
as likely culprits. In cancer cachexia long-term supplementation with very
large doses of fish oil or its fatty acid EPA have been found helpful (they
have anti-inflammatory effect and reduce at least IL-6 levels and
leukotriene production) by some studies. Anti-inflammatory drugs such as
indomethacin or celecoxib may also help in some cases.

For more information do PubMed (www.pubmed.gov) and google group searches
with various combinations of keywords cachexia, cancer IL-6 (or
interleukin-6), TNF-alpha, "fish oil", EPA.

Below some studies I was able to find with a very quick PubMed search:

Cancer cachexia.
Langenbecks Arch Surg. 2004 May 28 [Epub ahead of print]
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15168125>

Fathalla B, Hamada K, Vannier E, Smith D, Edwards C 3rd, Roubenoff R.
Effects of aging and cytokine blockade on inflammatory cachexia.
Clin Exp Rheumatol. 2004 Jan-Feb;22(1):85-90.
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15005009>

Walsmith J, Abad L, Kehayias J, Roubenoff R.
Tumor necrosis factor-alpha production is associated with less body cell
mass in women with rheumatoid arthritis.
J Rheumatol. 2004 Jan;31(1):23-9.
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14705214>

Catalano MG, Fortunati N, Arena K, Costelli P, Aragno M, Danni O, Boccuzzi
G.
Selective up-regulation of tumor necrosis factor receptor I in tumor-bearing
rats with cancer-related cachexia.
Int J Oncol. 2003 Aug;23(2):429-36.
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12851692>

Zaki MH, Nemeth JA, Trikha M.
CNTO 328, a monoclonal antibody to IL-6, inhibits human tumor-induced
cachexia in nude mice.
Int J Cancer. 2004 Sep 10;111(4):592-5.
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15239138>

Davis TW, Zweifel BS, O'Neal JM, Heuvelman DM, Abegg AL, Hendrich TO,
Masferrer JL
Inhibition of cyclooxygenase-2 by celecoxib reverses tumor-induced wasting.
J Pharmacol Exp Ther. 2004 Mar;308(3):929-34. Epub 2004 Jan 07.
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14711936>

Argiles JM, Busquets S, Lopez-Soriano FJ.
Cytokines in the pathogenesis of cancer cachexia.
Curr Opin Clin Nutr Metab Care. 2003 Jul;6(4):401-6. Review.
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12806213>

Tisdale M. J.
Biology of cachexia.
J. Natl. Cancer Inst., 89: 1763-1773, 1997
<URL:http://jncicancerspectrum.oupjournals.org/cgi/content/abstract/jnci;89/23/1763?ijkey=2ff3fc3b900f6c600694bf2da6c2b29d279961ea&keytype2=tf_ipsecsha>
<URL:http://jncicancerspectrum.oupjournals.org/cgi/reprint/jnci;89/23/1763.pdf?ijkey=2ff3fc3b900f6c600694bf2da6c2b29d279961ea>

Tisdale MJ.
Inhibition of lipolysis and muscle protein degradation by EPA in cancer
cachexia.
Nutrition. 1996 Jan;12(1 Suppl):S31-3.
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8850217>

Tisdale M. J., Beck S. A.
Inhibition of tumour-induced lipolysis in vitro and cachexia and tumour
growth in vivo by eicosapentaenoic acid.
Biochem. Pharmacol., 41: 103-107, 1991
<URL:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=1846070&dopt=Abstract>

Burns CP, Halabi S, Clamon GH, Hars V, Wagner BA, Hohl RJ, Lester E,
Kirshner JJ, Vinciguerra V, Paskett E.
Phase I clinical study of fish oil fatty acid capsules for patients with
cancer cachexia: cancer and leukemia group B study 9473.
Clin Cancer Res. 1999 Dec;5(12):3942-7.
<URL:http://clincancerres.aacrjournals.org/cgi/content/full/5/12/3942> 

-- 
Matti Narkia

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