The Immediate Causes of Death in Cancer

Warren, Shields

doi:10.1097/00000441-193211000-00002

Cited by 408 publications

(156 citation statements)

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“…It is a major factor of mortality in cancer patients (Warren, 1932). Cancer cachexia is characterised by anorexia and depletion of lipid and proteins of the host (Mider et al, 1948;Rechcigl et al, 1961;Lundholm, 1986).…”

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Body protein and lipid deficit in tumour-bearing rats in relation to age

Oudart¹,

Heitz²,

Bnouham³

et al. 1993

Br J Cancer

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Summary Cancer cachexia is among the most dramatic situations of depletion in body energy reserves. To ascertain whether the pattern of body composition alteration during tumour development is influenced by aging as in uncomplicated starvation, we compared the difference of body composition between Yoshida sarcoma bearing rats and young (200 g, 7 weeks) and adult (400 g, 13 weeks) control rats. After the same duration of tumour bearing, mass and composition of tumours were similar in adult and young rats, indicating that they are independent of host age. Food intake decreased to a remarkably similar value in both young and adults. Body water content was elevated in hosts of both ages. The relative deficit of body lipid vs controls was similar for both, the absolute lipid deficit being therefore larger in adult than in young tumour-bearing rats (14.3 ± 4.4 g vs 6.8 ± 0.9 g; P<0.01). In contrast, there was a relatively larger deficit of body protein in young rats. Paradoxically, these rats still maintained a positive nitrogen balance whereas this balance was negative in adult tumour-bearing rats. In conclusion, as previously shown in uncomplicated undernutrition, the anorexia induced by Yoshida sarcoma development is still associated with some protein accretion in young rats whereas cachexia develops in adults.Cachexia, a wasting of the host reserves, is a common feature in tumour-bearing animals (Rechcigl et al., 1961) and humans (Costa, 1977). It is a major factor of mortality in cancer patients (Warren, 1932). Cancer cachexia is characterised by anorexia and depletion of lipid and proteins of the host (Mider et al., 1948;Rechcigl et al., 1961;Lundholm, 1986). However, the anorexia accompanying cancer cachexia is not entirely responsible for the concomitant metabolic alterations, since pair-fed rats show a better body mass conservation than tumour-bearing rats (Lundholm et al., 1980;Tisdale, 1991). Although cytokines seem to play a major role in the wasting of host reserves (Tracey, 1992), the reason for the depletion of lipid and protein reserves has not been totally elucidated.During starvation, another situation in which body fuel reserves are depleted, the age of rats plays a major role in the mobilisation of lipid and protein reserves, through the initial availability in body lipids (Goodman et al., 1980). Similarly, the changes in body protein and lipid during underfeeding differ between young and adult rats (Widdowson & McCance, 1956). In tumour-bearing rats, total starvation increases tumour growth rate in adult, not in immature rats (Sauer et al., 1986). Thus, one possible way to investigate how body fuel reserves of the host are depleted during tumour bearing and how they influence the tumour growth is to compare rats of different ages.As a first approach, we studied the protein and lipid deficit of the host after the same duration of tumour development in young (200 g, 7 weeks old) and adult rats (400 g, 13 weeks old).

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Body protein and lipid deficit in tumour-bearing rats in relation to age

Oudart¹,

Heitz²,

Bnouham³

et al. 1993

Br J Cancer

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“…Cancer cachexia is an important cause of death in cancer patients (Warren, 1932), and in addition patients with cachexia display a reduced response to chemotherapy (van Eys, 1982). Cachexia is charaterised by progressive weight loss, and catabolism of host body compartments, particularly muscle and adipose tissue, is observed.…”

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Cancer cachexia

Tisdale¹

1991

Br J Cancer

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“…More than 80% of hospitalised cancer patients show evidence of protein-energy undernutrition (Nixon et al, 1980) and cachexia is a major contributing factor to mortality in patients with malignant disease (Warren, 1932). Often, the side effects of ineffective antineoplastic therapy exacerbate the nutritional consequences of progressive tumour growth.…”

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confidence: 99%