HORMONAL TREATMENT IN ADVANCED NONSMALL CELL LUNG-CANCER - FACT OR FICTION

In patients with advanced non-small cell lung cancer, cachexia is an i mportant cause of morbidity and mortality. The pathogenic mechanism of this finding, usually referred to as ''cancer anorexia and cachexia s yndrome'' (CACS), is complex and far from completely understood, but a disturbed equilibrium between possible food intake and metabolic need s seems to be fundamental, The literature data on the treatment option s in advanced non-small cell lung cancer (NSCLC) with cachexia are rev iewed. Based on the clinical studies on cancer cachexia, some recommen dations for the therapeutic approach of this disorder in patients with advanced NSCLC can be given, Metoclopramide is easily administered, c an alleviate gastric disturbances, but probably does not correct the c atabolic spiral of CACS, There are not enough data to advise the use o f parenteral nutritional support, hydrazine, cyproheptadine, tetrahydr ocannabinol or nandrolone decanoate, Corticosteroids are useful in add itional analgesia and fast palliation of very weak and debilitated pat ients in the final episode of their disease, Recent data in non-small cell lung cancer patients are in favour of the use of high-dose proges tagens to improve both appetite and weight.