Conclusions

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The metabolic alterations in progressive cancer have many parallels to other conditions with chronic systemic inflammation, and differ in some respect to the metabolic changes in pure starvation. Artificial nutrition alone does not appear to affect overall survival in advanced cancer, but nutritional support in combination with treatment targeted to the inflammation and subsequent metabolic abnormalities seems to be of greater value. Appetite stimulants can improve anorexia and thereby also energy balance, but the duration of the therapeutic effects is less impressive so far. Thus, early-intervention therapeutic strategies aimed at modulating mediators of the catabolic response, such as cytokines and eicosanoids, in combination with maintaining an adequate supply of nutrients may be most rewarding.

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25 "I—<—i—'—I—1—I—I—I—■—r •' "T" *• T T "<—r r •'— 0 1000 2000 3000 4000 5000

Caloric intake (Kcal/day)

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