ABSTRACT

The reduction or loss of appetite is defined as anorexia and it is a frequent condition during several chronic diseases, including cancer, impacting on patient's prognosis and quality of life. The pathophysiology of cancer anorexia is complex and involves different domains influencing eating behavior. Peripheral or central mechanisms can be recognized at the basis of cancer-associated anorexia: substances released from or by the tumor, that is, pro-inflammatory cytokines or peptides modifying food intake, increased peripheral tryptophan concentration leading to increased central serotonin, modifications of release of peripheral hormones that alter eating, physical obstructions causing dysphagia or altering nutrients intake. Most of the substances produced and released in periphery may also interact with the nervous system by transmitting central signals. The correct identification of appetite dysregulation in cancer may help physicians to implement tailored treatments aimed at avoiding the development of body weight loss and malnutrition.