Anorexia iN Cancer Patients: Assessment of the Gut HORmone and Cytokine Profile and Body Composition, and the Impact of Dietetic Support in Patients With Gastrointestinal Cancer. (ANCHOR Study)
The rationale for this study is to prospectively investigate the outcomes of patients undergoing standard dietetic interventions alongside treatment for their advanced gastrointestinal cancers, and to further characterise the relationship with body composition. A number of patients will be enrolled in a sub-study investigating the neuronal-enteroendocrine-hypothalamic axis. Gut hormone study. Our hypothesis is that proinflammatory cytokines produced by the tumour can not only affect appetite directly through the vagal and the central melanocortin system but also indirectly though the enhanced EEC activity; either through increased number or increased function. In this study, the investigators will explore and compare the pattern and levels (pre-prandial and post prandial) of the pro-inflammatory cytokines and gut hormones between stage-standardised anorexic and non-anorexic cancer patients and age-matched healthy controls.
• Inclusion criteria: Cohort A
∙ Patients with stage IV gastric or GOJ adenocarcinoma or locally advanced non-resectable adenocarcinoma
‣ Histologically proven adenocarcinoma, squamous cell carcinoma or poorly differentiated carcinoma
‣ Patients should be chemotherapy or immune therapy naïve (for their current diagnosis).
‣ Patient must be 18 years of age or above.
‣ Patient must be able to understand the study information given to them and be willing to give consent for trial participation.
‣ Patients should be commencing a course of palliative chemotherapy treatment with the upper GI team at the Christie Hospital
• In addition the above patients enrolled in cohort B must meet the following criteria
• 1\. Be physically able to perform moderate exercise (to their own tolerance) on a stationary bicycle or treadmill
• In addition to the above patients in cohort C must meet the following criteria
⁃ Histologically proven adenocarcinoma or poorly differentiated carcinoma
⁃ Patients should be chemotherapy or immune therapy naïve.
⁃ Patients must be able and willing to fast for 8-10 hours. 4 5.1 Patients in the anorexic group must have completed the FAACT AC/S questionnaire and scored ≤24 in total score and ≤ 2 in the appetite specific question.
• 2 For inclusion in the non-anorexic group patients must have completed the FAACT AC/S questionnaire; the total score should be \> 37 and ≥3 for the appetite specific question.
⁃ Participants must be 18 years of age or above.
⁃ Participants must be able and willing to fast for 8-10 hours.
⁃ Participants must be able to understand the study information given to them and be willing to give consent for trial participation.
⁃ Participants must have completed the FAACT AC/S questionnaire and scored ≤24 in total score and ≤ 2 in the appetite specific question, for the anorexic group. For inclusion in the non-anorexic group the total score should be \> 37 and ≥3 for the appetite specific question.