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Megace and Weight Gain


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A study by researchers at Wake Forest University Baptist Medical Center and colleagues showed that a drug originally used to treat breast cancer may help combat the severe weight loss that can plague patients undergoing radiation treatment for lung and head and neck cancer.

"The drug clearly reduced weight loss and improved quality of life in study patients," said Michael Farmer, M.D., who presented his results to the American Society for Therapeutic Radiology and Oncology (ASTRO).

The research involved megestrol acetate (Megace), a synthetic form of the female hormone progesterone. The drug was originally used as an anti-hormonal treatment for breast cancer and was found to induce weight gain as a side effect. Later studies showed the drug's effectiveness as an appetite stimulant for patients with HIV, chronic diseases and cancer cachexia, a "wasting syndrome" in which fat and muscle are lost because of the presence of a cancerous tumor.

Weight loss can also be a problem in patients undergoing radiation treatment for lung cancer and cancers of the head and neck, such as cancer in the mouth or throat. The high doses of radiation used to treat these cancers can cause decreased appetite and weight loss, nausea and painful swallowing. These patients typically receive radiation alone or a combination of radiation and chemotherapy, which can worsen the side effects of treatment, particularly nausea.

"Due to the pain and nausea, it is very difficult for patients to eat sufficient quantities of food and drink proper amounts of fluid during treatment," said Farmer. "It is a critical time to maintain adequate food intake and hydration, yet one of the most frequent complaints from patients during this type of therapy is a decreased appetite."

Farmer said the expected mean weight loss among these patients is about 12 pounds after eight weeks of radiation therapy and that weight loss is a significant predictor of how well patients fare.

"Weight loss is correlated with decreased overall survival, decreased quality of life and decreased response to treatment," he said. "In addition, if the weight loss is severe enough, it can lead to breaks in treatment that may decrease the effectiveness of therapy."

The study involved 38 patients with lung cancer or cancer of the head and neck who were treated at Wake Forest Baptist or through four other centers. Twenty patients received megestrol acetate daily during eight weeks of radiation treatment and for 12 weeks afterwards. The remaining 18 patients received an inactive placebo during the same time period.

The mean weight for patients receiving megestrol acetate did not change significantly. However, the group receiving placebo had a mean weight loss of 11 pounds after 20 weeks.

Previous studies with megestrol acetate in cancer patients focused on patients with advanced cancer who were already receiving radiation or chemotherapy and had already begun to lose weight. In the current study, patients were given megestrol acetate from the start of treatment, to prevent weight loss.

"While we know that weight loss is associated with a poorer outcome, we don't know for certain that preventing weight loss will improve survival," said Farmer. "This issue has not been well studied and warrants more attention," Farmer said.

The safety of megestrol acetate has been well-documented in the previous studies. Farmer said, however, that patients should be screened for a risk of developing blood clots.

"While there is a small increased risk of blood clots in advanced cancer patients who take megestrol acetate, we did not observe this in our study patients," he said.

The research was conducted by the Comprehensive Cancer Center of Wake Forest University Research Base, a National Cancer Institute funded network of 93 community cancer centers in 19 states working with Wake Forest to conduct clinical trials in cancer patients. Wake Forest is one of only six NCI-designated Cancer Center Research Bases in the nation performing community-based cancer clinical trials.

Adapted from materials provided by Wake Forest University Baptist Medical Center.

Source: ScienceDaily

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When my wife was brought home from the hospital, she was an eighty-five pound weakling. I did some research about Megace and the concept that it could bring back the weight loss of cancer patients. Our local pharmacist said there would be a 50-50 chance that Megace could work at gaining her weight back. The only way to find out if it would work was to try it (although it is enormously expensive). Within three months, she gain back 2/3rds of her normal weight. Actually, she gain back all the desired weight she lost. She made an extremely good comback! Although, in the end, her PE would have been most attributed to the advanced stages of her chemo-radiation necrosis and not from the small increased risk of blood clots in advanced cancer patients who take Megace.

Years later, I received an email from the lead investigator of the study on Megace for weight gain at Wake Forest University Medical Center. I had related the experience my wife had with Meagace. My wife's experience was very informative for him and heightened his encouragement of his studies. His research study showed that Megace (megestrol acetate) may help combat the severe weight loss that can plague patients undergoing radiation treatment. He was then going to do a study to see if it improves survival in patients who have lost weight and then gain it back on the Megace. He was also looking at a new form of Megace called Megace ES, which may actually be a better formulation of Megace.

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We've talked about this a lot over the years and many of us suggest Megace for many of the patients here at LCSC.

I was on it too,(many moons ago) but my doc put me on it for HOT FLASHES when I was going through my chemo and after I completed chemo. It worked like a charm for stopping the hotflashes (which is one reason they gave it to breast cancer patients). And I also gained the pounds from it. I never in my life weighed over 140 and in a couple of months I was well over 160 and headed to 170. It wasn't fun taking off those pounds, but I did it!

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I found out about Megace in 1999, from the fine nurses at Penn State Hershey Medical Center. They had a plethora of information about alternative treatments, supplements, nutrition, etc. My wife's stay at Hershey was when I started to take control of the disease with a much better understanding of it, rather than letting it control her through rubber stamping treatment decisions from the oncologists at our local hospital. I just wished I would have started having that better understanding a few years before, although I was on the internet researching from 1996, but there wasn't much on the net back then. My wife was making a "comeback kid" of her own.

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