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Researchers identify 'cancer anorexia'.

Some cancer patients appear to develop a specific type of anorexia that is not a direct effect of chemotherapy or the tumor itself but rather a "learned aversion" to specific foods they associate with their treatment or illness, according to a University of Washington at Seattle psychologist. Moreover, says the researcher, Ilene L. Bernstein, there is evidence that because the condition is behavioral as well as physiological, it can be at least partially corrected simply through a change in diet.

"Cancer patients develop aversions to foods eaten just before chemotherapy," Bernstein said last week in Los Angeles at the annual meeting of the American Psychological Association. "But we found that they will eat other foods."

Weight and appetite loss have historically been major problems with many such patients, and have generally been assumed to result directly from both the nausea-producing effects of chemotherapy and the chemical changes triggered by the tumor, says Bernstein. These mechanisms "clearly play a role" in cancer anorexia and in other cancer-rlated weight loss (see above), she acknowledges. But her research also indicates that not only do the learned aversions to chemotherapy-associated foods exist but "that tumor growth may also suppress appetite indirectly by producing chronic symptoms which act as ... stimuli in the acquisition of learned food aversions."

In the chemotherapy-related portion of her study, Bernstein looked at a total of 120 children receiving chemotherapy as outpatients at a Seattle clinic. One group of children was exposed to a "novel"-flavored ice cream jus prior to therapy, a control group received no ice cream and another group received ice cream, but not drugs. Two to four weeks later, the children were given a choice between eating the same ice cream or playing a game. "Patients in the experimental group were much less likely to choose to eat the ice cream than were patients in either control group," Bernstein reports. "Thus children will avoid eating a food which has previously been associated with...toxic chemotherapy."

In a separate study, rats implanted with tumor tissue and a control group of tumorless rats were first given continuous access for several days to a "complete rodent diet." Then, for 24 hours, they were given a choice between that diet and a novel one. "Tumor-bearing animals had developed a pronounced aversion to the [complete] diet, the diet available during recent tumor growth," says Bernstein. But, she adds, "we saw striking elevations in food intake...when an alternate food was available."

While these results "confirm" a learned food aversion, Bernstein suggests that because the aversion occurs only with certain tumors, there may also be a physiological component at work. Evidence indicates that this may involve the tumor's production of excessive toxins or hormones or its depletion of nutrients from the body. In either case, she says, it is theoretically possible to "balance" the system through diet, drugs or supplements.

She has already begun an intervention study with chemotherapy patients, using the novel ice cream as a "scapegoat taste" just prior to treatment. Preliminary results suggest that sacrificing one such food will enable patients to eat other foods and possibly prevent the anorexia.
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Author:Greenberg, Joel
Publication:Science News
Date:Aug 31, 1985
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