Neary, N.M., Small, C.J., Wren, A.M., Lee, J.L., Druce, M.R., Palmieri, C., . . . Bloom, S.R. (2004). Ghrelin increases energy intake in cancer patients with impaired appetite: Acute, randomized, placebo-controlled trial. Journal of Clinical Endocrinology and Metabolism, 89, 2832–2836.

To determine whether ghrelin stimulates appetite in patients with cancer who have anorexia. Ghrelin is an appetite-stimulating hormone.

Patients received ghrelin (5 pmol/kg/min) or saline; four patients received ghrelin then saline (n = 4) or saline followed by ghrelin (n = 3).

• The study reported on a sample of seven patients with metastatic cancer experiencing appetite loss and a mean weight loss of 13%.
• Patients were assigned numbers in order of recruitment.
• The sample was comprised of six females and one male, with an age range of 41–66 years.

Patients were recruited from oncology clinics at Charing Cross Hospital (United Kingdom).

The study was a prospective, randomized, placebo-controlled, crossover clinical trial.

• Edmonton Symptom Assessment Scale (for appetite as an individual item and all nine items as an overall measure of quality of life)
• Energy intake from a buffet meal designed to be in excess
• Meal appreciation assessed through visual analog scales (0–100 scale to the prompt “how pleasant was this meal?”)
• 24-hour food intake completed after each infusion through the use of food diaries
• Plasma ghrelin, insulin, glucose, triglyceride, and growth hormone levels

Energy intake from a buffet meal during saline or ghrelin infusion indicated there was a 31% increase in energy intake in patients during the ghrelin infusion, and greater meal appreciation (by 28 +/- 8%). No side effects of the ghrelin therapy were observed. No changes were reported in levels of insulin, glucose, or triglycerides. Patients recorded greater food consumption on the days they received the ghrelin.

Further investigations are needed before conclusions can be drawn.

• The study had a small sample size.
• Ghrelin had been administered to only 100 patients worldwide at the time of this investigation.
• The long-term effects of ghrelin have not yet been established.