Adrenocortical Carcinoma (Tumor of the Adrenal Cortex) in Dogs
- Occurrence: very rare
- Location of illness: Abdomen/pelvis
An adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. is a rare, malignantMalignant means "cancerous" and is used to describe tumors or neoplasms that grow invasively and have the ability to metastasize. Malignant tumors can cause serious health problems in dogs and cats. tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. that originates in the adrenal cortex of dogs and affects the hormone-producing tissue of these glands.
BASICS/CAUSES:
The adrenal glands are small, triangular glands located above the kidneys. They consist of two main parts: the inner medulla and the outer cortex. The cortex is responsible for producing vital hormones such as cortisolCortisol is a steroid hormone produced in the adrenal cortex. It plays an important role in the body's stress response, as well as in the metabolism of proteins, lipids, and carbohydrates. Cortisol also helps regulate blood sugar levels and suppress the immune system., aldosteroneAldosterone is a hormone produced by the adrenal cortex. It regulates the body's salt and water balance by promoting sodium reabsorption in the kidneys, thereby influencing blood pressure., and sex hormones. These hormones regulate numerous bodily functions, including metabolism, blood pressure, and stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. responses.
In adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer., cancerCancer refers to the uncontrolled proliferation of cells that can lead to tumors or spread throughout the body. Various types of cancer occur in dogs and cats, ranging from skin cancer to lymphomas. cells grow uncontrollably in the cortex of the adrenal glands. This can lead to overproduction or, more rarely, underproduction of these hormones, causing various health problems. The exact causes for the development of these tumors are not fully understood, but genetic factors and possibly environmental factors play a role.
Genetic predispositions may play a role in certain dog breeds, although no specific breed has been clearly identified. There is evidence that chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. and environmental toxins may increase the risk, but further research is needed to confirm these factors definitively.
The most important facts at a glance
Adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. is a rare but aggressive tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. of the adrenal cortex in dogs, which is often hormonally active and clinically associated with Cushing’s syndromeA syndrome is a group of symptoms that occur together and indicate a specific disease or condition. A syndrome can be caused by various factors and is often complex in its diagnosis and treatment.. The primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. is surgical removal, which requires precise diagnostics and specialized surgical technique. In inoperable cases, hormonal production can be controlled with medication. The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. depends strongly on the metastasisA metastasis is a secondary tumor that originates from a primary, malignant tumor in another part of the body. Metastases indicate that cancer has spread in the body. and resectability (how well a tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. can be surgically removed).
Causes
The exact causes are unknown, but genetic factors may play a role.
- Hormonal dysregulation: A malignantMalignant means "cancerous" and is used to describe tumors or neoplasms that grow invasively and have the ability to metastasize. Malignant tumors can cause serious health problems in dogs and cats. tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. in the adrenal cortex can lead to excessive cortisolCortisol is a steroid hormone produced in the adrenal cortex. It plays an important role in the body's stress response, as well as in the metabolism of proteins, lipids, and carbohydrates. Cortisol also helps regulate blood sugar levels and suppress the immune system. production. Rarer variants produce aldosteroneAldosterone is a hormone produced by the adrenal cortex. It regulates the body's salt and water balance by promoting sodium reabsorption in the kidneys, thereby influencing blood pressure. or sex hormones.
- Genetic factors: While there is no clearly defined breed predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases. for adrenocortical carcinomas in dogs, familial clustering is discussed in individual cases. In human medicine, mutations in tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. suppressor genes (e.g., TP53) are known, and a transfer to veterinary medicine is being researched.
- Breed prevalence: Certain dog breeds such as poodles, dachshunds, and beagles are more likely to show Cushing’s syndromeA syndrome is a group of symptoms that occur together and indicate a specific disease or condition. A syndrome can be caused by various factors and is often complex in its diagnosis and treatment. – however, this is mostly pituitary-related. An adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. as the cause is possible, but overall less common.
The exact pathogenesisPathogenesis describes the process of the origin and development of a disease, including the mechanisms that lead to the disease's symptoms and signs. of adrenocortical carcinomas has not been fully clarified. Genetic factors, chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. hormonal dysregulation, and environmental carcinogens are suspected of promoting the development. In human medicine, familial clustering has been described in the context of tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. syndromes, but this has not yet been proven in dogs. Hormonally active carcinomas can be influenced by autocrine stimulation of growth. Adrenocortical adenomas can degenerate, but a transition to carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. is rarely documented. A connection with previous glucocorticoid therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. has not been clearly clarified, but is the subject of ongoing research.
Symptoms
The symptoms of adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. can be varied and often depend on whether the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. is hormonally active. Owners often report increased thirst and increased urination in their dogs. This symptom is often accompanied by a change in appetite, which can be either increased or decreased.
Dogs may also show signs of Muscle weakness or wasting, especially in the hind legs. Furthermore, changes in the coat or skin problems can occur, such as Hair loss and thin, sensitive skin. In some cases, dogs may also Weight gain or develop a distended abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen., which may indicate an enlarged liver or spleen.
In advanced cases or if the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. has metastasized, general weakness, lethargy, and in some cases neurological symptoms such as Behavioral changes or Convulsions may occur. Because the symptoms are so varied, an accurate diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is crucial.
Diagnosis
The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. of adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. usually begins with a thorough clinical examination and a detailed medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits.. Blood tests are essential to check hormoneHormones are chemical messengers produced by endocrine glands and released into the bloodstream to affect specific cells or organs in the body. They regulate numerous bodily functions, including growth, metabolism, and reproduction. levels and rule out other possible causes of the symptoms. A special test, known as the ACTH stimulation testThe ACTH stimulation test is a diagnostic procedure used to check the function of the adrenal cortex. It tests the adrenal glands' response to adrenocorticotropic hormone (ACTH) to diagnose conditions such as Cushing's disease or Addison's disease in dogs and cats., can be used to assess the function of the adrenal glands.
Imaging procedures such as ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. and computed tomography (CT)Computed tomography (CT) is an imaging technique that uses X-rays and computer technology to create cross-sectional images of the body. It enables a detailed view of bones, organs, and other structures and is used for the diagnosis of injuries, diseases, and for planning medical interventions. are helpful in determining the size and location of the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. and determining whether it is spreading to surrounding tissue or has formed metastasesA metastasis is a secondary tumor that originates from a primary, malignant tumor in another part of the body. Metastases indicate that cancer has spread in the body.. An MRI can also be performed to obtain more detailed information. A biopsyA biopsy is a medical procedure in which a small amount of tissue is removed from the body to be examined under a microscope for signs of disease. Biopsies can help diagnose cancer and other conditions. may be necessary to confirm the diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients., especially if a malignantMalignant means "cancerous" and is used to describe tumors or neoplasms that grow invasively and have the ability to metastasize. Malignant tumors can cause serious health problems in dogs and cats. tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. is suspected.
In some cases, scintigraphy can be used to further evaluate the function of the adrenal glands. These comprehensive diagnostic measures are crucial to determine the best treatment strategy.
Therapy
The primary treatment for adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. is surgical removal of the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions., if possible. The surgery can be complicated, especially if the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. is large or has spread to surrounding tissue. In some cases, complete removal is not possible, and palliativePalliative refers to treatments that aim to alleviate the symptoms of a disease without curing the disease itself. Palliative care focuses on improving the quality of life of patients with incurable diseases. treatment is considered.
After surgery, chemotherapyChemotherapy refers to the treatment of diseases, especially cancer, with chemical substances or drugs. It aims to kill cancer cells or prevent their growth, but can also affect healthy cells. or radiation therapyRadiation therapy is the use of radiation, most often to treat cancer. It can be used to kill cancer cells or slow their growth without significantly damaging surrounding healthy tissue. may be used to fight any remaining cancerCancer refers to the uncontrolled proliferation of cells that can lead to tumors or spread throughout the body. Various types of cancer occur in dogs and cats, ranging from skin cancer to lymphomas. cells. The choice of treatment often depends on the size of the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions., its location, and the presence of metastasesA metastasis is a secondary tumor that originates from a primary, malignant tumor in another part of the body. Metastases indicate that cancer has spread in the body.. HormoneHormones are chemical messengers produced by endocrine glands and released into the bloodstream to affect specific cells or organs in the body. They regulate numerous bodily functions, including growth, metabolism, and reproduction. therapies can also be used to relieve symptoms, especially if the tumor was hormonally active.
Medications to control hormoneHormones are chemical messengers produced by endocrine glands and released into the bloodstream to affect specific cells or organs in the body. They regulate numerous bodily functions, including growth, metabolism, and reproduction. production and relieve symptoms may also be part of the treatment. Close monitoring of the dog through regular veterinary visits is crucial to assess the success of the treatment and detect any complications early.
Prognosis and follow-up care
The prognosis for dogs with adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. varies greatly and depends on several factors, including the size of the tumor, the presence of metastasesA metastasis is a secondary tumor that originates from a primary, malignant tumor in another part of the body. Metastases indicate that cancer has spread in the body., and the response to treatment. If the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. is detected early and completely removed, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. can be relatively favorable.
In cases where the tumor has metastasized or cannot be completely removed, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is generally poorer. Life expectancy can then be limited to months, depending on the aggressiveness of the tumor and the treatment strategy chosen.
Early diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. and treatment are crucial to improve the dog’s quality of life and optimize the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop.. Regular follow-up examinations are necessary to detect recurrence of the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. or the appearance of metastasesA metastasis is a secondary tumor that originates from a primary, malignant tumor in another part of the body. Metastases indicate that cancer has spread in the body. early.
Prevention
An adrenocortical carcinoma cannot be safely prevented, but early detection significantly improves the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop.. Regular check-ups with blood and hormoneHormones are chemical messengers produced by endocrine glands and released into the bloodstream to affect specific cells or organs in the body. They regulate numerous bodily functions, including growth, metabolism, and reproduction. profiles, especially in older dogs, are recommended. Symptoms such as increased drinking, Hair loss, Muscle weakness, or unusual Weight gain should be taken seriously. Avoiding unnecessary hormonal medications can reduce the risk of hormone-related changes. Close monitoring is advisable for genetically predisposed breeds. UltrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. examinations of the abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. can also make changes to the adrenal glands visible at an early stage.
Outlook on current research
Adrenocortical carcinoma in dogs is a rare but serious disease that affects the adrenal cortex. The adrenal cortex is responsible for producing vital hormones such as cortisol. Current research is investigating how genetic factors may contribute to the development of these tumors. Researchers are analyzing genetic markers that are more common in dogs with this disease to better understand the causes and possible hereditary components.
Another focus of research is on improving diagnostic methods. Currently, imaging techniques such as ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. and CT scans are used to locate and assess tumors. New techniques that are in development could improve the accuracy and timeliness of diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients.. Research into the development of biomarkers that can be detected in the blood is particularly promising, as they could potentially enable non-invasive diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients..
Treatment options for adrenocortical carcinomas are also an active field of research. Surgical procedures to remove the affected adrenal glands are currently the most common form of therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.. Researchers are working to optimize surgical techniques to reduce the risk of complications and shorten recovery time. In addition, the effectiveness of chemotherapyChemotherapy refers to the treatment of diseases, especially cancer, with chemical substances or drugs. It aims to kill cancer cells or prevent their growth, but can also affect healthy cells. and radiation as complementary treatment methods is being investigated. New drugs that specifically target the molecular properties of tumor cells are also being tested in preclinical and clinical trials.
Another important aspect of research is understanding disease progressionProgression refers to the advancement or worsening of a disease over time. It describes an increase in the severity or extent of the disease symptoms. and the factors that influence survival. Long-term studies in affected dogs help to document the natural progressionProgression refers to the advancement or worsening of a disease over time. It describes an increase in the severity or extent of the disease symptoms. of the disease and assess the impact of different treatment strategies on the dogs’ quality of life. These studies provide valuable information that can help develop personalized treatment plans tailored to the individual needs of each dog.
In summary, research on adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. in dogs aims to deepen the understanding of the genetic and molecular basis of the disease, improve diagnostic and treatment options, and ultimately increase the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. and quality of life of affected dogs. Advances in research could also reveal potential parallels to the treatment of this disease in humans, which could advance knowledge and therapies in both areas.
Frequently asked questions (FAQs)
- What is an adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer.? An adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. is a malignantMalignant means "cancerous" and is used to describe tumors or neoplasms that grow invasively and have the ability to metastasize. Malignant tumors can cause serious health problems in dogs and cats. tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. that originates in the adrenal cortex. This gland is responsible for the production of important hormones, and a tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. can impair its normal function.
- What symptoms do dogs with adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. show? Common symptoms include increased thirst and urination, Hair loss, Weight gain or loss, Muscle weakness, and Behavioral changes. These symptoms often result from the overproduction of hormones by the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions..
- How is adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. diagnosed? The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is usually made through a combination of physical examination, blood tests, ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. or CT scans. These tests help to identify the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. and determine its effects on the body.
- What treatment options are available for dogs with this disease? The primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. treatment is surgical removal of the affected adrenal glandThe adrenal gland is a glandular organ located above the kidneys in dogs and cats that produces hormones such as epinephrine, norepinephrine, and corticosteroids. These hormones are important for the stress response, metabolism, and electrolyte balance.. In some cases, chemotherapyChemotherapy refers to the treatment of diseases, especially cancer, with chemical substances or drugs. It aims to kill cancer cells or prevent their growth, but can also affect healthy cells. or radiation therapyRadiation therapy is the use of radiation, most often to treat cancer. It can be used to kill cancer cells or slow their growth without significantly damaging surrounding healthy tissue. may be used as complementary treatments, especially if the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions. cannot be completely removed.
- What is the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. for dogs with adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer.? The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. varies depending on the size of the tumorA tumor is an abnormal growth of tissue that can be benign or malignant. Tumors can develop in any part of the body and affect various functions., whether it has metastasized, and the dog’s general health. Early diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. and treatment significantly improves the chances of survival.
- Can adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. be inherited in dogs? While the exact cause is unknown, some studies suggest that genetic factors may play a role. Certain breeds appear to be more frequently affected, suggesting a possible hereditary component.
- Are certain dog breeds more susceptible to this disease? Yes, some breeds such as poodles, German Shepherds, and terriers appear to be at higher risk. This may be due to genetic differences that increase susceptibility to Tumors.
- How can I help my dog recover after surgery? After surgery, it is important to follow the veterinarian’s instructions, which often include restricted activity, a special diet, and regular follow-up examinations. A calm and stress-free environment can also contribute to recovery.
- Are there ways to reduce the risk of adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer.? Although there is no guaranteed method of preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring., a healthy diet, regular veterinary examinations, and control of stressStress refers to the state of an organism reacting to external stimuli or demands. In veterinary medicine, stress can have physical or psychological effects on animals, impacting their health and well-being. factors can help reduce the overall health risk.
- How does adrenocortical carcinomaA carcinoma is a type of cancer that originates in the epithelial cells that line the inner and outer surfaces of the body. Carcinomas are the most common form of cancer. affect my dog’s quality of life? Quality of life can be affected by symptoms such as weakness, loss of appetite, and Behavioral changes. Effective treatment aims to alleviate these symptoms and improve quality of life as much as possible.