■ Cancer may alter metabolism by causing glucose intolerance and insulin resistance, increasing energy expenditure, increasing protein catabolism, increasing fat catabolism, and increasing the use of fat for energy. ■ Anorexia, a common problem in people with cancer, may lead to weight loss and malnutrition. Pain, depression/anxiety, early satiety, taste changes, fatigue, and nausea caused by cancer or its treatment may be contributing factors. ■ Cancer cachexia is a progressive wasting syndrome characterized by preferential loss of lean body mass. Altered metabolism and anorexia are involved. The severity of cachexia is not directly related to calorie intake or tumor weight