Which of the following best describes the benefit of megestrol acetate in patients with cancer-associated cachexia?

• A. Increases lean muscle mass
• B. Improves appetite and ameliorates weight loss
• C. Decreases the risk of thromboembolic events
• D. Improves blood glucose control in diabetes mellitus

Answer: (B)

Megestrol acetate helps cancer patients with cachexia mainly by stimulating appetite, which leads to increased oral intake and a reduction in weight loss. This improvement in appetite and subsequent weight gain is the primary clinical benefit. The weight gain is often due to increased fat mass and sometimes fluid retention, rather than a reliable increase in lean muscle mass. It does not decrease thrombosis risk; in fact, progestin therapies can raise the risk of thromboembolic events. It is not used to improve blood glucose control in diabetes. So the best description of its benefit is that it improves appetite and ameliorates weight loss.