Not feasible to include the needed patients

To study activity in the reward-circuitry of the brain in patients suffering from cachexia induced by cancer or chronic disease.

The activity in the food reward-circuitry of the brain in patients suffering from cachexia induced by cancer (lung cancer or pancreatic cancer) or chronic disease (chronic obstructive pulmonary disease) will be analysed by using functional magnetic resonance imaging. In addition, the role of the peripheral satiety hormones will be evaluated.

Inclusion Criteria:

• For cachectic patients: weight loss exceeds 5% of total body weight over the past 6 months, or >2% when body mass index is <20 kg/m2
• For non-cachectic patients: no weight loss of ≥5% during the last 6 months
• Non-small cell lung cancer or gastro-intestinal cancer, pathology proven or diagnosis of COPD consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria

Exclusion Criteria:

• Contra-indications for fMRI examination (operation to your head or brain in the past; implanted electronic devices, for instance a pacemaker, neurostimulator, cochlear or hearing implant; insulin pump under your skin; Pregnant subjects, claustrophobia; pregnancy; metal parts in your body (except from teeth filling and connectors): implants; brain vessel clamps, prostheses, intra-uterine device, metal splinter in the eye, metal braces or other metal objects, permanent eye make-up)
• Psychiatric or other disorders likely to impact on informed consent
• Presence of brain metastasis (screening is not mandatory)
• Medical history of cerebrovascular accident, brain tumour, brain metastasis
• Previous radiotherapy to brain, both stereotactic and whole brain radiotherapy
• Memory problems
• Current use of tube feeding or parental nutrition
• Patients with an active second malignancy
• Patients unable to lie still for 2 hours
• Unable to complete the cognitive task
• Pre-existing swallowing difficulties
• Allergy to gluten-, milk- or wheat products
• Self-reported hyperthyroidism
• Self-reported diabetes mellitus
• Current use of appetite stimulant medications

Four groups will be included:

1. Cachectic cancer patients, including NSCLC and gastro-intestinal cancer
2. Non-cachectic cancer patients, including NSCLC and gastro-intestinal cancer
3. Cachectic COPD patients
4. Non-cachectic COPD patients

Individuals of all groups will be gender and age matched. In addition, COPD patients will be matched for FEV1.