b'Low Muscle Mass Along WithHigh Tumor IL-6 Expression Strongly Associated With Mortality in Renal Cancer The combination of low muscle mass and high tumor IL-6 expression predicts early death in patients with clear cell renal cell carcinoma, according to a new study. Cachexia is a major cause of morality in ccRc and should raise alarms, the authors cautioned.By Mary Anne DunkinINDIANAPOLISThe most common form of re-nal cancer and one of the most common cancers of the urinary tract, clear cell renal cell carcinoma (ccRCC)affectsalmosttwiceasmanymenas women. Due in large part to this and other risk factorsage,tobaccosmoking,obesityandhy-pertensionccRCC disproportionately affects the veteran population. Thus, a better understanding of the disease and factors in survival is a priority for the VA.PreviousresearchhasshownthatccRCCisfre-quentlyassociatedwithsymptomsofcachexiaa wasting syndrome characterized by a dramatic loss of fat and skeletal muscle masswhich itself is associ-ated with decreased quality of life and poor response to chemotherapy and has been implicated as the cause of death in as many as 20% of cancer patients.A recent study led by researchers at the Indiana UniversitySchoolofMedicineandRichardL. Roudebush VAMC in Indianapolis shows low mus-cle mass along with high tumor interleukin-6 (IL-6) expression is strongly associated with mortality in ccRCC.Cachexia is caused in part by the actions of inflam-matory cytokines on multiple tissues. Such actions range and include modulating the tumor microen-vironment; disrupting hematopoiesis; altering cen-tral mechanisms of food intake, basal temperature, activity and energy expenditure; and direct induc-tion of lipolysis, muscle catabolism and bone loss,Source: Kays JK, Koniaris LG, Cooper CA, Pili R, Jiang G, Liu Y, Zimmers TA. The Combination of Low Skeletal Muscle Mass and High Tumor Interleukin-6 Associates with Decreased Survival in Clear Cell according to the authors. Renal Cell Carcinoma. Cancers (Basel). 2020 Jun 17;12(6):1605. doi: 10.3390/cancers12061605. PMID: 32560494; PMCID: PMC7352265.Continued on Page 70 u63'