Cancer-Associated Muscle Atrophy and Weakness: An Investigation of Etiology

Inclusion Criteria:

- Age 35-80 years

- Diagnosis of metastatic cancer with cachexia (≥5% drop in body mass in less than 12
months), metastatic cancer without cachexia (<5% drop in body mass in 12 months) or no
history of cancer but similar in age and sex as other groups.

Exclusion Criteria:

- Current use of vitamin D analogs

- Fasting plasma glucose ≥126 mg/dL

- Renal failure (serum creatinine > 1.5mg/dl)

- Chronic active liver disease (Bilirubin > 17mmol/L, AST>144IU/L, or ALT>165IU/L)

- Contraindications to MRI (e.g., pacemaker, ferrous materials within body).

- Active coronary artery disease or history of unstable macrovascular disease (unstable
angina, myocardial infarction, stroke, and revascularization of coronary, peripheral
or carotid artery within 3 months of recruitment)

- Renal insufficiency/failure (serum creatinine > 1.5mg/dl)

- Oral warfarin group medications or history of blood clotting disorders.

- People who have taken Bevacizumab

- Platelet count <100,000 per uL

- Pregnancy or breastfeeding

- Alcohol consumption greater than 2 glasses/day or other substance abuse

- Untreated or uncontrolled thyroid disorders

- Debilitating chronic disease (at the discretion of the investigators)

- Previous injury/trauma/surgery to the region being measured without full recovery

- Pain in the area to be assessed

- Any medical condition affecting the ability to execute a maximal muscle contraction

- The presence of infections, highly communicable diseases (AIDS, active tuberculosis,
veneral disease, hepatitis) or metastatic bone disease that may interfere with safely
executing maximal effort.

- Significant neurological or musculoskeletal disorders or disease that may interfere
with safely executing maximal contraction

- Any congenital, developmental, or other bone disease or previous surgeries that may
interfere with successful testing