The primary aim of this proposal is to present a novel, multimodal treatment strategy for
increasing lean body mass in individuals with cancer who experience cachexia between baseline
and day 29 (+/- 3 days). The strategy includes graded resistance training and aerobic
exercise, targeted nutrient supplementation and pharmacologic intervention (melatonin).
We postulate that this strategy, together with the simultaneous management of symptoms that
decrease appetite (e.g. depression, pain, and nausea), will also accomplish our secondary
objectives of improving clinical outcomes such as strength and function between baseline and
day 29 (+/- 3 days).