Anamorelin Hydrochloride, Physical Activity, and Nutritional Counseling in Decreasing Cancer-Related Fatigue in Patients With Incurable Metastatic or Recurrent Solid Tumors

Inclusion Criteria: * Patient with a diagnosis of advanced cancer (metastatic or recurrent incurable solid tumors excluding prostate cancer) * Presence of fatigue on FACIT-F subscale of =\< 34 on a 0 to 52 scale (in which 52 = no fatigue and 0 = worst possible fatigue) * Patient should describe fatigue as being present for a minimum of 2 weeks prior to screening * CRP must be \>= 3 mg/l in the absence of any other more likely cause of increased CRP like an infection or an autoimmune disorder * No evidence of moderate to severe depression as determined by a HADS depression score of =\< 13 * Presence of unintentional weight loss ranging from \>= 2 - =\< 15% in last 12 months * Uncontrolled pain; if patient is on opioids for the treatment of cancer pain, he/she must have had no major dose change (\> 25%) for at least 48 hours prior to study entry; the dose of morphine equivalent daily should not exceed 120 mg/day unless approved by the principal investigator (PI); change in opioid dose after study entry is allowed * Patient must be willing to engage in telephone follow up with research staff * Patient must have telephone access to be contacted by the research staff * Hemoglobin level of \>= 9 g/dL * Estimated life expectancy of \> 4 months at the time of screening * Aspartate transaminase (AST) and alanine transaminase (ALT) levels =\< 5 x upper limit of normal (ULN) Exclusion Criteria: * Major contraindications to anamorelin e.g. hypersensitivity * Regularly engaged in moder…