Inclusion Criteria:

• Are referred to the Cachexia Clinic with involuntary weight loss of >5% of their premorbid weight within the previous 6 months.
• Are 18 years of age or older
• Have a Karnofsky performance score of 60 or higher.
• Can maintain oral food intake during the study
• Can understand the study procedures and can sign an informed consent form.
• Are not currently taking melatonin, a beta-blocker,a combination alpha and beta blocker or a non-steroidal-anti-inflammatory drug(NSAID).
• Are taking megestrol acetate and continue to lose weight despite at least 2 weeks of therapy.
• Have a calculated creatinine clearance of >/= 60 cc/min

Exclusion Criteria:

• Have dementia or delirium (as determined by the palliative care specialist) at study entry.
• Are pregnant
• Severe sinus bradycardia with a heart rate of < 45 beat/min,atrial fibrillation with an uncontrolled ventricular response,a high degree Atrioventricular block,a history of congestive heart failure;a history of myocardial infarction or stroke within the past 3 months, a history of hypertrophic cardiomyopathy; a history of moderate to severe stenotic valvular heart disease.
• Have been taking corticosteroids for longer than 48 hours.
• Have pulmonary edema, ascites or pitting edema on clinical examination.
• Are unable to walk.
• Hypersensitivity to ibuprofen or a history of asthma, urticaria or allergic-type reactions after taking aspirin or other NSAID's
• Have a history of serious adverse gastrointestinal events (i.e., bleeding or perforation),history of a coagulopathy or current anti-coagulant use.
• Have symptoms of dyspepsia or a history of uncomplicated peptic ulcer disease and are unable to add a proton pump inhibitor to their medication.
• Are older than 65 years, have a hemoglobin level <9 g/dl, platelet count less than 50 000/mm3, calculated creatinine clearance level of less than 60 cc/min, or ALT/AST>3x upper limit of normal.
• Have a history of hypersensitivity or allergy to beta-blockers,or a history of uncontrolled bronchial asthma or severe chronic obstructive pulmonary disease.
• Patients on methotrexate.
• Patients taking melatonin receptor agonists (such as Rozerem® [ramelteon]).
• Patients that, after discussion between the primary oncologist and the palliative care specialist, the oncologist is of the opinion that anti-neoplastic therapy is more likely to improve the cachexia and its associated quality of life.