Cancer and Loss of Appetite

Loss of appetite, known as anorexia, is a symptom in approximately 66% of patients with advanced cancer and is also present in 15-20% of all cancer patients [i].  Loss of appetite may happen by itself in direct response to tumor-induced alterations to the metabolism or can occur in combination with cachexia, as known as anorexia-cachexia syndrome. This is considered a wasting state which is common in chronic, advanced diseases such as cancer. The loss of appetite results in involuntary weight loss of both fat and muscle mass.

Not eating enough along with the hypermetabolic state of malignancy can lead to quick and drastic changes in body composition — including rapid loss of muscle mass. This symptom of cancer can be psychologically damaging to both the patients and the caregivers. It is critical to manage loss of appetite as soon as the symptom is present to avoid additional complications in nutritional status and treatment. Malnutrition is a common and dangerous complication of cancer.

 

How to Act

When seeing someone with these symptoms or experiencing this yourself, the first step is look for reversible and controllable causes. Are you unable to eat because of mouth sores, constipation, pain, nausea, vomiting, depression, or changes in gastrointestinal function? Then the first step is to address those symptoms. Once those issues are under control, we can come up with a plan to make sure you’re getting the calories you need to prevent weight dangerous loss.

 

Try these 7 tips to manage appetite loss

1. Snacks to the rescue – Eat small snacks every 2-3 hours. Having quick nutritious snacks on hand can make it easier for you to eat. High protein snacks such as peanut butter crackers, granola bars, nuts, yogurt, pudding, and cheese can be helpful.
2. Pack in extra calories – Add extra calories to your diet by adding extra butter, oil, mayonnaise, sauces, dressing, gravy, honey, jam, cheese, and nuts to your meals. Some people find it easier to drink high calorie liquids such as juice, milkshakes, smoothies, and protein drinks.
3. Protein power – Add extra protein by including poultry, meat, fish, eggs, yogurt, cheese, beans and nuts to your meals and snacks. Dried milk powder mixed in gravies, soups and sauces can add extra protein.
4. Don’t get too full! – Drink fluids half an hour before or after meals. Drinking right before or during a meal may make you feel full before you eat.
5. Be active – Exercise can help stimulate your appetite. There’s no need to hit the gym — choose activities that are appropriate for you. There are lots of options.
6. Make it social – Try to make mealtime enjoyable.  Invite friends or family over or play relaxing music.
7. Get help – Talk to your healthcare team about nutritional supplements or liquid meal replacements. If modifying your meals and other behavior changes aren’t enough to prevent weight loss, an oncologist may prescribe medications that can help manage cancer-related anorexia [ii].