LACK OF APPETITE
What is lack of appetite?
This symptom describes a lack of or decreased appetite despite basic caloric needs. Food may not taste right. Lack of appetite, if not treated and managed, can lead to a more serious condition. By improving your appetite, you can improve your quality of life and be better able to tolerate cancer treatments.
How do people describe lack of appetite?
People with cancer and people going through cancer treatment often report that they either have no appetite, or they indicate they get "full" more quickly, or both. When people with cancer dont eat well, they can develop poor nutrition.
What causes lack of appetite?
Many people report that their sense of taste and sense of smell change due to their treatment, and that these changes also decrease their appetite. For others, having nausea, vomiting, or even pain and fatigue that are not well controlled also causes changes in appetite.
Other factors that can contribute to appetite loss include loss of sleep, medications, anxiety, depression or sadness, difficulty swallowing, constipation or diarrhea.
Cancer itself can affect your appetite, how your food is digested, and the energy needed by the body. Lack of appetite can keep you from eating enough nutrients.
How do people cope with lack of appetite?
Try these self-care activities:
Assess your nutritional status by keeping a record of food intake. Keep a journal or diary. Some common ways that might help include:
a) Write down what you ate in the last 24 hours.
b) 3 day food diary-Write down all the food you eat for 3 days.
Dont be afraid to try new foods. Tastes can change and different foods may be a pleasant addition to your menu.
Freeze food in meal size portions.
Give food a chance. Even if you have trouble eating, you may find a time when eating is still a pleasure.
Weight yourself at regular intervals at the same time of day.
Your nurse, dietician, physician can help by assessing your nutritional status before and during your treatment.
Have a good supply of favorite foods, and foods that can be eaten during times of illness, such as popsicles, broths, lemon-lime soda.
Do not eat your favorite foods on the day of your treatments or when you feel nauseated. Your body may learn to associate these foods with nausea.
Using sauces and gravies can make swallowing easier.
If food odors bother you, eat foods that are either cold or at room temperature.
You need 8 (8 oz.) glasses of fluids per day.
Eat calorie-rich foods such as malts, shakes and omelets.
Do not try to lose weight while being treated for cancer, unless directed by your doctor.
If you dont feel like you can eat a full meal, try eating 5-6 smaller meals or snacks throughout the day.
Avoid carbonated beverages, they can make you feel full but do not add nutrition.
Light exercise 30 minutes (like walking around the block or around the house) before mealtime may help you feel hungrier.
With permission with your oncologist try Boost or Ensure added to your diet. These high-calorie supplements can also be mixed with fruit or ice cream to make a shake. Supplements can be filling, so try to eat your meal before taking them.
The supplements can also lay on your tongue and mouth, so many find it helpful to sip through a straw and drink them cold. If you have a metallic taste, try sucking on hard candy.
Meat, fruit and vegetables can be spread out throughout the day and eaten in very small portions. Avoid milk if it upsets your stomach.
Take a daily vitamin supplement.
Take your prescribed anti-nausea medications 30-60 minutes before eating.
Ask your doctor if an appetite stimulant like Megace (a hormone that improves appetite and can help you increase your calorie intake) would be for you.
Eat protein everyday (tuna fish, chicken, peanut butter, cheese).
For Caregivers:
Do not try pushing your family member into eating or drinking.
Provide encouragement and support without being overwhelming.
Keep snacks and utensils within easy reach.
Plan on small, frequent meals.
If your family member cannot eat, encourage fluids. Many fluids contain great nutrition and helpful calories. Your family member may not take much at a time, but juices and other fluids can be beneficial, even when you sip them a little at a time.
Be prepared that tastes may change from day to day. Favorite foods wont taste good some days.
Have high energy foods available.
What can family members and friends do to help me with my lack of appetite?
Have your family members and friends keep foods around that require little or no preparation time, like cheese, eggs, pudding, peanut butter or tuna fish.
Ask family members and friends to help with grocery shopping and cooking.
Ask your family members and friends to make mealtime pleasant. This may include fresh flowers on the table or pleasant music while eating.
How can I talk with my family members and friends about my lack of appetite?
Tell your family members and friends how the lack of appetite is affecting your daily activities and emotions.
Ask your family members and friends for suggestions that might help.
Make suggestions about your food preferences.
What should I report to my doctor or nurse?
When youve eaten poorly for several days (3-5).
Your urine is decreasing in amount, or darker in color.
Fever greater than 100.4º F for over 24 hours.
Dizziness.
Mental confusion.
Uncontrolled nausea or vomiting.
Inability to tolerate fluids for over 24 hours.
Loss of 5 pounds in a week or more than 2 pounds in 24 hours.
No oral intake for 24 hours.
Where can I get more information?
Contact your doctors or nurses.
Call the National Cancer Institute at: 1-800-4-CANCER, or visit on the internet at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer. Find and click on Nutrition in Cancer Patients.
Call the American Cancer Society at: 1-800-ACS-2345, or visit on the internet at: http://www.cancer.org. Click Patients, Family & Friends, then Coping with Treatment.
Visit the Family Care Research Program on the internet at: http://www.cancercare.msu.edu.
Visit the Oncology Nursing Society on the internet at: http://ons.org. Click on Side Effects.
Visit the National Coalition for Cancer Survivorship: Loss of appetite on the internet at: http://www.canceradvocacy.org>. Click on Essential Care.
References:
Cunningham, R.S. (2003). The anorexia-cachexia syndrome. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer symptom management, 3rd Ed. (pp. 137-167). Boston: Jones and Bartlett.
National Cancer Institute at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer.
