For Those Experiencing Cancer-Induced Weight Loss
Cancer itself or it’s treatments can greatly alter how your body uses the food you eat. Often times your energy needs increase and your food intake decreases due to a poor appetite or other symptoms. This results in weight loss. Even if you are eating a normal amount of food, your body might not be using the nutrients in your food properly or it may be burning energy faster than usual.
No matter what the cause, it is essential that unintentional, rapid weight loss is addressed as it has a negative impact on recovery. The most important thing you can do during cancer and weight loss is to eat little and often, snack frequently and introduce calories where ever possible.
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One of the most important things you can do is monitor your weight.
To track your weight you should weigh yourself weekly. Ideally this should be done on the same day each week, at the same time of day and on the same weighing scales. This is to make sure that all measurements are comparable. You should weigh yourself first thing in the morning in minimal clothing, after you have emptied your bladder.
Cancer and cancer treatments have different effects on everybody. The side effects can vary from person to person and not everybody will experience them. Chemotherapy can result in many of the side effects discussed below. Radiation therapy usually affects the area being treated e.g. receiving treatment to the head and neck may result in difficulty eating and swallowing. Surgery to remove a tumour can result in problems eating and digesting a normal diet. For some people tube feeding may be necessary post-surgery.
A change in appetite is very common during cancer treatment. Your favourite foods may no longer appeal to you, you may have a reduced appetite or you may not want to eat at all. Without forcing yourself to eat, it is important to try to eat small amounts regularly, to avoid weight loss.
- Eat whenever you feel hungry. If you are hungriest in the morning then eat your biggest meal at that time.
- Eat frequent, small meals to avoid feeling uncomfortably full. Snack often and avoid large, off-putting portions. Make these snacks high in calories and protein.
- Limit drinks before and during meals as they fill you up.
- Limit fibre as it fills you up quickly.
- Bland foods may be easier to tolerate.
Fighting cancer and undergoing cancer treatments can often drain your energy and leave you feeling tired and fatigued. It can be due to a variety of reasons. Persistent fatigue can lead to weight loss quite easily as you might not have enough energy to shop, prepare or even eat food.
- Get a friend or family member to do your shopping. Many larger shops deliver groceries directly to your house when you order online.
- Prepare your meals when you have energy and refrigerate/freeze them.
- Get help cooking meals.
- When too tired to cook, consume nourishing, high-calorie drinks such as milk, smoothies, juices, milk-shakes or prescribed nutritional supplements.
- Eat foods that require little preparation and snack frequently. Light exercise may help reduce fatigue and increase appetite.
NAUSEA AND VOMITING
Nausea is when you feel sick, have an unpleasant feeling in your stomach or throat, feel dizzy, clammy and don’t want to eat. Vomiting is actually being sick or throwing up. The most common cause of these symptoms is chemotherapy. You should discuss these symptoms with your doctor as anti-sickness medications can ease nausea and prevent you throwing up. If you are vomiting frequently, seek medical advice and try to stay hydrated with clear fluids or nourishing fluids like milk and sports drinks.
- Eat little and often. Avoid skipping meals as this can lead to hunger which worsens nausea.
- Bland, cold foods have less taste and smell and will be better tolerated. Avoid greasy, spicy and sugary foods with strong odours.
- Drink flat ginger ale or include ginger in meals as ginger helps to soothe nausea.
- Avoid your favourite foods when nauseated as you may grow to dislike them.
- Avoid eating 1-2 hours before treatment as this may help to lessen nausea.
- Try not to prepare meals when nauseated and rest after meals.
Various cancer treatments can cause diarrhoea by irritating the lining of your digestive system. Medications and drugs may also cause diarrhoea so discuss these with your doctor. The tumour itself can also stimulate diarrhoea in certain gut cancers. The most important thing to do is to remain hydrated and to replace the body’s lost salts, called electrolytes.
- Constantly sip fluids such as sports drinks or flat carbonated beverages. Eat little and often.
- Limit high fibre foods like beans, whole grains and raw fruits and vegetables, as they may worsen diarrhoea.
- Pro-biotics may help alleviate symptoms but can interfere with chemotherapy so consult your doctor first.
- Avoid foods that are greasy or fatty and foods that contain citrus, sweeteners or caffeine. Also avoid prune, apple or pear juice as they worsen diarrhoea symptoms.
- Eat foods which are easy to digest such as bananas, oatmeal and white pasta.
- Dairy products can sometimes aggravate symptoms due to lactose sugars in milk.
Chemotherapy may interfere with the nerve supply to the bowel that can cause constipation. Anti-sickness drugs and painkillers can make this worse. Surgery to the stomach or bowel may result in constipation due to problems pushing stool out. Tumours in the abdomen or bowel may make it difficult to have a bowel movement. Constipation is also caused by some drugs, lack of fibre, not enough exercise and not drinking enough water.
Gradually increase fluids and fibre to help alleviate constipation. Certain drinks stimulate a bowel motion. These include prune juice, pineapple juice and hot drinks in the morning.
High fibre foods include beans, peas, nuts, dried fruit, raw fruits and vegetables, and whole grain cereals and breads.
If constipation is making you bloated, avoid foods like beans, broccoli, cauliflower and carbonated drinks.
Gentle exercise can help prevent and treat constipation.
INDIGESTION AND REFLUX
Some chemotherapy or biological therapy drugs used to treat cancer can cause indigestion.
- Avoid large meals. Eat small, frequent meals instead.
- Herbal teas and peppermint tea may help to soothe indigestion. Avoid eating foods that are fatty, spicy, vinegar based or citrus foods as well as carbonated drinks, caffeine and alcohol.
- Often, indigestion and reflux is worse when you are lying down. Avoid eating 2-3 hours before bed and don’t lie down after eating a meal. Raising the head of your bed can also help.
Some anti-cancer drugs may result in sores forming in the mouth or mouth pain. Treatments to the head and neck area often result in a sore mouth and it can make eating and swallowing quite difficult.
- Eat soft foods like puddings and yogurts. Moisten foods with gravy or sauces to make them easier to eat.
- Puree foods to make them easier to eat and swallow.
- Avoid rough textured foods like toast and foods that are overly tart, salty or vinegar based.
- Sip fluids throughout the day.
- Cold foods such as ice-cream can help soothe a sore mouth.
Chemotherapy and radiation therapy can damage salivary glands and thicken saliva or reduce the amount of saliva in your mouth. This results in a dry mouth. This makes it a lot more difficult to eat and enjoy food.
- Sip fluids throughout the day to moisten your mouth.
- Maintain good dental health and oral hygiene. Milk helps protect teeth.
- Soft, moist, pureed foods are easier to eat. Add sauces to moisten foods.
- Rinsing your mouth with water and baking soda can help.
- Avoid salty foods as well as spicy food, caffeine and alcohol which dry out your mouth further.
- It is best to avoid foods that stick to the roof of your mouth e.g. fresh bread and pastry.
- Chewing gum or sucking hard boiled sweets may help to stimulate saliva.
Foods and thin liquids may cause coughing, choking or it may feel as though there is food caught in your throat. This can be caused by the cancer itself or by head and neck radiotherapy. Many people with difficulty swallowing lose a lot of weight, it is very important to maintain adequate nutrition.
- Moisten foods with sauces.
- Thickening thin liquids can make them easier to swallow. This can be done with corn starch or a prescribed thickener.
- Finely chop meat and vegetables to make them easier to chew and swallow.
- Eat little and often and consume plenty of high calorie drinks if you cannot eat.
TASTE AND SMELL CHANGES
Cancer and cancer treatments can greatly affect your taste and smell. Foods that once appealed to you may no longer be desired. Your sensitivity to smells may increase and your taste may decrease or often patients find that they have a metallic taste in their mouth. Foods may seem bitter, bland or salty.
- Try new foods and eat whatever appeals to you. You may suddenly like foods that you once disliked.
- Rinse your mouth with a solution of water and baking powder before and after eating to help normalise taste.
- Cold or lukewarm foods have a weaker taste and smell and may be more tolerable.
- If food tastes too bland, add herbs, seasoning, spices, garlic or onions to boost flavour. Fat is a great flavour carrier so add fats to meals freely.
- If there is a metallic taste in your mouth, rinse your mouth regularly and try eating with plastic utensils instead of metal ones.
- Marinating meats can help to mask any metallic tastes.
Will sugar fuel my cancer?
A common myth is the belief that sugar feeds cancer. This is an oversimplification of a complex process. All carbohydrates are broken down into simple sugar units, called glucose, in the body. All of our body cells, whether they are cancerous or not, then use this glucose as energy. Giving more sugar to your body won’t speed up the growth of cancer cells, and depriving yourself of carbohydrates won’t slow their growth either- if you eliminate all carbohydrates your body will adapt and create glucose from other sources.
Is following a high protein, high calorie diet bad for my health?
Research has shown that weight loss during cancer recovery is detrimental. It is linked with poorer outcomes and reduced survival. Maintaining your weight is therefore the main nutritional priority during cancer treatment. For those experiencing cancer-induced weight loss, the only way of achieving this is to follow a diet rich in energy and protein. Although high protein, high calorie advice may contradict usual healthy eating recommendations, the risks associated with losing weight far outweigh any advantage of following a low-fat diet in this situation. Once your weight has stabilised your dietitian will be able to advise you on returning to a healthy-eating diet.
These Tips and Tailored Recipes are in our Free Cookbook: Good Nutrition For Cancer Recovery