Loss of Appetite and Weight Loss
Poor appetite and weight loss are complex problems and are very common occurrences in patients with lung cancer, and can cause a great deal of distress to patients and relatives. It is therefore something that GP's and lung cancer teams are used to dealing with and can help to advise and manage these side effects of the lung cancer or its treatments.
Causes
The exact causes can be difficult to identify in any one individual as there can be many factors involved in poor appetite and weight loss. Poor dietary intake can be as a result of having little or no appetite, taste changes, feeling full quickly, having cooking smells or large portions putting individuals off their food. Side effects of treatment causing heartburn, or nausea/vomiting can affect dietary intake, also having mouth or swallowing difficulties, or constipation and other symptoms can also lead to eating problems. This can lead to weight loss, fatigue, muscle wasting, reduced concentration, etc.
Management
There are many ways to try to help improve appetite and slow down weight loss or even stabilise the weight of individuals with lung cancer. Macmillan Cancer Support provide an excellent booklet: "Diet and Cancer" which is free and can be obtained by calling 0800 500 800 or by ordering online at Be.Macmillan. Also you local team may have access to diet sheets which give advice.
· Eat little amounts as often as possible if you cannot face big meals. Try to have a small portion of food every two hours during the day.
· Tempt your taste buds by making your food look as attractive as possible. Put small portions on your plate and garnish the food with lemon, tomato or parsley.
· A glass of sherry or brandy half an hour before a meal is a good way of stimulating your appetite. Some people find a glass of wine with their meals helps their digestion.
· Keep snacks handy to nibble whenever you can. Bags of nuts, crisps, dried fruit or a bowl of grated cheese are quite light and tasty. If these are hard for you to swallow, a yoghurt or fromage frais may slip down more easily.
· Sweet or savoury nourishing drinks can be used to replace small meals and can be sipped slowly over the course of a day. These can be obtained from a pharmacy or can be prescribed by your GP, specialist nurse or other members of your care team.
· Eat your meals slowly, chew the food well and relax for a little while after each meal.
· Sometimes the smell of food cooking can be appetising, but occasionally it can put you off eating. If cooking smells spoil your appetite, keep away from the kitchen and ask your family or friends to cook, or eat cold foods attractively presented.
· Everyone's appetite changes and you may have good and bad days. Make the most of the good days by eating well and treating yourself to your favourite foods.
· Have your meals in a room where you feel relaxed and without distractions.
· It may be possible to stimulate your appetite using medicines such as a low dose of steroids or the hormone medroxyprogesterone. Your doctor may prescribe these for you.
· Your GP or lung cancer team can access specialist advice for you and arrange for you to be seen by a dietician, either at the hospital, health centre or in your own home.
· Other symptoms should be assessed and managed appropriately if they are impacting on your ability to eat and drink, for example, pain management, treatment of constipation or nausea, assessment and management of mouth problems, etc.
References
http://www.macmillan.org.uk/Cancerinformation/Livingwithandaftercancer/Eatingwell/Eatingproblems/Poorappetite.aspx