Changes in appetite are common with cancer and cancer treatment. People with poor appetite or appetite loss may eat less than usual, not feel hungry at all, or feel full after eating only a small amount. Ongoing appetite loss may lead to weight loss, not getting the nutrients from food that the body needs, and loss of muscle mass and strength, all of which are serious complications. The combination of weight loss and muscle mass loss is called cachexia, or wasting.
Appetite loss in a person with cancer has many causes:
- Some types of cancer–including ovarian, pancreatic, and stomach cancers–may cause a loss of appetite, usually by affecting a person's metabolism, which is the process of the body breaking down food and turning it into energy.
- Advanced cancer
- Some cancers may cause the spleen to become larger. When a spleen grows in size, it can push on the stomach, creating a feeling of fullness.
- Ascites, which is a buildup of fluid in the abdomen that may create a feeling of fullness even after eating a small amount of food
- Medications, including chemotherapy, immunotherapy, and drugs called sedatives that cause feelings of calmness or sleepiness
- Radiation treatment or surgery to any part of the gastrointestinal organs, such as the stomach or intestines
- Other side effects of cancer treatment, such as:
Relieving side effects—also called symptom management, palliative care, or supportive care—is an important part of cancer care and treatment. Talk with your health care team about any symptoms you experience, including any new symptoms or a change in symptoms.
If possible, the first step in treating appetite loss is to address the underlying cause. Treatment for conditions such as mouth sores, dry mouth, pain, or depression may help improve appetite.
Treatments for appetite loss and associated weight loss may include medications that increase appetite and medications that help move food through the intestine. These include:
- Megestrol acetate (Megace) or medroxyprogesterone are forms of the progesterone hormone that can improve appetite and weight gain.
- Steroid medications can increase appetite, improve a person's sense of well-being, and help with nausea, weakness, or pain. Because of serious side effects, steroids should only be used for a short time.
- Metoclopramide (Reglan) can prevent feeling full before eating enough food.
- Dronabinol (Marinol), a cannabinoid made in the laboratory, may stimulate appetite.
- Other medications are being studied to help people with cancer improve their appetite and gain weight.
Medications that help food move through the intestine, nutritional supplement drinks, and tube feeding, which is the use of a tube that passes through the nose into the stomach, can also be helpful.
Although you may not feel like eating, remember that getting good nutrition and keeping a healthy weight are important parts of your recovery. Eating well can also help you better cope physically and emotionally with the effects of cancer and cancer treatment. Consider the following tips for getting proper nutrition when your appetite is poor:
- Eat five to six small meals a day, and snack whenever you are hungry.
- Determine which times of day you are hungry, make sure to eat at those times, and do not limit how much you eat.
- Eat nutritious snacks that are high in calories and protein, such as dried fruits, nuts, yogurt, cheeses, eggs, milkshakes, ice cream, cereal, pudding, and granola bars.
- Keep your favorite foods on hand for snacking.
- Add calories and protein to foods by adding sauces, gravy, butter, cheese, peanut butter, cream, and nuts.
- Drink fluids between meals, rather than with meals. Drinking during a meal may make you feel full too quickly.
- Choose nutritious or filling drinks, such as milk or nutritional milkshakes or smoothies.
- Ask family members or friends to get groceries and prepare food for you when you are too tired shop or cook, and consider buying precooked meals.
- Try to eat in pleasant surroundings, and eat meals with family or friends.
- Try placing food on smaller plates rather than larger plates.
- If the smell or taste of food makes your nauseous, eat food that is cold or at room temperature to decrease its odor and reduce its taste.
- However, if you are having trouble tasting food, try adding spices and condiments to foods to make them more appealing.
- If you have changes in taste, such as a metallic taste in your mouth, sucking on hard candy like mints or lemon drops before eating a meal can be helpful.
- Ask your doctor about ways to relieve gastrointestinal symptoms, such as nausea, vomiting, and constipation or if you are having any difficulty with managing pain.
- Try light exercise, such as a 20-minute walk, about an hour before meals to stimulate your appetite. Consult your health care team before starting an exercise program. Exercise also helps maintain muscle mass.
- Meet with a registered dietitian for additional advice on meal planning.