Changes in your 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 (satiated) after eating only a small amount. Ongoing appetite loss can lead to weight loss, malnutrition, and loss of muscle mass and strength. The combination of weight loss and loss of muscle mass, also called wasting, is referred to as cachexia.

Causes

Appetite loss is common in people with cancer. Certain types of cancer, including ovarian, pancreatic, and stomach cancers, can cause a loss of appetite, usually by affecting a person’s metabolism. Cancer-related weight loss can be serious because a person also loses muscle mass. Appetite loss also occurs in 80% to 90% of people with advanced cancer. Reasons for this include:

• Changes in metabolism
  
  
• Early satiety (feeling of fullness) from ascites (accumulation of fluid in the abdomen)
  
  
• Other symptoms of cancer.

Other causes of appetite loss include:

• Chemotherapy
  
  
• Immunotherapy
  
  
• Sedative medications (drugs that cause feelings of calm or sleepiness).

In addition, radiation treatment or surgery to any part of the gastrointestinal organs, such as the stomach or intestines, can also cause appetite loss.

Several of the side effects commonly experienced with chemotherapy and radiation treatment may also cause appetite loss, including:

• Nausea and vomiting
  
  
• Mouth sores and mouth pain
  
  
• Dry mouth
  
  
• Difficulty swallowing
  
  
• Difficulty chewing
  
  
• Changes in taste and smell
  
  
• Pain
  
  
• Fatigue
  
  
• Depression

Management

If possible, the first step in treating appetite loss is to treat the underlying cause. Treatment for conditions such as mouth sores, dry mouth, pain, or depression should help improve appetite. Additional treatment for appetite loss and associated weight loss may include appetite-stimulating medications, medications that help food move through the intestine, nutritional supplement drinks, and tube feeding (often a nasogastric tube that passes through the nose into the stomach).

Although you may not feel like eating, it is important to remember that good nutrition and maintaining a healthy weight are important parts of your recovery. Eating well can also help a person better cope physically and emotionally with the effects of cancer and cancer treatment. The following tips may be helpful in maintaining proper nutrition when your appetite is poor.

• Eat five to six small meals a day and snack whenever you are hungry.
  
  
• Determine what 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 (for example, dried fruits, nuts, yogurt, cheeses, eggs, milkshakes, ice cream, cereal, pudding, and granola bars).
  
  
• Keep 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 can make you feel full too quickly.
  
  
• Choose nutritious or filling drinks, such as milk or milkshakes.
  
  
• Ask family members or friends to prepare foods when you are too tired to cook. Ask them to shop for groceries or buy precooked meals.
  
  
• Try to eat in pleasant surroundings and eat meals with family or friends.
  
  
• Eat food that is cold or at room temperature to decrease its odor and reduce its taste.
  
  
• Ask your doctor about ways to relieve other gastrointestinal symptoms, such as nausea, vomiting, and constipation.
  
  
• If your sense of taste is diminished, try adding spices and condiments to foods to make them more appealing.
  
  
• Try light exercise, such as a 20-minute walk, about an hour before meals to stimulate your appetite. (Consult your doctor before starting an exercise program.) Exercise also helps maintain muscle mass.
  
  
• Meet with a registered dietitian (RD) for additional advice on meal planning.