Most cancer patients will exhibit loss of appetite or eating problems at some point in their treatment. Medline Plus Medical Encyclopedia lists the more common cancers prone to appetite loss as colon, ovarian, stomach and pancreatic with tumor growth being a considerable factor. However, all cancers, surgeries, treatments and tumor growth can become problematic. Psychological factors contribute to appetite loss as well. It is imperative to recognize the symptoms as early as possible to avoid a loss of strength and stamina, compromised immunity and muscle wasting. The attending oncology team can prescribe additional nutritional supplements and medications to improve conditions if they are addressed in time.
Psychological Problems
Depression, overwhelming fears and anxiety related to diagnosis and the future are normal and justifiable reactions in cancer patients. They can also contribute greatly to a loss of appetite. The University of Pittsburgh Medical Center encourages a reduction in caffeinated beverages in the diet, plenty of rest and indulgence. Family and friends should be included in meal planning if it increases relaxation and lifts the spirits while the atmosphere can be made more pleasant with the addition of soft music and pretty table settings. Antidepressant and antianxiolytic medication is also an option.
Chemotherapy and Radiation Treatments
Chemotherapy and radiation treatments can cause a variety of complications to appetite from pain, nausea, vomiting and poor taste or sense of smell. The American Cancer Society suggests speaking with the oncology team at the onset of appetite problems, as many of these complications can be remedied with medication. They also suggest trying to eat smaller meals more frequently throughout the day and relying on a variety of comfort foods if that is what is preferred. The oncology team will specify dietary restrictions, but imagination and frequency are key.
Surgery
Surgery is a process in which the cancerous tumors are physically removed, sometimes resulting in appetite loss. The "Journal of Supportive Oncology" posits that the removal of areas pertaining to the head, neck or digestive tract can later cause swallowing problems, a condition known as dysphagia. In addition to the removal of cancerous tissue in these areas, there is often accompanying pain, infection, mouth sores or the requirement of tube feeding where liquid nutrition is given through either the mouth or stomach.
Dysphagia
Dysphagia, the condition related to a difficulty with swallowing, can occur on several levels for the cancer patient. The "Journal of Supportive Oncology" lists 5 corresponding grades to swallowing difficulty. The first grade is when there is a normal function. The second grade is comprised of a difficult time swallowing some hard solids, but semi-solids are well tolerated. The third grade is a condition in which the patient simply cannot take in any food, except in liquid form; this is generally where nutritional supplements and meal replacements become necessary. The fourth grade then begins a significant decline in the inability to take in liquids, and in many situations they are thickened to a more desirable consistency to prevent choking and aspiration of fluids. The fifth grade is the point at which the cancer patient cannot tolerate swallowing their own saliva, much-less thickened liquid nutritional supplements or food.
Tumor Growth
Tumor growth can also impair the cancer patient's ability to retain a healthy appetite. The Pancreatic Cancer Action Network suggests that cancerous tumors can cause significant metabolic changes in the patient's body. These metabolic changes can lead to muscle-wasting, a condition referred to as cancer cachexia. This condition not only prevents nutrition from going to work where it is needed, but it can suppress appetite and lead to rapid weight loss. This is a serious and life threatening stage that requires at minimum, surveillance and palliative care.
References
- Medline Plus Medical Encyclopedia: Appetite-Decreased
- University of Pittsburgh Medical Center: Managing Loss of Appetite (Anorexia) from Cancer Therapy
- American Cancer Society: Caring for the Patient with Cancer at Home: A Guide for Patients and Families
- "Journal of Supportive Oncology"; Palliation of Malignant Dysphagia in Esophageal Cancer: Literature-Based Review
- Pancreatic Cancer Action Network: Controlling Weight Loss
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