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Treatments

Nutritional problems related to side effects should be addressed to ensure adequate nutrition and prevent weight loss. In particular, cancer patients should maintain an adequate intake of calories and protein to prevent protein-calorie malnutrition. The patient's caloric requirements can be calculated by a dietitian or doctor since nutrient requirements vary considerably from patient to patient.

The following dietary tips may help to reduce weight loss:

Eat more when feeling the hungriest.
Eat foods that are enjoyed the most.
Eat several small meals and snacks instead of three large meals. A regular meal schedule should be kept so meals are not missed.
Have ready-to-eat snacks on hand such as cheese and crackers, granola bars, muffins, nuts and seeds, canned puddings, ice cream, yogurt, and hard boiled eggs.
Eat high-calorie foods and high-protein foods.
Take a small meal as to enjoy the satisfaction of finishing a meal. Have seconds if still hungry.
Eat in a pleasant atmosphere with family and friends if desired.
Make sure to consume at least eight to ten glasses of water per day to maintain fluid balance.
Consider commercial liquid meal replacements such as Ensure, Boost, Carnation, and Sustacal.

An appetite stimulant may be given in order to prevent further weight loss such as megestrol acetate or dexamethasone. In clinical trials, both these medications appear to have similar and effective appetite stimulating effects with megestrol acetate having a slightly better toxicity profile. Fluoxymesterone has shown inferior efficacy and an unfavorable toxicity profile.

Alternative and complementary therapies

Depression may affect approximately 15% to 25% of cancer patients, particularly if the prognosis for recovery is poor. If anorexia is due to depression, there are antidepressant choices available through a physician. Counseling may be also be sought through a psychologist or psychiatrist to cope with depression.

It is important to check with a dietitian or doctor before taking nutritional supplements or alternative therapies because they may interfere with cancer medications or treatments. St. John's Wort has been used as a herbal remedy for treatment of depression, but it and prescription antidepressants is a dangerous combination that may cause symptoms such as nausea, weakness, and may cause one to become incoherent.

See Also Taste alteration

Resources

BOOKS

Keane, Maureen, et al. What to Eat If You Have Cancer: A Guide to Adding Nutritional Therapy to Your Treatment Plan. Lincolnwood, IL: National Textbook Company/Contemporary Publishing Group, 1996.

Nixon, Daniel W., M.D., Jane A. Zanca, and Vincent T. DeVitaThe Cancer Recovery Eating Plan: The Right Foods to Help Fuel Your Recovery. New York: Times Books, 1996.

Quillin, Patrick, and Noreen Quillin. Beating Cancer With Nutrition—Revised. Sun Lakes, AZ: Bookworld Services, 2001.

PERIODICALS

Kant, Ashima, et al. "A Prospective Study of Diet Quality and Mortality in Women." JAMA 283, no. 16 (2000): 2109-15.

Loprinzi, C.L., et al. "Randomized Comparison of Megestrol Acetate Versus Dexamethasone Versus Fluoxymesteronefor the Treatment of Cancer Anorexia/Cachexia." Journal of Clinical Oncology 7, no. 10 (1999): 3299-306.

Roubenoff, Ronenn. "The Pathophysiology of Wasting in the Elderly." The Journal of Nutrition 129, no. 1 (1999):256-9.

Tisdale, Michael J. "Wasting in cancer." The Journal of Nutri tion 129, no. 1 (1999): 243-6.

ORGANIZATIONS

National Center for Complementary and Alternative Medicine (NCCAM). 31 Center Dr., Room #5B-58, Bethesda, MD20892-2182. (800) NIH-NCAM, Fax (301) 495-4957.<http://nccam.nih.gov>.

The National Cancer Institute (NCI). Public Inquiries Office:Building 31, Room 10A31, 31 Center Dr., MSC 2580, Betheseda, MD 20892-2580 (301) 435-3848, (800) 4-CANCER, <http://cancer.gov/publications/>, <http://cancertrials.nci.nih.gov>, <http://cancernet.nci.nih.gov>.

American Institute for Cancer Research. 1759 R Street NW, Washington, D.C. 20009. (800) 843-8114 or (202) 328-7744. <http://www.aicr.org>, e-mail: support@aicr.org.

Crystal Heather Kaczkowski, MSc.

Anorexia

—A condition frequently observed in cancer patients characterized by a loss of appetite or desire to eat.

Cachexia

—A condition where the bodyweight "wastes" away, characterized by a constant loss of weight, muscle, and fat.

Cancer

—A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread through the bloodstream and lymphatic system to other parts of the body.

Chemotherapy

—Chemotherapy kills cancer cells using drugs taken orally or by needle in a vein or muscle. It is referred to as a systemic treatment due to fact that it travels through the bloodstream and kills cancer cells outside the small intestine.

Enteral nutrition

—Feedings administered through a nose tube (or surgically placed tubes) for patients with eating difficulties.

Parenteral nutrition

—Feeding administered most often by an infusion into a vein. It can be used if the gut is not functioning properly or due to other reasons that prevent normal or enteral feeding.