Cancer: managing appetite loss during treatment

The number of new cases of cancer in the UK has been increasing every year for the past thirty years. This is due to the ageing of the population as well as improved detection methods.

Once the diagnosis is established, care plan is set up. 

What are the different types of treatment for cancer? 

Care plan involves several treatments that are administered throughout the care process, from the announcement of the disease to supportive care and follow-up after the cure.

The choice of treatments is decided by the medical team in agreement with the patient.

The main cancer treatments are:

• Surgery, the main treatment for cancer, which consists of removing the tumour; also known as exeresis or resection,
  
• Radiotherapy: the use of high-energy ionising radiation to destroy cancer cells,
  
• Chemotherapy is the administration of cytotoxic drugs that destroy tumour cells,
  
• Targeted therapies, which consist of specifically targeting certain molecules in the body, blocking the mechanisms of proliferation of cancer cells and therefore the development of the tumour,
  
• Hormone therapy is the administration of drugs that block the synthesis of certain hormones and prevent their binding to receptors. This concerns the growth of certain cancers, favoured by the sex hormones produced by the body (e.g. breast cancer, cervical cancer, prostate cancer, thyroid cancer),
  
• Immunotherapy, which acts mainly on the patient's immune system to make it capable of attacking the cancer cells,
  
• Stem cell transplantation is a type of treatment that consists of replacing the patient's bone marrow. It is used for the treatment of leukaemia and lymphoma.
  

Combinations of treatments are possible and there is no typical combination in cancer treatment.

Unfortunately, most of the time, cancer treatments cause side effects. They are not systematic and depend on the treatments received, the doses administered, the type of cancer and the way the patient reacts to the treatment.

Among these side effects, loss of appetite is very common.

Why can loss of appetite be linked to cancer treatment? 

Cancer and its treatment can cause a change in eating habits. This is also due to the psychological consequences of the disease and the location of the tumour.

Among other things, there is a decrease in or loss of appetite, but also an alteration in taste and smell as well as digestive problems.

It is recommended that the risks of nutritional imbalances, which could lead to weight loss, undernutrition or obesity in the medium and long term, are discussed with the oncologist immediately after the start of treatment.

As far as the loss of appetite is concerned, this is most often the consequence of chemotherapy and radiotherapy treatments, which can cause anorexia. This should be monitored closely as too much weight loss is linked to a poor prognosis.

Drugs can also cause nausea, vomiting and sometimes inflammation of the mouth or oesophagus, which can lead to pain or ulcerations that make it difficult to chew and swallow food.

A change in taste and smell (metallic taste, disgust for strong smells) due to treatments can also lead to loss of appetite.

30% of people with cancer lose weight during their treatment. However, limiting this weight loss allows them to better bear the treatments and to recover more quickly.

What can you do to have a better appetite during cancer treatment? 

In order to identify risks, the assessment of the patient's nutritional status is essential throughout the care process. This is why nutritional management is integrated into support care.

Health professionals are recommended to provide a better support for each cancer patient. This is an important issue that allows the success of treatments, the improvement of quality of life and the reduction of the risks of relapse.

In the most extreme cases, i.e. when weight loss is too significant, partial or total parenteral nutrition is necessary.

Before this, drugs are sometimes prescribed to increase the appetite, such as corticosteroids or androgenic steroids, megestrol and dronabinol.

Other solutions, more related to the patient's nutritional behaviour are also possible:

Watch your weight and report weight loss of more than 5% to your doctor 

With the loss of 5 to 10% of weight, there is a risk of undernutrition.

Have a suitable physical activity 

Physical exercise stimulates the appetite. Regular exercise makes you feel good and helps combat sedentary lifestyle.

Indulge yourself

Anticipate meals and snacks, take the time to prepare them well, eat at the table, choose colourful foods. Don't hesitate to satisfy your craving for food or snacks as soon as it arises. Remember to vary your dishes and try other flavours.

Prefer small calorie portions and split meals

Lighter and smaller meals are more digestible and avoid generating disgust. Remember to chew well and slowly.

If you have a poor appetite, you should choose meals that provide energy and calories.

Make your food taste better

Adding more flavour to your food stimulates the appetite, so don't hesitate to add lemon, spices and herbs. It also reduces the amount of salt.

Red meat consumed during treatment is often associated with a metallic taste that causes sickness. So try to prefer white meat.

Eat cold and water-rich foods

In the event of dry mouth due to chemotherapy, for example, it is recommended to eat cold and liquid (or semi-liquid) food and also to drink plenty of water.

It is better to drink between meals in order to avoid the feeling of satiety accentuated by the water taken during the meal.

Create a friendly atmosphere

Being accompanied by family and friends, having a well-prepared meal at a nicely set table, with music or a bouquet of flowers encourages you to enjoy your meal and stimulates your appetite.

Eat at a distance from taking medication

Some medicines have the side effect of reducing the patient's appetite or causing nausea and vomiting. When possible, they should be taken between meals.

Talk to your doctor before applying any of these solutions, as there are many contraindications and also risks related to certain food-drug interactions during cancer treatment.