Do you no longer have a desire to eat? Have you lost the enjoyment of food? Do you eat a small amount and feel full? Does half of your food go untouched? These are just some of the things that people with a cancer diagnosis may experience.
We know that loss of appetite is particularly common for those with a cancer diagnosis and this can happen anytime - before, during or after cancer treatment. When this happens, it is common for people to eat less than they usually would, many experience a feeling of ‘fullness’ despite only eating very small amounts while others may not feel like eating at all.
Without consciously realising, we have many fixed routines and habitual practices when it comes to food. Some of these routines can include eating at set times – for example at breakfast, lunch and dinner or choosing similar foods to eat on a routine basis – for example having the same breakfast of say - porridge and toast every morning.
Recent surveys (Bord Bia, 2013) report that 85% of Irish people believe its is important to spend time together as a family over dinner while 70% of Irish people report enjoyment from being able to cook a meal. When people lose their appetite, they are likely to start to think and feel differently about food and the social circumstances that surround this. Simple tasks and daily routines – like preparing food, cooking a meal, sitting down to eat as a family or going out to eat in a restaurant - suddenly become an unsavoury (for want of a better word!) challenge for many.
So, what causes a loss of appetite for those with a cancer diagnosis?
There are many factors which can contribute to a loss of appetite when someone has a cancer diagnosis. Some of these include:
- Stress and emotional trauma associated with a new cancer diagnosis
- Changes in metabolism
- The type, size or location of the tumour. For example, tumours located on the head or neck area have the potential to cause swallowing difficulties while tumours located on or near the gastrointestinal tract (like stomach, bowel, ovarian or pancreatic cancer) can cause a variety of digestive problems.
- Side effects associated with some cancer treatments including; early satiety (feeling full), nausea, vomiting, abdominal pain, changes in bowel habits will also negatively affect appetite
- Fatigue: in some cases, this can leave people feeling they do not have the energy to prepare food and cook a meal let alone sit down and eat. - Coping with Cancer-Related Fatigue
- Sensitivity to cooking smells: particularly strong smells (e.g. fish, meats, onions, soups) which tend to ‘waft’ when hot
- Changes in taste – Tips for taste changes
- Uncontrolled pain
Does it really matter?
At some stage, it is likely we may all experience a loss in appetite. For most, this is usually not serious and can be a side effect to common illnesses e.g. colds/ flu, gastrointestinal viruses or ‘bugs’. When this happens, appetite loss is usually only for a few days and once we feel well again our appetite tends to come back quite quickly!
For a person with a cancer diagnosis loss of appetite is different.
Loss of appetite for someone experiencing cancer tends to last for more than just a few days and for some it can be cyclical depending on treatments and medication. It can lead to an unbalanced diet and an inadequate intake of energy (calories), protein and micronutrients (vitamins & minerals). If this happens, weight loss is likely, which in turn can contribute to increased levels of fatigue, reduced strength and for some, a delay in recovery.
What can be done to help my appetite?
Firstly, to provide a solution, it is important to establish the cause!
It is important to speak with a nurse, GP, consultant or medical professional to discuss your concerns. In some cases, loss of appetite may be secondary to a symptom which is amenable to treatment. For example, appetite loss related to nausea can often be helped with the prescription of anti-sickness medication. You may also be referred to a dietitian.
If I am referred to a dietitian what can they do?
A Dietitian is a degree-trained nutrition expert and the only qualified health professional that can assess, diagnose and treat diet and nutrition-related conditions.
If you have been referred or wish to refer yourself to a dietitian because of loss of appetite they will typically ask you for information about your weight and usually take a diet history (a record of a ‘typical day’ of eating). They may also ask you questions about symptoms or circumstances which may be impacting on your appetite. Once they have fully assessed your diet they will typically provide you with practical nutritional advice to help ensure your diet is as balanced as possible with an aim of preventing weight loss going forward. Ongoing support and nutritional reviews is dependent on the individual needs of the patient.
Ten Top tips for loss of appetite
1. Choose a ‘little and often’ approach: aim to eat every 2-3 hours.
2. Choose smaller meals: aim to have 6-8 small plates of food throughout the day.
3. Choose foods and snacks which are higher in energy (calories) and protein. Avoid foods which are aimed at people trying to lose weight e.g. ‘low fat’ or ‘light’ ranges.
4. Do not restrict yourself or avoid specific food groups (unless you have been asked to by your doctor or dietitian). Make the most of your appetite and when it is good – eat what you want!
5. Choose meals that are easy to prepare and do not require long periods of time standing or cooking in the kitchen. Some people may also find it helpful to cook in bulk and freeze. If you can - get someone to help with shopping or cooking.
6. If hot foods are causing symptoms, avoid cooking smells and choose cold snacks / meals.
7. If you cannot manage to eat a meal or snack, try to have a nourishing drink instead. Milk-based products tend to be a good choice.
8. Try to drink in between meals as drinking with meals can make you feel full more quickly.
9. Consider trying prescribed nutritional supplement drinks (special high calorie shakes) - your doctor or dietitian can advise further.
10. If you think the side effects of a treatment or medication is causing your loss of appetite, approach a health professional e.g. a doctor / nurse specialist and ask if there are any medications which can help!
(adapted from the Irish Cancer Society website)
Will my appetite come back?
Yes, for most people appetite loss is temporary, however it is difficult to provide a time-frame as it tends to depend on many individual factors relating to both the diagnosis and the treatments.
Remember - Think of food as part of your treatment. Food is Fuel 😊
To schedule an appointment with our Registered Dietitian Joanne McCarron based in Strive Clinic Galway call 091 393 180
We also have a new Registered Dietitian at Strive Clinic Killybegs - Fiona Chawke. To schedule an appointment call 074 971 3100