Perhaps the food just doesn't taste right…or mouth and throat discomfort makes eating an uncomfortable experience at times…or you just don't feel hungry. You may also be coping with other side effects, such as nausea, constipation and diarrhea, that also tend to diminish interest in eating. Whatever the cause, loss of appetite is a common problem for people with cancer. This may be an issue for you for just a few days, perhaps around the time of receiving chemotherapy, or it may be ongoing.

The bottom line is this: you must eat to keep strong and help your body fight the cancer. So the challenge should be not whether you will eat, but to find ways to make eating a tolerable and even pleasurable experience while you consume enough calories to maintain your weight and overall health. Just as you are taking treatments and medications to fight your cancer, you should consider your investment in eating properly a positive and necessary step in having the best quality of life possible.

Prevention & Coping

While it may not be possible to really protect yourself from loss of interest in eating, there are some steps you can take to cope:

• Understand loss of appetite for what it is — a normal and even expected side effect of some cancers and treatments. Don't interpret temporary loss of interest in food as an indicator that you're getting sicker.
  
  
• Understand the nutritional relationship between your food and your well-being. Spend some time reading up on how nutrition works, what different foods contribute to your health. It's important to understand that you'll need both high protein foods (these keep your body tissues from breaking down during treatment) and high calorie foods to prevent weight loss. Weight loss undermines your body at a time when it can least afford to use its stored nutrients as a primary energy source. Continuing weight loss also increases the risk of infection. See our Nutrition section.
  
  
• Realize you are not alone in experiencing loss of appetite — and speak with others about coping with the problem. Ask your health care team for a reference to a dietician; she or he can help you think through effective coping skills to eat well. If you participate in a cancer support group, raise the issue there. You'll find others have had this same problem, and some of their techniques may also work for you.
  
  
• Resolve to minimize the stress around eating. Many cancer patients find that their caregivers are upset by the patient's refusal to eat — and this increases stress on both parties. Encourage your caregivers to educate themselves about problems cancer patients sometimes experience about eating, and find ways to manage this issue together. Working as a partnership in managing eating works far better than a tug-of-war.
  
  
• Weigh yourself at regular intervals at the same time of day, using the same scale each time.
  
  
• Understand the ups and downs of eating while in treatment. Don't be surprised if foods taste different than usual — or that a snack you thought would be appealing, just isn't ten minutes later when you try to eat it. All of this may be chemical, and it is not occurring because you are getting sicker or being difficult. It's important that your caregivers understand these things, too.

Treatment

There are many approaches that cancer patients have used to encourage eating when experiencing loss of appetite. Here are some of the best for you to consider:

• If you develop an aversion to a particular food or foods you used to like, don't try to force yourself to eat it. Your liking for this food will probably return after treatment ends, and there is no reason to force yourself to eat it during treatment.
  
  
• Think small, and think frequent, in terms of meals. Many patients find eating big, traditional meals three times a day uncomfortable. Experiment with what works for you — such as eating when you're interested in doing so, regardless of time of day, and eating many small servings of food throughout the course of the day and evening. And be prepared for your patterns of eating to change as you progress through treatment. What worked last week may need adjustment this week — and that's fine.
  
  
• If possible, be "in the world," staying involved in as many of life's normal activities and work as possible. Being active encourages appetite. If possible, fit moderate exercise into your day; this encourages appetite, too. Like many things, some exercise is better than none.
  
  
• Make planned meals as pleasant as possible. Encourage company when you eat, and make the setting pleasant and attractive. If you are alone, read or watch a favorite television program or movie. Distractions like these help head off thinking about how many more bites one must take, how much food is left to eat, and so forth.
  
  
• If preparing food is a problem, ask for help from caregivers, family members and friends. Many people are looking for ways to help you — and meal preparation can be one such way. If caregivers aren't available, many communities have agencies that can help; ask your hospital social worker for assistance with finding these community organizations.
  
  
• Sometimes cold foods may be easier to eat, as they have less odor.
  
  
• Eat what tastes good to you. Worry less about eating a balanced diet than you usually would.
  
  
• If you are having heartburn or reflux symptoms, or feeling "full" after eating just a little, report this to your health care provider.
  
  
• If you find you are still not eating enough every day and are losing weight, consult a dietician and your health care team about using nutritional supplements.
  
  
• It's important to eat protein in sufficient quantities every day. Make a special effort to seek out foods that contain protein to keep you strong. Foods that are high in protein include canned tuna fish, some soups (look at the label for information), chicken, turkey, red meats, fish, canned nuts, cottage cheese, ricotta cheese, peanut butter, milkshakes, yogurt, milk, cheese, eggs, hummus, some granola bars and puddings. If milk products upset your stomach (meaning you are lactose-intolerant), seek out special milk that is lactose-free or lactose-reduced.
  
  
• If eating a given food, such as meat, is off-putting to your appetite, consider combining the meat, such as ground beef, in with sauces and vegetables and pasta, for example. Combining food in creative ways can be more pleasing to a fading appetite. For example, if just eating cheese is unappetizing, consider preparing a simple grilled cheese sandwich or melting some cheese as a sauce for vegetables.
  
  
• Adding additional butter or margarine to foods can not only help to add calories, but it also can alter the taste and texture of the food in pleasing ways.
  
  
• Work to control nausea; nothing is more off-putting to an appetite. There are excellent medications to help control nausea and you should make certain your health care team is providing these to keep your nausea controlled.
  
  
• Constipation and diarrhea can affect your appetite, especially if persistent, and should be treated. See Constipation and Diarrhea.
  
  
• After some types of cancer surgery, high fat foods can cause digestive problems such as gas, diarrhea, cramping or constipation. Ask your health care team if your surgery might be expected to cause these symptoms.
  
  
• Drink plenty of fluids, avoiding carbonated beverages if possible. Keeping well-hydrated helps control nausea and other chemotherapy-caused side effects.
  
  
• If your mouth has a continuing "metallic" taste, try sucking on sweet hard candies or other flavored candies to reduce the metal taste. Experiment to find which tastes work best.
  
  
• Use seasonings to subtly alter the taste of food you are finding unpleasant. Seasonings like basil, oregano and rosemary can make meat or fish or poultry more interesting, for example. Marinating these foods in sweet fruit juices or tart dressing can also produce a flavorful taste.
  
  
• Use cooking methods that are not off-putting. If the odor of frying food is disturbing to you, consider baking or roasting.

If your appetite is so impaired that you are steadily losing weight, your health care team will need to help solve this problem. They may want you to use medications to help increase appetite, and to use food supplements as well. Severe weight loss, called "wasting," is a serious side effect of cancer treatment, and it must be corrected.

Questions for Your Doctor

In treating loss of appetite, your health care team may include a nurse, dietician and oncologist.

1. How can you help me find ways to improve my diet, even though I lack an appetite?
   
   
2. How many calories should I consume each day?
   
   
3. I'm not eating much because I've gained weight during my cancer treatment. How can I modify my diet to get good nutrition without gaining more weight?
   
   
4. Is there a dietician available for me to consult?
   
   
5. How long will I continue to experience strange tastes in my mouth? What is causing this?
   
   
6. I am losing weight steadily. How can we approach and reverse this problem? What are my options?
   
   
7. I continue to eat very little because of continuing nausea from treatment. How can you help me control my nausea?
   
   
8. Should we consider using medications like corticosteroids, dronabinol (Marinol) or megestrol (Megace) to treat my lack of appetite?

Resources