Symptom Specific Services

Weight Loss
• Weight loss
• Benefits of good nutrition
• Nutritional assessment

Weight Loss
Weight loss is a particularly common problem for people with cancer. Weight loss is the result of the inability to maintain nutrition, which can have many causes in people with cancer. Cancer and its treatment can lead to severe protein-calorie malnutrition, which is the single most common secondary diagnosis in the cancer patient.

Protein-calorie malnutrition exists when the intake of calories is inadequate to meet nutritional needs. This malnutrition may lead to progressive wasting, weakness, debilitation, compromised immune function, compromised intolerance to cancer treatment and, ultimately, death.

Anorexia, the loss of appetite or desire to eat, is the most common symptom in people with cancer. It may occur early in the disease process or later as the tumor grows and metastasizes. This condition is different from “anorexia nervosa,” which is a psychiatric diagnosis.

Anorexia is present in 15 percent to 25 percent of all cancer patients at the time of diagnosis, and it is almost universal in patients with advanced disease. Anorexia is the most common cause of decreased nutrient intake. It can trigger malnutrition and progressive exhaustion from hunger, deterioration with muscle wasting, and body compositional changes.

Cachexia is a clinical wasting syndrome. Symptoms include weakness and a marked and progressive loss of body weight, fat, and muscle. Anorexia and cachexia frequently occur together; however, cachexia can occur in individuals who are ingesting adequate calories and protein but who are not absorbing nutrients well.

It has been estimated that one half of all people with cancer experience cachexia and two thirds of all patients with progressive cancer experience cachexia. Researchers have found that cancer cachexia differs from simple starvation: individuals adapt to simple starvation by decreasing their metabolic rate, whereas in cancer patients, the metabolic rate does not adapt and calories are used inefficiently.

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Benefits of good nutrition
Patients who eat well often feel better and have more energy. Eating well during cancer treatment means getting enough calories and protein to help prevent weight loss, regain strength, and rebuild normal tissues.

Eating a balanced diet will help your body cope with whatever side effects you have and will also help you regain your strength. There may be times during chemotherapy when you do not feel like eating. Familiar foods may taste or smell different. Some patients experience a slightly metallic taste when they are chewing.

Good nutrition is important for everyone, but especially for people being treated for cancer. Eating nutritious foods while undergoing cancer therapy can help you:

• Feel better

• Keep up your strength and energy level

• Keep up your weight and your body's nutrition supply

• Tolerate treatment-related side effects

• Decrease your chance of infection

• Recover and heal as quickly as possible

For more details about the nutritional aspects of your disease, visit the following Web site: http://www.oncolink.com/coping/coping.cfm?c=3

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Nutritional assessment
Because nutrition is important, Continuum Cancer Centers of New York provide free nutrition screenings, follow-up, and one-on-one counseling sessions with specially trained nutritionists. A nutritionist will help you learn about your nutritional needs during treatment and help you cope with side effects that may affect eating.

Continuum Cancer Centers of New York understands that nutritional needs vary from person to person. Our health professionals, including doctors, nurses and dieticians, will work with you to determine your specific needs.

The following suggestions may help increase your appetite:

• Eat food when you feel hungry. Don't wait until mealtime.

• Select foods that appeal to you. Try new dishes.

• Walk before meals. It may stimulate your appetite.

• Rinse your mouth with a non-alcohol-based mouthwash before meals. This may reduce the metallic taste some people experience.

• Avoid drinking soda or other fluids before meals as they may make you feel full sooner.

• Don't become discouraged if you do not eat on the day of your chemotherapy or a few days after. Resume eating as tolerated, returning to a pre-treatment diet.

Dieting
While dieting is not advised, many patients with cancer change their diets to reflect healthier eating patterns. Many patients report that post-treatment lifestyle changes have helped them improve their quality of life. Some women getting adjuvant chemotherapy for breast cancer may gain weight. This special situation can be helped with guidance from the nutritionist.

Alcohol
You may be advised to avoid or limit your intake of alcohol, as it may interact with some of your medications. Alcohol also causes dehydration and it is particularly important to stay hydrated during chemotherapy. Do not drink alcohol the day before, during, or after treatment. In small quantities alcohol may increase your appetite.

Medications
Medications are often helpful in dealing with weight loss caused by cancer. Megestrol acetate (Megace), an anabolic steroid, may increase weight. Dronabinol and Marinol are FDA-approved forms of marijuana that can help stimulate the appetite. Ask your doctor about these medications.

Complementary and alternative treatments
Certain vitamins and alternative or complementary treatments can interfere with the effects of chemotherapy. In general, a multivitamin is acceptable but it is important to speak with your doctor or nurse before taking any vitamins or other medications.

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