Breast Cancer and Loss of Appetite

(LifeWire) - Breast cancer treatment can really throw your appetite for a loop. Not only do chemotherapy, radiation and other therapies directly decrease hunger, but other side effects can also interfere with your desire or ability to eat. You may be dealing with nausea, vomiting, mouth sores or changes in your sense of smell or taste, or both. The stress and fear that can accompany diagnosis and treatment of breast cancer may also affect your appetite.

Why Do Cancer Treatments Affect Appetite?

Cancer treatments can wipe out many normal cells in the body, including some of those that line the gastrointestinal tract, thus causing nausea. Cells in the mouth and nose can also be affected, causing changes in smell and taste that can make eating less desirable.

If you stop eating healthy, regular meals, your immune system could be further weakened, making it that much harder to fight the cancer. Poor nutritional status can also lead to a loss of muscle mass and an electrolyte imbalance, adding to already existing feelings of weakness and fatigue. Even if you don't find yourself hungry, you should try your best to follow the basics of a healthy diet, including:

• Consuming an appropriate number of calories per day for your weight and height. To maintain your current weight, a rule of thumb is 15 calories per pound of weight, per day.
• Making sure that no more than 30% of your daily caloric intake comes from fat.
• Eating foods high in protein, which helps the body repair damaged tissues and boosts your immune system. Multiply your body weight by 0.5 to 0.6 to calculate your target protein intake in grams.
• Concentrating on eating the healthiest foods, including five or more servings of fruits and vegetables and whole (not processed) grains.

Eating when your appetite is at an all-time low can be a frustrating and difficult experience. Because it's so important to your recovery, you might try looking at it as another dimension of your treatment plan. You may not notice yourself feeling hungry, so it's a good idea to schedule your meals and snacks and do things to make this time as pleasant as possible for yourself.

A good first step might be to ask for a consultation with a registered dietitian who can provide counseling about appropriate targets for calories, fat and protein intake. In severe cases, your doctor might also recommend an appetite-stimulating medication. Other suggestions include:

• Eat smaller meals.
• Eat more frequently -- perhaps a small snack every few hours.
• Don't drink liquids during or just before meals, because they'll just fill you up. Healthy, solid food will provide your body with better nutrition. (If you suffer from dry mouth, disregard this suggestion.)
• Cut back on foods and beverages that supply only "empty calories" -- that is, calories that don't provide nutritional benefits, such as sweets, alcohol, salty snacks and soda.
• Keep healthy snacks (yogurt, nuts, cheese sticks) on hand, and carry them with you when you go out.
• If you are struggling to consume the necessary amounts of proteins, fats, vitamins and minerals through solid foods, consider using a liquid or powdered nutritional supplement. You can buy these mixes or nutrition shakes at most grocery stores or pharmacies. Of course, consult your doctor before taking any supplement.

Chemotherapy and radiation treatments have a number of side effects that can make eating more difficult. Here are some suggestions to help you deal with some of the following problems:

Mouth sores or sore throat

• Avoid acidic, spicy and salty foods.
• Avoid raw, crunchy, crisp or rough foods.
• Try softer foods, including pureed foods, milkshakes, smoothies, soups and healthy juices.
• Try very cold and frozen foods, such as ice pops and sorbet, which can be soothing.
• Take tiny bites and cut food into small pieces.
• Use a straw instead of drinking from a cup.
• Ask you doctor about using lozenges or sprays that can lightly numb your mouth, making it less painful to eat.

• Keep water or other beverages on hand during meals.
• Try softer, more liquid foods.
• Use sauces, butter or gravies to help moisten your food.
• Ask your doctor about using artificial saliva.

• Don't fight your preferences. If certain foods that you once enjoyed become unappealing, choose other nutritious foods that are now more appetizing.
• Boost flavor with herbs, spices, sauces or marinades.
• As long as citrus doesn't bother you, try a squirt of lemon or lime on foods to perk up flavor.
• If smells bother you, eat cold foods, which tend to give off fewer aromas.

• Keep some crackers by your bed, and eat a few before getting up in the morning.
• Sniff a lemon or eat a small piece of candied ginger; many find these tricks soothing.
• Avoid heavy, oily, fatty, spicy and fried foods.
• Eat very small meals every few hours, rather than three large ones.
• If you are on anti-nausea medications, which most patients tend to be, be sure to take them as directed and on time.

_Sources:

<sub>"Coping with Physical & Emotional Changes." Cancer.org. 2008. American Cancer Society. 12 May 2008.

Doyle, C., et al. "Nutrition and Physical Activity During and After Cancer Treatment." CA: A Cancer Journal For Clinicians." Nov-Dec 2006; 56 (6): 323-353.

"Eating Hints for Cancer Patients: Before, During, and After Treatment: An American Cancer Society Guide for Informed Choices." Cancer.gov. 2008. US National Institutes of Health. 12 May 2008.

"Nutrition Problems and Their Solution." ClevelandClinic.org. 3 Apr. 2008. Cleveland Clinic Center for Consumer Health Information. 13 May 2008.</sub>