Loss of Appetite

Many cancer patients experience a loss of appetite, which is a common side effect of cancer and its treatments. Ongoing appetite loss may lead to serious complications. These include weight loss, malnutrition, as well as fatigue and weakness from muscle loss, which is called cachexia (see below). These issues can hinder recovery and lead to breaks in treatments.

A loss of appetite can be caused by the cancer itself or due to cancer treatments, causing symptoms that may lead to loss of appetite. Causes of loss of appetite include:

• Progression of tumour
• Symptoms such as pain, nausea, constipation, oral ulcers, ascites, difficulty in chewing or swallowing.
• Side effects of medications and treatments
• Psychological factors, such as depression and stress.
• Felling of fullness over the abdomen due to fluid in the abdomen (ascites), abdominal mass
• Unpleasant odours or sights

One should talk to the doctor about their loss of appetite.  Some medications may improve may help regain appetites:

• Metoclopramide (Maxolon)
  • Usually taken 15 minutes before meals, three times a day.
  • Helps to improve nausea and to move food out of the stomach. It can prevent the sense of fullness before eating enough food.
• Steroids
  • This can stimulate appetite and improve a person’s sense of well-being. 
  • Usually used for short periods of time, as long-term use is associated with many unwanted side effects.
  • It is especially helpful if the patient has large liver tumours causing distending discomfort.
  • Steroids are usually given in the morning to avoid problems with sleeping.
• Megestrol acetate (Megace)
  • These are forms of the progesterone hormone that can improve appetite and weight gain. It may be associated with a higher risk of blood clots.

• Maintain oral hygiene. Clean the mouth (i.e. with mouthwash, brushing teeth) before eating to enhance the sense of taste.
• Relieve symptoms such as dry mouth, nausea, constipation, pain and emotional issues.
• Stick to regular mealtimes and eat frequent meals
  • Having frequent meals with smaller portions
  • Try not to skip meals. Try to eat regularly, even a few bites.
  • Carry a snack bag and keep favorite foods in hand for snacking
• Make meals appealing and fun
  • Use interesting containers
  • Decorate the food
  • Try placing food in smaller containers
  • Prepare favourite foods based on changes in taste
  •  Decorate the dining table
• Stimulate one’s appetite
  • Try to eat in pleasant surroundings and with family or friends
  • Try playing upbeat music and turning on soft lights to make mealtimes relaxing and pleasurable
  • Try exercising lightly or walking before meals
  • Avoid certain foods that can produce gas, such as beans, broccoli, corn, cabbage, cauliflower, carbonated drinks and chewing gum.
• Consume more calories
  • Eat nutritious snacks that are high in calories and protein. This includes nuts and nut butters, yogurt, cheeses, eggs, ice cream, pudding, and protein bars.
  • Choose nutritious or filling drinks, such as milk, nutritional milkshakes or smoothies.
• Cover up tastes and smells
  • Consider adding spices and condiments to enhance flavour
  • Use plastic utensils to help prevent a bitter or metallic taste
  • Clean the mouth before and after eating to get rid of any aftertastes and to freshen the mouth
• Avoid lying in bed or sleeping immediately after eating

Smart patient (by Hospital Authority): Loss of appetite

HKU Med, Jockey Club Institute of Cancer Care: Diet for health after cancer treatment

Videos

▶️ Hospice Home: Loss of appetite (Chinese version only)