Anorexia
About cancer related anorexia

Anorexia, or the lack or loss of appetite that is combined with decreased food intake, is one of the most frequently reported problems for people with cancer. A poor appetite can result from the effects of the cancer itself or from treatments for cancer. It is the most common symptom contributing to poor nutrition in cancer patients. Some evaluators feel that as many as 80% of those with cancer experience changes in appetite. ³³ Anorexia can keep you from eating enough nutrients. It can have a severe impact on your quality of life. Sometimes these changes last a few days. For others anorexia becomes an ongoing concern. Anorexia can be one of the most challenging symptoms for patients and families.

Anorexia associated with cancer is the result of many aspects of altered body function. Researchers continue to learn what has an effect on eating and digestion. Studies try to determine how each identified function interacts within the process to maintain adequate nutritional health. Food intake is controlled in the brain. Currently, studies are trying to determine the role of the brain and the hormones and other chemical messengers that control the amount of food taken into your body. Many of the chemical messengers have been identified and further study is needed to determine how they affect anorexia.¹⁸

A cancerous tumor can affect the appetite, the digestion of food eaten, and the energy requirements of the body. Studies have shown that tumors produce chemicals that change the way the body uses nutrients. All cancer treatments can cause anorexia and affect your nutritional health. Research continues to search for the exact causes and for the treatments of anorexia so that the nutritional status of those with cancer can be improved.

Many factors contribute to the loss of appetite. You may not have any of the factors. The good news is that if you do experience these difficulties, they can often be well controlled. Some contributing factors are:

• changes in taste, smell, or saliva,



• mucositis



• inflamed mouth



• inflamed esophagus



• difficulty swallowing



• poor teeth, ill-fitting dentures



• anxiety, depression



• fear



• pain



• medications



• fatigue



• loss of sleep



• difficulty breathing



• nausea, vomiting



• bloating



• lactose intolerance



• constipation



• diarrhea



• early satiety (feeling full earlier than expected)



• therapeutic diets (special diets prescribed by your health professional)



• food aversions (specific foods that you find particularly unpleasant)



• unpleasant odors or sights



• social isolation

Anorexia with decreased eating has crucial consequences for people with cancer, and can affect how you feel daily. Anorexia, if not treated and managed, can progress to a more severe condition, known as cancer cachexia. While limited weight loss is sometimes expected during treatment, the benefits seen by managing anorexia include an increased quality of life and a better ability to tolerate treatments.

Prevention of weight loss is the goal for anyone undergoing cancer treatment. Your nurse, dietitian, physician and other members of the health care team are resources to you. They will want to assess your nutritional status early during your treatment. This assessment identifies any dietary changes that may be needed to keep you as nutritionally healthy as possible.