Cancer and preventing weight loss

According to the American Cancer Society, in 2021, there was an estimated 1.9 million newly diagnosed cases of cancer in the United States. The leading types in men are prostate, lung, and colon or rectal cancer and in women are breast, lung, and colon or rectal cancer. While there is not a significant difference in diagnosis in men versus women, over 80% of individuals that are diagnosed with cancer are age 55 or older.

Risks for developing this disease vary from non-modifiable causes such as family history to modifiable risk factors related to smoking, drinking alcohol, an overweight or obese status, and an unhealthy diet. Depending on the cancer type, nutrition status can be impacted making it more difficult for some to meet their energy and protein needs, resulting in weight loss. Working with a registered dietitian can be helpful to prevent malnutrition and limit excessive weight changes.

Symptoms and impact

With cancer diagnosis, treatment, and progression, the amount and severity of symptoms can increase affecting not only nutritional status but also overall quality of life. Most common symptoms contributing to malnutrition are appetite loss, early satiety, xerostomia, weight loss and constipation. These concerns can be associated with treatment but in some individuals may persist once treatment is completed. In those with symptoms that are not well managed, malnutrition is more likely to influence mental, physical and functional health.

What is cancer cachexia?

In some cases, a person with cancer may experience cancer cachexia. This condition is a change in the body’s metabolism triggered by disease inflammation. Individuals may notice unintentional loss of muscle and fat mass, a lack of appetite, have increased energy needs for everyday activities, and lose weight as a result of these changes. Most often, this condition is associated with head and neck, stomach, pancreatic, lung, or lower gastrointestinal (GI) tract cancers. Limiting weight loss from cancer cachexia is a primary goal to promote positive overall outcomes.

Weight loss management

When trying to maintain a healthy weight, a registered dietitian may suggest several different options. Identifying the primary problem or problems contributing to the weight loss is essential in determining an individualized plan. Providing an accurate food and nutrition history, weight changes and symptoms being experienced are important in finding a starting point. For managing common symptoms with cancer that cause weight loss, consider the following recommendations.

• Appetite loss. At some point, up to 70% of individuals with cancer voice concerns over appetite loss. Meals once enjoyed no longer taste the same and skipping meals becomes a new norm. Lack of nutrition, especially over a long time, can quickly add up and create multiple deficiencies of nutrients the body needs. Several ideas should be trialed in times of a low appetite. Consider finding the time of day when hunger is more likely and be sure to eat a nutrient-dense meal, avoid low calorie options, and select high calorie/high protein foods like an oral nutrition supplement or bar. If possible, try to do some exercise to help stimulate appetite.
• Early Satiety. Feeling full at meals or even after only a couple of bites is problematic in almost half of patient’s dealing with cancer. Determining if this symptom is treatment-related or if there is a change in actual GI function can help to fix this problem. There are several different types of medications that can help with this symptom and stimulate the GI tract if this is the problem. Diet modifications to suggest with early satiety are small, frequent meals, creating a meal “schedule” based on certain times of the day, avoiding liquids with solids at meals, and to stock up on easy-to-fix meals and snacks.
• Xerostomia. Pesky xerostomia or extreme dry mouth may not develop until after treatment is started but can significantly impact intake and weight. Chewing and swallowing may be more difficult and lack of saliva from the mouth can change the taste of food and beverages. Adding moisture to meals and snacks can help to alleviate this problem. Taking sips of a liquid after a bite of a meal and cooking with broth or soups can help make food easier to eat. Staying hydrated with no less than 8 cups of water per day can also improve dry mouth.
• Constipation. Lack of bowel movements can lead to stomach discomfort and bloating. The longer this problem occurs the more difficult it is to eat. Forty percent of patients undergoing cancer treatment notice a change with their normal bowel function. Medications, food, and fluids can all influence constipation. To help manage this condition, drink 64 to 80 ounces of water per day, add foods with insoluble fiber including bran or flaxseed, and discuss a bowel regimen with medicinal fiber or stool softeners with your care team.

If you have more questions about your diet, it’s always a great idea to speak with a registered dietitian. Registered dietitians are the only credentialed experts qualified to address your unique health questions. Click here to request a direct consultation with a dietitian today!

References:

American Cancer Society. Cancer Facts & Figures 2021. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf. Accessed June 14, 2022.

Levin R. Managing Nutrition Impact Symptoms of Cancer Treatment.  In: Oncology Nutrition for Clinical Practice. 2nd edition. United States: Academy of Nutrition and Dietetics; 2021:194-217.

Levin R. Nutrition Risk Screening and Assessment of the Oncology Patient. In: Oncology Nutrition for Clinical Practice. 2nd edition. United States: Academy of Nutrition and Dietetics; 2021:60-67.

Trentham K, Donato A, Huddleston E. Nutrition Management of Oncology Patients in Palliative and Hospice Settings. In: Oncology Nutrition for Clinical Practice. 2nd edition. United States: Academy of Nutrition and Dietetics; 2021:546-547.

Trujillo E, Hamilton-Reeves J. Energy Balance, Body Composition, and Physical Activity for Cancer Prevention, Treatment and Survivorship. In: Oncology Nutrition for Clinical Practice. 2nd edition. United States: Academy of Nutrition and Dietetics; 2021:44-45.