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  • General

  • Cancer Cachexia

    Why it happens: 

    Cancer cachexia, also known as the ‘wasting syndrome’, is a complex condition caused by a combination of changes in the body’s metabolism and reduced food intake. People with cachexia may experience severe loss of weight, loss of appetite, feeling sick, anaemia (low red blood cells), weakness and tiredness. In cancer cachexia, this can occur even if they are eating well. Some people may benefit from specialist oral nutritional supplements that may help with weight loss as a result of cachexia. You can speak to your Healthcare Professional or ask to see a Dietitian about this who can provide advice.

    Weight loss

    Why it happens: 

    Some people will experience weight loss during their cancer journey. This can be due to the location of the cancer in the body, the side effects of different cancer treatments or a combination of these. Some types of cancer can affect the body’s metabolism, making the body break down both fat and muscle which can lead to weight loss. The side effects of treatment itself can cause nausea, vomiting or changes in taste that may put a person off their food.

    Helpful tips: 

    If you are losing weight, it is important to increase calorie and protein content in your diet. Here are some practical tips to help slow down or prevent further weight loss:

    • Eat small, frequent meals and snacks every 2-3 hours.
    • Avoid drinking too much fluid with meals.
    • Increase your intake of foods that are high in calories and protein. Use full fat milk instead of semi-skimmed, and mix grated cheese or cream into foods such as mashed potato and soups. For more tips on foods to eat, see the recipe ideas.  
    • Keep high-calorie snacks within easy reach. Cheese and crackers, biscuits, cakes, nuts, crisps, dried fruit and peanut butter on toast are a good way to get extra calories and protein throughout the day.
    • A high energy and high protein oral nutritional supplement can also help increase calorie and protein intake. Talk to your Healthcare Professional or ask to see a Dietitian to discuss whether this could be an option for you.

    Weight gain

    Not all people with cancer will experience weight loss during the cancer journey and some may even gain weight. In certain types of cancer weight gain is more common. For example, those patients with breast, prostate or ovarian cancer taking hormone therapy or receiving chemotherapy which includes steroids in the regimen may experience unwanted weight gain.

    Helpful tips:

    Here are some ideas that can help you deal with your weight gain when you have a good appetite.

    • Plan ahead! This way you will have all the ingredients you need to prepare a balanced meal.
    • Eat everything in moderation. There is no need to cut out any food group, as long as you control portions. For example, you can have smaller portions by using a small plate.
    • Replace high fat and sugary snacks with healthier, high fibre alternatives.
    • Snack on high fibre foods which can keep you feeling fuller for longer. Nuts, fruit and vegetables are high in fibre and make nutritious snacks.
    • Eat plenty of fruit and vegetables. Try including fruit or vegetables at every meal, for example add fruit to cereal at breakfast.
    • Keep high calorie foods out of sight and make pieces of cut up fruit and vegetables available to snack on.
    • You may find it helpful to see a Dietitian for advice on how to lose weight after you complete your treatment.


    Why it happens:

    Cancer treatment may go on for weeks, if not months, and sometimes people living with cancer say they often feel exhausted as they continue through treatment. This can make it a real struggle to cook meals and you may even be too tired to eat. It is important to discuss this with your Healthcare Professional who can see if there is any particular reason why you feel so tired, for example if you are anaemic which they could give you treatment for.

    Helpful tips:

    • Have plenty of snacks on hand. Keep foods like biscuits, sweets, chocolate, dried fruit (raisins, dates, and apricots), cheese and crackers in the house.
    • When you are feeling better, prepare large quantities of your favourite meals and freeze the leftovers in meal-size portions.
    • Consider buying readymade or oven ready meals and foods, take-away meals or having meals delivered.
    • When you are unable to eat as much, taking oral nutritional supplements in between meals as a top up can help. Talk to your Healthcare Professional about options that may be available.

    Emotions around Eating

    There are many emotional reasons why someone may not eat as much during cancer treatment. If you are living with a diagnosis of cancer you may be feeling worried, anxious and upset. This can affect your appetite and how much you feel like eating.

    Helpful tips:

    If you are feeling low in mood, eating well can help give you the energy and strength you need to feel better.

    • You may not always feel like cooking meals and if you are normally the person in charge of the cooking it may feel strange to let someone else take on this role. Try not to feel guilty about this change.
    • Talk about your emotions and feelings with a close friend or confident.
    • If you find it hard to talk about these feelings with family and friends, you can also speak to your Healthcare Professional or social worker. There may be local counselling services that you could be referred into.

    The content of this page was reviewed by Saira Chowdhury
    Specialist Upper GI Oncology Dietitian
    Guys & St Thomas' NHS Foundation Trust
    January 2015