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Cancer, cancer treatments and loss of appetite
Question
My husband is very ill with oesphogal cancer which has spread to lymph glands. He has had one course of chemotherapy where the tumours did reduce but we have found they have grown back, and that they may have spread to the bones. Waiting for result of bone scan. He has also recently had radiotherapy on the oesophagus area and neck. All this has hit him very hard and I cannot get him to eat anything. He is also sleeping a lot and has lost his voice. Would this be a result of the radiotherapy or just depression? Have you any suggestions as to what to do? I am realistic about outcomes but would just like to see him eating more with more energy if possible.
Answer
Discussing your concerns with your husbands Doctor or Healthcare professional will help you to understand the side effects he is experiencing, and assist you in setting realistic goals in terms of his eating and drinking.
For many people, the side effects of oesophageal cancer and its treatment can make eating very difficult. Many of these symptoms can be improved, and so again, I would recommend that you discuss them with his Healthcare professional. Achieving good symptom control may benefit food intake.
If your husband would like to see a Registered Dietitian, he can ask his GP or Hospital Doctor to make a referral. The Dietitian will be able to undertake an individual nutritional assessment, taking into account your husbands specific eating and drinking difficulties in order to provide you with personalised specialist dietary advice.
If he is experiencing swallowing difficulties, it is likely that softer, smoother foods will be better tolerated. For example:
Creamy soups, custard, milk puddings, smooth yoghurts. Using sauces and gravies will help to moisten food and make it easier to swallow. The Dietitian will be able to provide you with further suggestions and written information to help with menu ideas. If your husband feels able to eat, the following general dietary suggestions may help:
- Eat ‘little and often’ i.e. small amounts every 2-3 hours rather than 3 larger meals. Soft snacks that may be good to try include: egg custard (no pastry), soft trifle, mousse, fromage frais, full fat yoghurt.
- Choose foods that are higher in protein and/or calories e.g. full fat milk rather than skimmed milk, or full fat yoghurt in preference to diet yoghurts
- Add extra calories and protein to food by adding cream, cheese, or butter to savoury items. Try adding sugar, honey or evaporated milk to sweet items
- Make meal times as relaxed and pleasant as possible. Gentle encouragement to eat can be helpful, but insistence can be wearing for you both.
If your husband really doesn’t feel like eating, then he should try to drink small amounts of nourishing fluids (e.g. milk, fruit juice, milk shakes, and smoothies) as often as he can. Nutritional supplement drinks may be helpful. Supplement drinks contain protein, calories, vitamins and minerals. They are available in a variety of styles and flavours, and your husband may benefit from trying a few different types so that he can find the ones he prefers. Doctors can provide a prescription for nutritional supplement drinks, and your husband’s Healthcare professional can help to arrange this. The Dietitian will be able to explain what nutritional products are available and help decide which ones may be most suitable for your husband.
Source: Nutrition in cancer Editorial Board
