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Deaconess Cancer Services Dietitians

Cancer and its treatment can have effects that lead to changes in eating habits and the desire to eat, including a loss of appetite.

Loss of appetite is called anorexia. People with a very low appetite that lasts more than a few days usually lose weight. Losing weight from not eating enough can often make a person feel weak and have fatigue. This may affect their quality of life and ability to do usual activities. It can also affect how they respond to cancer treatments.

Eating as well as you can is an important way a person with cancer can help to take care of themselves. It's important to talk to the cancer care team about any expected appetite changes before surgery for cancer, or before other types of treatment are started. Reporting appetite changes early can help limit problems from losing too much weight and having poor nutrition.

Here are some hints that may help if you are having changes in your appetite:

Eat several small meals or snacks throughout the day, rather than 3 large meals.
Avoid drinking liquids with meals, or take only small sips of liquids while eating to keep from feeling full early (unless you need liquids to help swallow or for dry mouth). But remember it's important to stay hydrated, so it might be best to drink most of your liquids between meals.
Make eating more enjoyable by setting the table with pretty dishes, playing your favorite music, watching TV, or eating with someone.
Be as physically active as you can. Start off slowly, and increase your activity over time as you feel stronger. Sometimes a short walk an hour or so before meals can help you feel hungry.
Keep high-calorie, high-protein snacks on hand. Try hard-cooked eggs, peanut butter, cheese, ice cream, granola bars, liquid nutritional protein supplements, puddings, nuts, canned tuna or chicken, or trail mix. (See the table of high-protein foods in Eating Well During Treatment.)
Review the tips on adding calories and protein to foods and include these in meals and snacks throughout the day.

Eat your favorite foods any time of the day; for instance, if you like breakfast foods, you can eat them for dinner.

How can caregivers help with loss of appetite

Try giving the patient 6 to 8 small meals and snacks each day.
Offer starchy foods, such as bread, pasta, or potatoes, with high-protein foods, such as fish, chicken, meats, turkey, eggs, cheeses, milk, tofu, nuts, peanut butter, yogurt, peas, and beans.
Keep cool drinks and juices within the patient’s reach.
If the smell of food bothers the patient, serve bland foods cold or at room temperature.
Create pleasant settings for meals, and eat with the patient.
Offer fruit smoothies, milkshakes, or liquid meals when the patient doesn’t want to eat.
Try plastic forks and knives instead of metal if the patient is bothered by bitter or metallic tastes.
Don’t blame yourself if the patient refuses food or can’t eat.
Be encouraging, but try not to nag or fight about eating.
If the patient can’t eat, you might want to offer just your company. Or offer to read to them or give them a massage.

Taste Changes
Certain types of cancer and its treatment can change your senses of taste and smell. Common causes include:

Certain kinds of tumors in the head and neck area
Radiation to the head and neck area
Certain kinds of chemotherapy and targeted therapy
Mouth sores or dryness due to certain treatments
Some medications used to help with side effects or other non-cancer problems

Taste and smell changes can often affect your appetite. They might be described as:

Not being able to smell things other people do, or noticing a reduced sense of smell.
Noticing things smell different or certain smells are stronger
Having a bitter or metallic taste in the mouth.
Food tasting too salty or sweet.
Food not having much taste.

Here are some tips to help the patient with taste changes:

Try using plastic forks, spoons, and knives and glass cups and plates.
Try sugar-free lemon drops, gum, or mints.
Try fresh or frozen fruits and vegetables instead of canned.
Season foods with tart flavors. Use lemon wedges, lemonade, citrus fruits, vinegar, and pickled foods. (If you have a sore mouth or throat, do not do this.)
Try flavoring foods with new tastes or spices (onion, garlic, chili powder, basil, oregano, rosemary, tarragon, BBQ sauce, mustard, ketchup, or mint).
Counter a salty taste with added sweeteners, a sweet taste with added lemon juice and salt, and a bitter taste with added sweeteners.
Rinse your mouth with a baking soda, salt, and water mouthwash before eating to help foods taste better. (Mix 1 teaspoon salt and 1 teaspoon baking soda in 4 cups of water. Shake well before swishing and spitting.)
Keep your mouth clean and brush your teeth to help ease bad tastes.
Serve foods cold or at room temperature. This can decrease the foods’ tastes and smells, making them easier to tolerate.
Freeze fruits like cantaloupe, grapes, oranges, and watermelon, and eat them as frozen treats.
Eat fresh vegetables. They may be more tempting than canned or frozen ones.
Try marinating meats to make them tender.
If red meats taste strange, try other protein-rich foods like chicken, fish, beans or peas, tofu, nuts, seeds, eggs, or cheese.
Blend fresh fruits into shakes, ice cream, or yogurt.

To reduce smells, cover beverages and drink through a straw; choose foods that don’t need to be cooked; and avoid eating in rooms that are stuffy or too warm.