Cancer patients must pay special attention to their diet to avoid suffering from appetite loss. They need to consume foods and drinks that are rich in key nutrients, such as vitamins, minerals, protein, carbohydrates and fat. If a patient appears to be losing weight, a physician will review the patient’s medical history and perform a physical examination. If anorexia is diagnosed, the patient will work with members of the cancer care team to ensure that adequate nutrition levels are maintained.

A registered dietitian can help patients plan appropriate meals by providing a nutrition screening and comprehensive diet recommendations. This should continue throughout a patient’s cancer treatment, as circumstances may change over time. For example, patients receiving treatment for early-stage cancers may experience excessive weight gain during chemotherapy.  In contrast, most patients in later stages of cancer are more likely to experience significant weight loss.

To prevent weight loss, patients may be placed on high-calorie diets. Protein content may be boosted to prevent muscle wasting. Foods that may be included in the patient’s diet are peanut butter, dairy products high in fat and meats.

In some cases, cancer patients find it difficult to consume fats and may require a low-fat, high-protein diet. Such foods include lean meats and low-fat dairy products, such as yogurt and cottage cheese.

Patients also are encouraged to eat a variety of fruits and vegetables. Fruit juices and dried fruits are good sources of nutrients that are also packed with calories. Calorie-dense vegetables include corn, peas, potatoes and squash.

Many cancer patients complain that treatments change their sense of taste and smell. In some cases, sweet foods taste sour, sour foods taste sweet and meats taste bitter (due to the release of proteins in the mouth). Chemotherapy and radiation therapy can also leave patients with a metallic taste in their mouths. All of these factors can result in a loss of appetite and decreased intake.

Patients can take several steps that may help lessen these undesirable effects, including:

• Brush teeth several times daily. Mouth rinses such as diluted bicarbonate of soda can also be helpful.
  
  
• Sweeten foods and beverages. Bitter sensations can be lessened by adding sweet fruits, honey or artificial sweeteners such as aspartame.
  
  
• Use substitutes for meat. Bland chicken or fish, eggs, mild cheeses, or tofu may taste less bitter than meat. These foods may taste better in casseroles or stews. Marinating these foods can help as well.
  
  
• Add flavorings to foods but avoid spicy, highly seasoned foods.
  
  
• Use butter or margarine on starchy foods. This helps improve the taste of bread, potatoes and rice and also adds fat and calories.
  
  
• Try foods that previously seemed unappealing. Because of the taste changes associated with chemotherapy, patients may find that they enjoy foods they previously disliked.
  
  
• Eat smaller meals throughout the day, rather than three big meals. Patients may find this is easier both in terms of their desire to eat and their body’s ability to adequately process foods. Snacks also may help patients with bouts of nausea while providing calories. For patients who are unable to tolerate solid foods, high caloric or protein drinks may serve as a supplement to meals.
  
  
• Keep a diet log. Recording the foods consumed can help the patient and dietician determine the nutritional intake. A log can also help patients keep track of the items that are better tolerated for future meal planning. In turn, it can help eliminate the foods that might cause side effects, such as nausea or diarrhea.
  
  
• Consult with other cancer patients and support groups. Individuals who have dealt with cancer may provide valuable recommendations from personal experiences. These suggestions may help patients who are currently suffering from the same complications.
  

In some cases, patients may need prescribed medications to help stimulate their appetite. Such medications include:

• Prednisone. A corticosteroid hormone.
  
  
• Megestrol acetate. Synthetic relative of the female hormone progesterone.
  
  
• Marinol. A legally available synthetic form of marijuana that is delivered in capsule form. 
  

There are some cancer patients that eat properly, but still become malnourished. This may be due to an inability of the body to properly absorb nutrients. In such instances, patients may need to be placed on a feeding tube to ensure that they receive adequate nutrition. There are several forms of feeding tubes that can be used depending on the needs of the patient.

One tube, known as a nasogastric tube (NG tube) is placed in the nose, through the throat and into the stomach. This thin, flexible tube allows specially formulated liquid nutrition to enter the stomach through the tube in the nose. Patients can still eat through their mouths, with the feeding tube used only when necessary. Tube feedings can usually be taken at home and can be performed by the patient or caregiver with training.  In some cases, a more permanent tube may be surgically placed directly into the stomach (gastrostomy) or the intestines (jejunostomy). Liquid feedings may be provided through the tube as the primary source of nutrition or to supplement what is eaten by the patient. When the tube is no longer needed for nutrition, it can be removed by a physician.

Other patients may receive nutrient solutions that are injected directly into a vein. This is known as hyperalimentation or total parenteral nutrition (TPN), and it is typically used for a shorter duration than a feeding tube. Circumstances that might require this type of nutritional support include:

• Surgery of the digestive system
  
  
• Complete blockage of an intestine
  
  
• Severe vomiting and diarrhea
  
  
• Complications that prevent eating or use of a feeding tube
  
  
• Temporary complications expected to resolve in a short period of time
  

Finally, lack of appetite in cancer patients is sometimes related to emotional factors, such as depression. Patients will be monitored for emotional problems and may be referred to a mental health professional if necessary. In some cases, an antidepressant may increase a patient’s appetite.

Anorexia is easier to control if it is treated early. Many patients with the form of malnutrition known as cachexia do not experience a complete reversal of the syndrome, even after undergoing aggressive nutrition therapy. For this reason, it is important for cancer patients to use nutrition monitoring and plan to prevent cachexia before it occurs. 

Patients with anorexia may experience different outcomes. For example, patients who experience anorexia during cancer treatments find it to be mild, and often gain their appetite within weeks after they end treatments. Other patients may experience more severe symptoms and have increased problems with maintaining their nutrition and health. The patient's cancer care team can help determine the best plan of treatment and provide individual recommendations.