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Loss of appetite

What is loss of appetite?

Loss of appetite is marked by a reduced or lack of desire for food. Appetite loss is common among cancer patients, and can be directly caused by cancer, particularly cancers of the gastrointestinal tract like stomach and pancreatic cancers, as well as ovarian and lung cancer. A loss of appetite can be the result of a condition called “cachexia,” or a metabolic change caused by the cancer itself, which can also be complicated by cancer treatments. Many anti-cancer drugs and treatments, such as chemotherapy, immunotherapy and radiation therapy treatments that are focused on the stomach and intestines, are also linked to a loss of appetite. Side effects that disrupt the gastrointestinal tract may prompt a loss in appetite, too. These include dry mouth; mouth sores; issues with chewing or swallowing; and constipation. Pain, fatigue and depression may also lead to loss of appetite. If left unchecked, appetite loss may lead to serious weight loss and wasting of muscle marked by loss of strength, as well as compromised immune function. Weight and muscle loss can also lead to increased treatment toxicity, as well as treatment interruptions and/or delays.

How likely are cancer patients to experience loss of appetite?

Loss of appetite is common in cancer patients, especially those with ovarian, lung, stomach or pancreatic cancer. It also is a frequent side effect of radiation, chemotherapy and immunotherapy treatments. Other side effects linked to these treatments, such as mouth sores and difficulties chewing and swallowing, can compound appetite loss.

How can integrative care help?

Integrative cancer care clinicians can help address appetite loss by targeting some of the underlying causes, such as nausea and altered taste.

Nutrition Therapy

Consuming enough nutrients to maintain a good nutritional status may be difficult for cancer patients if they don’t feel like eating. Dietitians may recommend scheduled eating times, instead of relying on hunger-based cues, which may be blunted or absent. Dietitians also work with patients’ medical oncologists to recommend appetite stimulants, if appropriate. If loss of appetite is caused by nausea, altered taste, mouth sores or pain, nutrition recommendations may include modified consistency foods and liquid nutrition that are well tolerated and easy to ingest. Dietitians may also recommend vitamin and/or mineral supplementation to make up for deficits in the diet. Additional supplements that contain fish oil or EPA may help correct underlying changes in metabolism. Patients prescribed a feeding tube or intravenous feeding may need additional nutritional support. Dietitians regularly reassess patients’ response to other interventions and communicate with the care team if this type of nutritional support is needed. They will also provide education and monitoring to help patients manage these feedings.