Lack of Appetite

Some people with cancer may have a poor appetite. This can be caused by chemotherapy treatments, medications, or the disease itself. For example, you may not feel like eating if your treatment makes you feel sick, or you may go off food if your treatment has caused temporary taste changes. In most cases people find their appetite and taste goes back to normal once their treatment has finished, however it may take a few months before it returns to normal.

Medication

If your appetite is reduced because of feeling sick, your doctor can prescribe anti-sickness drugs which should be taken regularly so that the sickness is controlled. Please contact your hospital medical team for further advice.

If you have a reduced appetite and are losing weight as a result of this, it may be possible for you to be prescribed a low dose of steroids or a drug called Medroxyprogesterone acetate (Provera) to boost your appetite. Please contact your hospital medical team for further advice.

If you have been prescribed steroids, Medroxyprogesterone acetate (Provera) or anti-sickness medication, make sure you take them as prescribed by your doctor. Do not exceed the maximum dose that you have been prescribed.

If you are struggling to eat properly or are losing weight, your medical team may suggest you use meal supplements. Meal supplements are food products (either ready-made soft or liquid products such as hot drinks, cold drinks, milkshakes, savoury soups, yogurts or soft desserts, or in powder form to make up yourself or add to food) that contain nutrients and calories to supplement your regular diet or completely replace meals if you are unable to eat. Meal supplements such as Ensure, Fortisip or Fresubin will usually be prescribed by your hospital medical team or GP.

Some of these supplements (either ready-made or in powder form) such as Complan or Build-Up can be bought without a prescription from pharmacies and some supermarkets, however they can be expensive and you may need to try a few different types to see which you prefer. You should not take more than your doctor or dietician recommends, as some of the supplements contain vitamins that could be harmful if taken in large amounts. It is important to tell your hospital medical team if you are taking any other vitamin supplements.

Eating

The dietary advice on this page may not be applicable to you if you have diabetes, have had oral, stomach or bowel surgery or have difficulty chewing or swallowing.

Eating

If you do go off food it is important to eat what you like when you feel like it, and to make sure that you have as many calories as possible. Do not give yourself a hard time if you really do not feel like eating in the 2 or 3 days after any treatment you may have had, you can make up for lost calories in between treatments. On a good day when you do have an appetite try to eat really well.

Attempt to eat a well-balanced diet of small regular (high protein and high calorie) meals every 2-3 hours during the day.

Keep snacks handy to nibble – such as nuts, crisps, cheese or fruit.

Although fluid intake is important do not fill your stomach with a large amount of liquid before eating.

Try to eat high calorie foods to keep your weight up. Choose full fat and high calorie options whenever you can.

If the smell of food cooking spoils your appetite ask family or friends to cook for you. If this is not possible consider eating cold foods that do not need cooking.

Try to eat when you are relaxed and without distractions.

Prepare and store small servings of your favourite foods in advance, so there is always something to eat when you feel hungry.

Have a stock of convenience foods in the cupboard, such as tinned soups and puddings.

Ginger, either as ginger biscuits, ginger tea or ginger beer can reduce feelings of sickness.

Tips to Boost Energy in Everyday Foods

There are lots of ways to add extra calories to your meals and snacks.

You may like to try a few of them to see which work best for you:

Use butter, milk, honey and cheese to add extra calories and protein to foods that you eat.

Use full cream milk instead of semi-skimmed or put 2 to 4 tablespoons of milk powder into a pint of full cream milk to make fortified milk.

Add full cream or fortified milk to tea, coffee or bedtime drinks such as Horlicks, Ovaltine or drinking chocolate.

Make up packet sauces or soups with milk or fortified milk instead of water and add cream to canned soups.

Soak porridge oats in full cream milk with added sugar overnight. This softens them and makes them easier to eat. You can then add dried fruit or seeds to boost nutrients and calories.

Mix grated cheese or cream with mashed potato.

Melt butter on top of hot vegetables or garnish with grated cheese, chopped hardboiled egg, or a sauce made with fortified milk.

In sandwiches use plenty of butter or margarine and spread fillings thickly. Add mayonnaise to sandwich fillings like hardboiled egg or tuna.

Try biscuits with your drinks.

Add minced meat, lentils, beans, noodles or pasta shapes to soups.

Add cheese and a little cream to an omelette.

Dip cooked soft vegetables in dips such as hummus or sour cream.

Make milkshakes or smoothies with ice cream, yoghurt and fresh fruit.

Have full fat fromage frais and yoghurt.

Add sugar, jam, honey or syrup to desserts.

Add ice cream, cream or evaporated milk to cold puddings and add custard (made with full cream or fortified milk) to hot puddings.

Tips for Dealing with Taste Changes

Chemotherapy can affect your sense of taste. About half of people receiving chemotherapy experience taste changes. You might find food and drinks taste different than usual (more salty, bitter or metallic). In most cases people find their taste goes back to normal once treatment has finished, however it may take a few months before it returns back to normal. There are no specific treatments for taste problems.

Consider the following tips to cope with taste changes:

Eat foods that taste good to you and avoid those that taste unpleasant. Try these foods again after a few weeks as your taste may have improved.

To prevent an unpleasant taste in your mouth it can help to suck ice lollies and boiled sweets or chew fresh pineapple, celery or chewing gum.

Experiment with different flavours by using herbs, spices, garlic and lemon juice in your cooking (however be careful with strong spicy/citrus food if your mouth is sore). You can also use chutneys, pickles or relishes to add flavour to food.

Some people find cold foods taste better than hot foods, whilst others prefer hot foods over cold foods. See which works best for you.

If you go off the taste of tea or coffee try herbal or fruit tea instead.

If food tastes metallic, try using plastic forks or spoons.

Try stronger tasting versions of your favourite foods – for example have smoked ham or bacon or strongly flavoured cheese.

Physical Activity and Exercise

Physical activity may help to increase your appetite. If possible, try to take some gentle regular exercise.