How to Stay Nourished and Hydrated if You Have Metastatic Non-Small Cell Lung Cancer

What Are the Risks of a Loss of Appetite?

Not eating enough healthy foods can lead to unwanted weight loss, loss of muscle mass, increased fatigue, and malnutrition. And failing to maintain adequate nutrition and hydration can affect how well you respond to treatment and affect your quality of life, according to the ACS.

“It’s less likely that any treatment will help you if you can’t keep nutrition up and get up and move about,” says David Graham, MD, a hematologist and medical oncologist with Atrium Health Levine Cancer Institute in Charlotte, North Carolina. “I tell people, ‘You’re on the see-food diet: If you see food, eat it!’”

Sometimes, conventional wisdom about eating and nutrition has to be discarded entirely, Dr. Graham says. “One of the biggest problems I have to get through with patients,” he says, “is that so many of us are raised on three meals a day. With cancer, that often becomes frustrating if you can’t eat a big meal.”

His advice? Always have something around to munch on that’s high in calories and protein. “I don’t care as much about cholesterol or any of that,” he says. “I want good calories and protein.”

What You Can Do About Appetite Loss

Remember that good nutrition is important, even when you don’t feel like eating. Try to think of food as part of your treatment, since it can help you keep up your strength and energy, maintain a healthy weight, and reduce your risk of infection, according to the National Cancer Institute (NCI).

The Advances in Nutrition review notes that early intervention to prevent or treat malnutrition and muscle loss plays a vital role in reducing the risk of treatment complications and death.

If your appetite has been affected by treatment for metastatic non-small cell lung cancer, try these tips from the ACS and NCI to help get the calories and nutrients you need:

• Talk to your doctor about ways to address other underlying problems or conditions that may be contributing to your poor appetite. Your doctor may also prescribe medications that can help directly with appetite and weight loss.
• Instead of three large meals a day, try having six to eight small meals.
• Eat foods you enjoy, whenever you feel hungry. (But try to eat healthy, whole foods that are dense in calories and protein when you can). Try pudding, ice cream, yogurt, hard-boiled eggs, peanut butter, and cream-based soups.
• Don’t be afraid to try new foods, because you might find you enjoy different things during treatment.
• Add sauces and gravies to meats cut into small pieces to make it easier to chew and swallow.
• Avoid dry or coarse snacks if you have dry mouth or difficulty swallowing. Chewing gum or sucking on ice cubes or hard candy can help with dry mouth.
• Try light exercise an hour before meals to stimulate your appetite, and remain as active as you can throughout the day.
• Use flavored supplements designed to boost nutrition.
• Drink between meals rather than with meals to avoid feeling too full.
• Try eating foods cold or at room temperature, rather than hot, if you’re sensitive to taste or smell.
• Add spices or flavorings to make the taste of food more appealing.
• Ask friends and family to help you shop for or prepare meals if you’re fatigued.
• Make meals more enjoyable by playing your favorite music or watching TV while you eat, or eating with a friend.

Caregivers, you can help with nutrition by offering snacks and starchy foods (bread, pasta, potatoes), keeping cool drinks handy, and making shakes and smoothies when the person you’re caring for doesn’t want to eat. Encourage eating without nagging or arguing. And the ACS stresses that it’s important not to blame yourself if your loved one refuses to or can’t eat.

Taofeek Owonikoko, MD, a thoracic medical oncologist and executive director of the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center in Baltimore, says he tells his patients to “eat as much of a balanced diet as they can.”

He adds that marijuana might also help, because it may stimulate appetite, but remains cautious. “I cannot be an advocate for it,” Dr. Owonikoko says, “but my patients who have used marijuana have reported improvement in appetite and less nausea. People report good outcomes with the use of medicinal marijuana products.”

Obtaining it can be tricky. Laws on medical marijuana use vary by state, which can make it difficult to buy, depending on where you live. Visit the National Conference of State Legislatures to learn more about your state’s medical marijuana laws.

The ACS notes, though, that medical marijuana wasn’t better than a placebo or a drug (megestrol acetate) used to increase appetite in studies of people with cancer. They support the need for more research on medical marijuana for people with cancer and say decisions to use it should be made by the cancer patient and their doctor.

Owonikoko also encourages exercise to help stimulate appetite, with a caveat. “You shouldn’t overdo it,” he says. “You should do as much as you feel you can tolerate.”

He also says you might want to seek professional help. “Depending on where you have been treated, you might have dietitians who can give you advice on what kind of food to eat. That’s something that can help.”

If you’ve lost your appetite, talk to your doctor or a registered dietitian about ways to get the essential nutrients you need to help you power through treatments.

Additional reporting by Colleen de Bellefonds.