Managing Your Loss of Appetite

The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.

• What Will I Learn By Reading This?
• Should I Eat Differently During My Chemotherapy?
• How May Chemotherapy Change How I Eat?
• What Is Loss of Appetite?
• How Long Will My Loss of Appetite Last?
• What Can I Do To Manage My Loss of Appetite?
• When Should I Call My Doctor?
• What Have I Learned By Reading This?
• Key Words

What Will I Learn By Reading This?

When you have chemotherapy (key-mo-ther-a-pee) to control your prostate cancer, you may have side effects or unwanted changes in your body. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. You will learn:

• Why you need to eat differently when you have prostate cancer treatment
• How chemotherapy can affect how you eat
• Why chemotherapy causes a loss of appetite (feeling hungry or wanting to eat)
• Things you can do to manage your loss of appetite
• When to call your doctor

It is important for you to learn how to manage the side effects you may have from chemotherapy so that you can keep doing as many of your normal activities as possible.

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Should I Eat Differently During My Chemotherapy?

How a person is told to eat during his prostate cancer treatment is very different from how he would eat if he were not having prostate cancer treatment. This can be confusing for many people because these new ways of eating may seem to be the opposite of what they've always heard. You will usually hear on the news or read in the newspaper that to be healthy you should eat lots of fruits, vegetables, and whole grain breads and cereals; including a small amount of meat and dairy products; and cutting back on fat, sugar, alcohol, and salt. When you have prostate cancer treatment some of these healthy eating rules are not followed.

When you have treatment for your prostate cancer, you may be told to eat higher calorie (the amount of energy a food gives to your body when you eat it) foods that are high in protein. You may also be told to eat or drink more milk, cream, cheese, and cooked eggs. You might also be told to use more sauces and gravies or to change how you cook so that you use more butter, margarine, or oil. Sometimes, you might be told to eat less of certain high-fiber foods like bran or whole grain breads because these foods can make your side effects (unwanted changes in your body) worse.

How a man with prostate cancer eats is different from how a person without cancer eats. When you go through prostate cancer treatment you are told to eat in a way that helps build up your strength and helps you get through the side effects of your prostate cancer and its treatment. Eating well can help you:

• Feel better
• Keep your strength and energy
• Keep up your weight
• Handle treatment side effects better
• Lower your chance of getting an infection (when germs enter your body causing you to have a fever or pain, redness, and swelling in one part of your body)
• Heal and get better faster

When you are healthy, eating enough food to get the nutrients (materials that food is made up of that gives your body energy) you need is usually not a problem. During your prostate cancer treatment it can be hard to get the food you need to help keep your body strong because of side effects or you don't feel well.

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How May Chemotherapy Change How I Eat?

The powerful anticancer medicines you take can affect the healthy cells in your body, including your cells that line the inside of your digestive system (the system in your body made up of your mouth, throat, stomach, and intestines that uses the food you eat to give your body energy). This can make it very hard for you to eat. The chemotherapy medicines you are taking can also:

• Make you lose your appetite
• Change the way foods taste and smell
• Make your mouth sore
• Make you feel sick to your stomach (nausea)
• Make you want to throw up (vomiting)
• Give you diarrhea or constipation

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What Is Loss of Appetite?

Loss or lack of appetite is when you do not feel hungry, do not want to eat, or have no taste for food. This is a very common side effect from chemotherapy treatment.

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How Long Will My Loss of Appetite Last?

Most chemotherapy medicines cause you to lose your appetite. How bad your loss of appetite will be depends on:

• The kind of chemotherapy medicine you are given
• How much chemotherapy medicine you get
• How you take your chemotherapy medicine

The good news is that your change in appetite will not last. It may take two to six weeks after you stop chemotherapy for your appetite to come back. There are also medicines your doctor can give you that can help you if your loss of appetite is really bad.

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What Can I Do To Manage My Loss of Appetite?

On some days you may feel like you just can’t eat. Many people getting chemotherapy feel this way. This can be hard for you and for the person in your family who cooks the meals. What tastes good to you today may not taste good to you tomorrow. There are things you can do to help deal with this treatment side effect.

• Try to drink plenty of fluids. It is important to do this on those days when you don't feel like eating. Water is very important to keep your body working well. Getting enough fluids will make sure that your body has the water it needs. Try to drink 8 eight-ounce cups of fluid a day. Try carrying a water bottle with you during the day. That may help you get into the habit of drinking plenty of fluids.
• Choose and make foods that look and smell good to you. If you don't feel well and can eat only one or two things, stick with them until you are able to eat other foods.
• If food does not smell good to you, ask a family member, friend, or neighbor to help you by cooking a meal for you. People often want to help you during your treatment and this is an easy thing that they can do.
• Try a liquid or powdered meal replacements, such as "instant breakfast," for extra calories, protein, or when it is hard for you to eat food.
• Stay open to trying many different kinds of food. This may help your appetite if foods you like do not taste good. Try new seasonings such as ginger, salt, cinnamon, vinegars, or soy sauce to make food taste better to you. You may find that you need to use more seasoning on your food than before you started treatment. For a change, try eating out at a friend’s or family member’s house.
• Keep snacks within easy reach so you can have something whenever you feel like it. Cheese and crackers, muffins, ice cream, peanut butter, fruit, and pudding are good possibilities. Take a snack you can carry with you when you go out, such as peanut butter crackers or small boxes of raisins.
• When you can eat, try to eat meals and snacks high in protein and calories such as meat, fish, milk, eggs, cheese and nuts. These foods help you keep up your strength, prevent body tissues (groups of cells that form parts of your body like your muscles, skin and nerves) from breaking down, and rebuild tissues that cancer treatment may harm. If red meat, such as beef, tastes or smells strange, try chicken, turkey, eggs, dairy products, or mild-tasting fish instead. To help keep up your weight, you can add high calorie foods, such as sour cream or melted cheese to a baked potato or ice cream to a shake.
• Many people find their appetite is better in the morning. Take advantage of this and eat more then. Consider having your main meal of the day early.
• Try tart foods, such as oranges or lemonade that may have more taste. If you have a sore mouth or throat, tart or citrus foods might cause pain or discomfort.
• Try softer, cool, or frozen foods, such as yogurt, milkshakes, or popsicles.
• Eat several small meals and snacks throughout the day rather than two or three larger meals. For example, eat breakfast at 8 am, a snack at 10 am, lunch at noon, another snack at 2 pm, and then dinner at 5 pm. If you feel full after eating even small amounts of food, cut down on the amount of liquid you drink with your meal or drink liquids after you finish your meal.
• Stay away from unpleasant smells. These may lower your appetite.
• Chew sugar-free gum or eat candies and mints to help get rid of the metallic or bitter taste in your mouth and help get rid of mouth dryness.
• If smells bother you, try serving foods at room temperature, turning on a kitchen fan, covering foods when cooking, and cooking outdoors in good weather.
• Make mealtimes as relaxed and pleasant as possible. Presenting food or meals in a nice-looking way may also help.
• Eating cold foods rather than hot foods may be more enjoyable.
• If your doctor says it is ok, have a small glass of wine or beer during a meal. It may help to increase your appetite.
• On those days when you can't eat at all, don't worry about it. Do what you can to make yourself feel better. Start eating again as soon as you can. Let your doctor know if this problem doesn't get better within a couple of days.
• Try doing light exercise (walking, cooking, or washing dishes) 30 minutes before you eat. This may increase your appetite.
• Tell your doctor or health care team if you have problems eating or with your weight.

Plan For Managing Your Loss of Appetite

Do you need to go to the grocery store to buy any food? If so, what will you buy?

• Do you have a family member, friend, or neighbor who might be able to help you by cooking a meal for you? Write down their name and contact information.
• How do you get in touch with your doctor or health care team if you need help?

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When Should I Call My Doctor?

You should call your doctor if:

• You have trouble swallowing
• You are losing weight
• You have nausea that keeps you from eating even if you are taking medicine to make this side effect better
• You vomit (throw up) more than four to five times in one day
• You get mouth sores (small cuts or ulcers that appear on your lips or mouth during your chemotherapy treatment)
• You still have a loss of appetite even though you’ve tried some of the suggestions.

If you have any of these signs talk to your doctor or health care team. There are medicines and treatments that can help you feel better. It is important that you talk to your doctor or health care team about any side effects you may have during or after your treatment. Your health care team can help treat these problems.

What Have I Learned By Reading This?

You learned about:

• Why you may need to eat differently during your chemotherapy
• What loss of appetite is
• Why chemotherapy can cause a loss of appetite
• Things you can do to help manage your loss of appetite
• When to call your doctor

If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.

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Key Words

• Anticancer: medicines used in the treatment of cancer.
• Calorie: the amount of energy a food gives to your body when you eat it.
• Chemotherapy (key-mo-ther-a-pee): a prostate cancer treatment, which treats your whole body with powerful anticancer medicines to kill many of your prostate cancer cells.
• Constipation : when your bowel movements become less regular than normal and your stool is hard, dry, and difficult to pass.
• Diarrhea (dye – a – re – a): loose and runny bowel movements that happen more three or more times in one day.
• Digestive system : the system in your body made up of your mouth, throat, stomach, and intestines that uses the food you eat to give your body energy.
• Infection: when germs enter your body causing you to have a fever or pain, redness, and swelling in one part of your body.
• Mouth sores : small cuts or ulcers that appear on your lips or mouth during your chemotherapy treatment.
• Nausea: an unpleasant feeling in the back of your throat and stomach that may cause you to vomit.
• Nutrients: materials that food is made up of that give your body energy.
• Side Effects: unwanted changes in your body caused by your prostate cancer treatment.
• Tissues : groups of cells that form parts of your body like your muscles, skin and nerves
• Vomiting: a powerful tightening of your stomach muscles that causes the contents of your stomach to come up through your mouth; Throwing up.

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