More than 50 percent of cancer patients experience substantial weight loss during their illness. This can be caused by side effects of the treatments, or by emotions related to living with cancer. For example, some reasons why cancer patients have difficulty eating include:

• Tumor obstructions that make patients unable to digest nutrients.

• Physical alterations, such as surgery on the stomach or esophagus, that make it difficult to consume food.

• Alterations in taste and smell and abnormalities in the central nervous system that control food intake and the sensation of feeling full after meals.

• Generalized edema (swelling) and inflammation and sores within the mouth caused by radiation therapy.

• Nausea and vomiting caused by chemotherapy or radiation therapy.

• Depression, fatigue and generalized lack of interest.

Severe malnutrition can lead to "cancer cachexia," which is a complex syndrome characterized by loss of appetite and even anorexia (inability to eat), a generalized "wasting" of the body and muscle atrophy, dysfunction of the immune system, and other problems with devastating health consequences.

A loss of 10 percent or more of body weight within the previous six months is a sign that a cancer patient may need nutritional therapy. This can be delivered orally or through feeding tubes in patients who are unable to eat normally.

Cancer patients can try to maintain adequate nutrition by eating healthy foods before, during and after treatment. If patients have been eating a healthy diet before treatments, they will have the reserves to help maintain strength, prevent body tissue from breaking down, rebuild tissue and remain strong against infection. Patients who eat well are also better able to cope with side effects.

Some other tips to help ensure proper nutrition include:

• Eat a light meal or snack before chemotherapy.
• If side effects make it difficult to eat, try eating small, frequent mini-meals or snacks.
• Avoid fried, greasy foods and other fatty foods, which are harder to digest. Instead, eat meals and snacks that are high in protein.
• Drink plenty of water and liquids such as juice, soup and milk-based drinks.
• Ask family and friends to help provide appetizing meals.
• Ask your physician or nurse about medications to help with mouth sores.

Prompt attention to managing nutrition-related problems will help cancer patients maintain their weight, keep energy levels high, and should improve their feeling of well-being..

SOURCES: Cancer Journal for Clinicians vol. 48, 1998, and "Eating Hints for Cancer Patients:  Before, During, and After Treatment", National Cancer Institute