What's up with so much weight loss?

[cindyz]

I guess this might be a very simple question with a simple answer, but it eludes me! I cannot figure out why Stephen doesn't have an appetite. He's lost about 60 pounds since dx and is at about 168 or so. He's very tall, usually very athletic, and now he's skin and bones. I can't figure it. He's had Megace prescribed, but it really doesn't help that much. He says, basically, that nothing sounds appetizing.

It's not nausea; he's really had absolutely none of that. It's not aversion to food. He just really doesn't want to eat much. Nothing excites him, he doesn't crave anything, he is very apathetic about taking his meals and I know probably tries to force food down him just to maintain his weight.

What I don't understand is the reason why. What has been happening to his body to take his appetite away? He's joined the gym and exercises probably an average of 3 times a week both cardio and weights. Pretty much takes it out of him but he does it anyway. He knows it's good for him.

His friends have offered him marijuana (more times than I can count) and even though he used to enjoy this recreationally back in his younger years, he said he really didn't have any inclination to do it now. I know he's supposed to "graze" throughout the day and eat smaller meals, but this still doesn't really help the appetite.

I'm thinking...if I could figure out what's physically going on to prevent him from wanting to eat, maybe I can figure out how to make that better. He does get a pain in his abdomen and says that he's never felt completely right since his colon resection...says it feels like built up gas or something. Could this have something to do with it (even though it might not be gas)?

Thanks for any ideas or suggestions!

[SkiFletch]

Wish I could offer more help/advice Cindy, but that's the way I feel on some of my chemo days, although it does not persist at all. Even though he has no nausea, has he tried meds like compazine, zofran, ativan, emend, etc for nausea? I know they help me feel more like eating when I'm in that chemo lull in appetite.

[cindyz]

Well...he has promethezine for nausea (I think I'm spelling that right) but he never takes it because he never had nausea. It's not really related to chemo either, there isn't a "good time or a bad time" for when he's hungry or not. He just basically is...not.

On another side note...yay! Got our picture up finally. This was our wedding day last year.

[michelle c]

Hi Cindy

Sorry to hear that your husband has lost weight and has no appetite.....it must be a worry for you. I also suffered with this especially after my colon resection and physically I could only eat small amounts.

My GP prescribed a medication called mirtazapine, initially to help me sleep as I was suffering from severe anxiety from the diagnoses. It is also an anti-depressant although I wouldn't say that I was depressed just very anxious but apparently it is good for anxiety too. Another thing it does is helps to increase your appetite. I didn't notice it at first but then I started to notice that I was always hungry which is great if you have lost weight or don't have any appetite. I've now gone off it as I really don't want to put on more weight, I was on it for about 6 months. You take it at night - I started with 15mg for 2 nights then increased to 30mg at night. At first it made me quite sedated but this did wear off after a week or two. No other side effects to mention. Please google it and read the wikipedia site. If you have any questions please ask or send me a PM.

Best wishes

Michelle

[John603]

Cindy,

I losy 57 pounds in the first 6 months of 2007 from diagnosis, surgery, and my first three months of chemo. My wife would make supper and I would say that I wasn't hungry. She would put 5 pieces of vegetables, five pieces of pasta and three very small pieces of meat. I would start to eat and I would usually finish the plate and ask for seconds. You just need to get him to start the first plate. Never give him a large plate overflowing with food. It is instant nausea.

[Kathryn in MN]

What is happening? Treatment for cancer is happening. Even if you don't have nausea, you can certainly have lack of appetite. I do. But I force myself to eat and drink. Mouth sores can add to the not wanting to eat or drink.

It is easier for me if someone else makes the food - I do deal with a lot of nausea. And even when i don't want to eat, most of the time once I start, I can finish. But sometimes the food will taste so "off" that my stomach turns and I'm done for several hours. Food loses its taste for a lot of us - I find that once I am feeling better the last few days before treatment time again, I can eat more variety. I go for stronger flavors - sour or spicey - because I can taste them. So many things just taste like cardboard, and that isn't a lot of fun to eat.

Maybe try slightly sour or spicey items in small portions, and insist he take 3 bites. Once he gets the first few in, he can probably finish. Sometimes the first few just don't even taste like food. But it seems if you keep eating it gets a little better. Keep bananas around and see if he'll eat those. Soup is good to get in fluids and calories together. So is hot cereal like Cream of Wheat.

Also, don't worry about it being real healthy - if something sounds good, have him eat it. Banana cream pie or whatever it may be - go for it. Also some form of protein shake could be good. I drink Isagenix shakes and put a banana in them. This gives me extra calories and extra protein. I'm having trouble eating very much protein most days, but later in the cycle I can eat tuna, peanut butter and beans, so the shakes really help. If he isn't on oxy and can drink cold things, you can make him malts. Not just shakes, but malts. With lots of malt powder. When I had a lot of trouble during my pregnancies and with the first one could only eat certain cold cereals and drink milkshakes (I normally have very little dairy, but somehow it went down at the time), my OB/GYN told me to switch to malts and put in extra malt powder for the calories. It helped a lot. So just find what foods he will eat, and find a way to make them higher in calories if you can.

[Gaelen]

I didn't lose much more weight during my first year with cancer, but I didn't gain any weight, either.
Food tasted off.
On chemo, my stomach hurt and ached if I ate more than a half-cup of anything at a time - including drinking anything. So, I didn't actually eat very much.
I drank protein shakes. At room temperature, because I couldn't handle anything cold.

And I will tell you, honestly, that making me a plate and/or offering me food and expectantly waiting for me to eat it...even five little bites of food...would have been the fastest way for me to NOT eat it.
It wasn't about being stubborn. It was about I.am.not.hungry. And then you get out of the habit of eating. And/or it's uncomfortable when you eat, and you don't want to be any more uncomfortable than you already are.

I know that people want their loved ones to eat, and food = love, and all that.
But eating is different when you have cancer, and frankly I wouldn't force the eating issue with a cancer patient. Have food in the house, be willing to make whatever he wants, but do not make him a plate and make a big deal out of his response to it. If he loses enough weight that his doctor wants him to be on TPN (IV nutrition), then well, that could happen. But if anyone had forced me to eat, I would have developed nausea and discomfort, and that would have associated itself with the food and made it worse. Just sayin'.

[karin]

What's his megace dose??? Full dose is 400 mg BID or 625 mg if ES. I don't think Remeron will work if Megace doesn't work.
Maybe Marinol if he isn't into smoking pot at this point.....

[Terry]

Thanks Karin, I could remember the name. Marinol worked really well for the patients I gave it to when it was pescribed.

Besides trying that, I have to agree with Gaelen. I'm on Folfori and even though I feel hungry I start to eat and it's like gross. In your mind something might sound good but eating it is another story because for one it doesn't feel good and second, just doesn't taste right. After awhile your body just gets use to not eating so you don't even think anything sounds good any more. Maybe shakes like Ensure would be the best way to go, they're small and that's what we give the elderly when they won't eat because it's full of nutrients.

I would ask the doc for marinol and give that a try and take it from there. I understand how you feel, if he eats he may feel better. Also, besides all the chemo he's been on he's just had sirts done so I'm sure that doesn't help.

You guys are in my thoughts and prayers.

By the way, You guys are a beautiful couple!:)

[tooyoung]

While I was having radiation and 5FU I had no appetite. It wasn't that food tasted bad or didn't sound appetizing, it was that I always had that feeling that you have on Thanksgiving after eating a ton of food - I was full. I also had trouble getting enough liquids. I tried to eat as much as I could of whatever I could. I ended up keeping hydrated with IV fluids with dextrose (in the hospital for almost 3 weeks).

I also had the gassy feeling that your husband has. I never knew what to say when they asked me if I had pain. Most of the time, I didn't have traditional pain but I had major gas-like pain. The pain medication did nothing for it. I would take the pain meds just to knock me out so I could sleep and not have to deal with the gas pain. Extra-stength GasX sometimes helped.

The good news is that it's been 4 weeks since my last radiation treatment and I'm eating normal again and the only med I'm taking is a Probiotic (which I really think helps a lot - especially with my lactose intolerance). My appetite came back gradually and now I try to eat as much as I can when I'm even the slightest bit hungry. The weight is coming back on. Every once in awhile I'll get a shooting gas pain but it's usually gone in a few minutes.

Good luck! Hope you figure things out.

[Guest T]

My husband is going though the same thing. Like the others have said, I don't force anything but will make or go get anything. For nutrition purposes give him ensure. A little hint that might help: sometimes smell will induce appetite make some of his favorite's for yourself He may change his mind.

Good Luck!

Toni

[Lee]

When I was on chemo, I found snacking through out the day to be better than 3 meals a day. This helped keep nausea at bay. Also I tended to eat food I could taste, thus it could be junk food, but I figured junk food was better than nothing. I drank Ensure daily. I tired to eat healthy when not on chemo.

I would grab breakfast Burger King on the way to chemo. Those breakfast sandwiches had protein and carbs which helped me on that first day of chemo, not to mention it just tasted good.

Lee

[CaliforniaBagMan]

A lot of stories here are just like my experience-- during treatment I just didn't feel like eating. I am 186 pounds today, I hit a low of 136 during treatment.

For me, one small thing that helped was to keep me far away from where the food was being prepared and away from the smell of food prior to a meal. Even then it was rough.

The thought about using Ensure or Boost is a good one-- I could finish off a chocolate Boost drink even when I wasn't wanting to eat .....