WEIGHT LOSS

Weight loss occurs in almost all patients with advanced cancer. At any stage in the disease weight loss suggests a worsened prognosis. Gross wasting (cachexia) occurs in about 20% of patients.

Management options:

• Treat anorexia

• Nutritional supplementation

• Explanation about diet

• Readjust dentures

• Consider clothing alterations

• Counsel about body image, pressure areas

Discussion – Both the patient and family may feel guilty about poor food intake. It needs explaining that weight loss is not simply due to poor diet. Intensive intravenous feeding often fails to promote weight gain and does not increase survival.

Nevertheless it is worthwhile trying to improve dietary intake for psychological reasons and also in the hope that weight loss may be slowed down. Aim to improve appetite and add oral supplements to attain a positive energy and protein balance. The average sedentary individual needs 1,500 calories per day. There is no evidence that supplementary feeding “feeds the tumor” or increases tumor growth. (see Anorexia, Diet, Nutrition)

In advanced disease weight loss is inevitable and weight no longer has diagnostic usefulness, so avoid routine weighing which can be demoralizing. 

The previous body image is lost and some patients find it frightening to feel they no longer recognize their own bodies. Old photographs are sometimes helpful to “explain” to new carers how the person thinks of himself. New clothes that fit are a boost to morale and recent photographs of the patient with his family can emphasize that there is still a place and a role for this “new person”. (see Body Image)

Weight loss usually slows as the disease progresses and it can be helpful to explain this.

Loose dentures are a common problem. Dental relining is simple, restores chewing and improves facial appearances. Eyeglasses tend to get too loose, and need to be tightened to be worn comfortably.

The author and publisher have taken precautions to ensure that the information in this book is error-free. However, readers must be guided by their own personal and professional standards of good practice in evaluating and applying recommendations made herein. The contents of this book represent the views and experience of the author, and not necessarily those of the publisher.