For people diagnosed with lung cancer, weight loss is a significant concern. Weight loss has been found to be associated with poor outcomes, especially for patients with non–small-cell lung cancer (or NSCLC).1 In fact, many people with this type of lung cancer have lost significant weight by the time they are diagnosed. Having cancer, especially lung cancer, and receiving cancer treatment increases the number of calories a patient needs to consume each day to maintain his or her body weight.
It can therefore be challenging for many patients with lung cancer to keep up with the increased need for calories, especially if the patient is dealing with the symptoms characteristic of lung cancer, such as shortness of breath, or the side effects of cancer treatment, such as nausea, mouth sores, altered taste, and/or decreased appetite.
Unintentional Weight Loss
Unintentional weight loss occurs when your body is not getting sufficient nutrients to keep up with the energy required for daily functioning. In addition, many patients with lung cancer have symptoms such as shortness of breath, chronic coughing, and mucus buildup, which may affect their ability or desire to eat. The result can be weight loss, malnutrition, and significant fatigue.
Good nutrition habits during treatment can help to prevent malnutrition related to your treatment. Many patients with lung cancer, and their caregivers, can benefit from a consultation with an oncology dietitian. Ask your oncology care team if you may have access to an oncology dietitian at your treatment center or facility.
Tips for Managing Poor Appetite
Here are some tips for a few of the most common side effects people facing lung cancer are challenged with. Try these strategies to make sure that you provide your body with adequate calories for healing.
If you don’t have much appetite, or if you quickly become full, the following tips can be helpful:
- Eat something within an hour of waking.
- Eat a small, high-calorie, high-protein snack every 2 to 3 hours.
- Set a timer to remind you when to eat (or ask your caregiver to remind you).
- Don’t nap for longer than 2 hours, so that you don’t sleep through snack time.
- Prepare easy-to-grab snacks (such as hard-boiled eggs), blended foods (such as smoothies or milkshakes), nuts, peanut butter sandwiches, or individual cups of fruit, yogurt, or cottage cheese (or ask your caregiver to do this).
- Make meals more enjoyable by placing flowers on the table, eating with friends (virtually or in person), or listening to music while eating.
- Use nutritional supplements at mealtimes if you can’t tolerate solid foods.
- Regular bowel movements are important. If yours are irregular, contact your treatment team and ask for a bowel management protocol that will help you to maintain regular bowel movements.
- If your appetite does not improve, check with your doctor about medications that can help to increase appetite or gastric emptying.
- Be as physically active as you can.
Maintaining Good Weight
If you are experiencing unintended weight loss, the following strategies may help you to increase your calorie and protein intake, which can improve your situation:
- Consume small, frequent meals.
- Do not skip meals.
- Eat breakfast foods at any meal, if you find such foods more appealing and easier to consume.
- Add 1 cup of dry milk powder to 1 quart of regular milk to make fortified milk (which increases the calories and protein intake, as well as other nutrients).
- Add fat to the food you eat. For example, melt butter and mix it into applesauce with cinnamon and sugar; add oil or butter to broths; add oil to noodles, bread, rice, and hot cereals.
- Use variety in the fats and sugars you choose, such as avocados, monounsaturated sources of oil, olive oil, nuts and nut butter, sunflower seeds, honey, maple syrup, and plain full-fat yogurt to what you are eating. These can be a good way to add calories to fruit smoothies or to green smoothies.
- Do not eat your favorite foods when you are nauseated. Save those for the good days.
- If you are able to tolerate solid foods and are using nutritional supplements for extra calories, make sure you don’t use them as meal replacements, because you may miss out on important nutrients that are provided by solid foods. It is best to consume a 1/2 cup of such supplements after each meal or as snacks during the day. If you are getting nutrition only from supplement drinks, ask your dietitian exactly how many cans you need to meet your individual calorie requirements.
Fatigue is a common side effect for people who are dealing with cancer, including lung cancer. No medications are available to address fatigue, but you may find these tips helpful:
- Be as physically active as possible, including exercising whenever you can. Request a referral to an exercise or a rehab program, if available.
- Rest when you feel the worst, and be active during the times of day that you feel the best.
- Make sure to get quality sleep.
- Ask friends and family members to help, by shopping and preparing meals so you could spend your energy on leisure activities.
- Stock the kitchen with easy-to-prepare and easy-to-eat foods.
- Eat small, frequent meals and snacks.
- Drink enough water; dehydration can increase fatigue.
Optimize Your Healing
The best way to know if you are getting enough calories and protein is to weigh yourself weekly. Also, remember to make sure that you are providing your body with adequate fluids. If you lose more than 3 pounds in a week, it is probably because of fluid loss. If your weight continues to drop from week to week, try to increase your calories until you start to maintain your weight.
By working to provide your body with adequate nutrition during your treatment, you will optimize your body’s healing potential, minimize the side effects of the cancer treatment, and improve your quality of life.
For more tips on nutrition during cancer treatment, visit www.cancerdietitian.com/tips.
Mytelka DS, Li L, Benoit K. Post-diagnosis weight loss as a prognostic factor in non–small-cell lung cancer. Journal of Cachexia, Sarcopenia and Muscle. 2018;9(1):86-92.
- Weight loss among patients with cancer is associated with poor outcomes, especially among patients with non–smallcell lung cancer
- Patients with lung cancer can have symptoms such as shortness of breath, chronic coughing, and mucus buildup, which may affect their appetite or ability to eat
- To help ensure that you are eating enough, eat within an hour of waking up, set a timer to remind you to eat, be as physically active as possible, and prepare easy and quick meals
- Make sure to drink adequate fluids. If you lose more than 3 pounds in a week, it is probably because of fluid loss