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Dad has now completed three treaments of chemo (carboplatin and Paclitaxel). He has also revieved a Zometa infusion, to improve bone strength and to hopefully prevent further bone mets. The chemo has been done in conjunction with 15 "mega dose" session of radiation to his arm, which were completed yesterday.

Overall he has done remarkably well, other than a couple incidents of short lived nausea and of course fatigue, he has really not had many "side-effects". His blood levels are all remaining in a good range and he has even had a couple days where he has said he felt "really good".

The one concern that really is beginning to show.. is weight loss. He weighted 155lbs at his first chemo appointment about 3 weeks ago and is now down to 144lbs when he was weighed at his last radiation treatment. His appetite has all but vanished! His wife instist that she has tried everyhing... giving him small meals, shakes, snacks etc. but he refuses to eat saying he isn't hungry and nothing taste good. I have read a few post about Megace (or Megestrol) being used in increase a patients appetite.

My question is ... is this an appropriate time to ask the doctor about this? And if not at what point is it appropriate? I really want to call the doctor now to ask about it as it seems to me that a 10lb weight loss in 3 weeks is significant and should be promptly addressed. However I don't want to "over react" if this is normal for the drugs that he is taking and not a concern at this point.

Any advice or insight you may be able to provide would be most welcome and appreciated!

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Absolutely! My husband did not eat for 3 days, I called the head nurse at the oncs office and told her. She called right back and said that MEGACE has been called in to our pharmacy and it is ready for pick up. It is very important that he get his nourishment in order to heal. Every little bit will help. Take care and God Bless.

Love,

Malou

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Maintaining weight can be a challenge during tx. The prescription may help. Don always recommends small snacks throughout the day as opposed to 'regular' meals. There are LOTS of high calorie snacks to choose. Try to have things he likes just sitting around......maybe tempt him a little.

Kasey

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Kasey is right -- I recommend small snacks every 2-3 hours. Your mom is going to have to insist your dad eat something, if he is to survive. Weight loss is a sign the body is weakening, and he will not be able to fight off the disease like he should.

My daughter called me the "Food Nazi" because I did not give my wife a choice of to eat or not. I would try several things at one time and give her a choice of what to eat. I tried many things. It is a given that your dad will neither be hungry nor will the food taste right. That cannot be used as an excuse unless he wants to die sooner than he should. As mentioned, there are many high calorie snacks and liquids that can be used.

Although my wife eats fine now, I still give her a snack between meals to keep down the nausea and to get her used to continued feeding. She contributes my insistence on food intake as one major factor to her longevity so far. Don

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I would call the Doctor! Like others said you need to maintain your weight, it is VERY important while going thur treatment.. When My dad was going thur treatment we were like the food police it would pis_ him off, but in his heart he knew it was because we Loved him...

Take care!

Love Michele

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Don has it right. Given, you won't feel like eating, and things will taste funny for a long time, depending on the kind of chemo. But if you want to live, you have to eat. Small meals, frequently. Things that are easy to swallow. Frequently soft foods go down easier than liquids. Megace may help, so may the anti nausea medication Zofran (although it is expensive), also maybe Prilosec if reflux is a problem. But you have to want to live. I consulted with nutritionists in the hospital, who advised me about getting the most per mouthful -- putting olive oil on vegetables, sour cream and butter on baked potatoes, whatever I could add that would add caloric value, add it! Shakes (Scandia shakes were best) with ice cream added were real calorie boosters. Ensure or boost has come a long way, I bet the new flavors are better thn the old ones.

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Thanks everyone for your replies. I decided to stop worrying myself and JUST CALL! I hardly slept at all last night and have been worried all morning. So I just did it.

I talked to the PA who oversees his chemo and he said just the answer are "YES" and "Now" so come in and pick up the MEGACE- they have samples they can give him. So his wife (my step mother (SM)- I suppose though it seems a bit odd to refer to her as that ..LOL, as they married after I had moved out and had kids of my own) is going to go down and pick it up now.

He had a REALLY rough evening/night yesterday throwing up and generally quite miserable, but is feeling much better today..even ate some oatmeal this morning!! Way to go Dad!!

Don I have read a post about your making a couple of things and INSISTING that your wife eat one thing -- that eating nothing is NOT an option! I LOVE THIS APPROACH and while I was there utilized it quite effectively. Since I have returned home, I have suggested this repeated to both SM and my Dad and SM says she has tried it and having small snacks "at the ready" but nothing has worked.

High calories are definately in order. When I was there he ate 3 or 4 piece of cake (freshly baked spice cake - his favorite!) and we laughed to the point of tears when he had gained 2 lbs when weighted the next day. I have suggested maybe I need to FEDEX him another spice cake :wink:

He is having a lot of pain and bloating in his lower adominal region so this is contributing as well (maybe from the liver/adrinal mets?). The PA assures me that he will address this with the Dr. prior to SM picking up the MEGACE and if neseccary the will write him yet another 'script.

Thanks again for listening to my banter and for giving me so much great information and support! Without this board I truly think I would be nuts (or my husband would be because I would make him nuts.. :lol:)

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Hi Cindy,

glad that he is coming around. Not losing weight was one of the most important goals when I was first presented with a treatment plan. The doctor said that studies showed that people who lost weight did not survive as long as people who did not. This was one little thing that was in my control. And like it or not, I ATE!!! (So far, I have gained XXX # of pounds... :roll: !) So. Tell him, like Don said, losing weight is not an option. Glad that his PA jumped on this right away.

Cindi o'h

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So glad to hear all the good news. My dad has found that as long as he has SOMETHING in his tummy he can keep away the yuck tummy...at least up until this point. He keeps pretzels by his bed at night, and when he wakes to go to the bathroom, or whatever, he grabs a few...he has only had the heaves one time...and only three or four at that....best of luck!

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If your treatment center has palliative care experts they may be able to help... ours suggested low dose of steroids to increase appetite when weight loss became a real concern. Worth asking the question! Good luck. We also had luck with the shakes from "AdvantEDGE" by EAS... he thought they tasted better than "Boost" or other products. Nutritionist recommended high protein products, peanut butter crackers, etc. and not letting the stomach get "empty" which creates that nausea sensation.

Sandy

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