Mom stage IV NSCLC - trouble eating/digesting food

[mtienes]

My mom was diagnosed with stage 4 NSCLC in July 2013. By that time she was already having trouble eating and keeping food down and had lost some weight. She went through a number of rounds of Chemo, and each one was very hard on her body, making her very sick. The doctors decided to stop chemo treatments about a month ago (mid October) in order for her to recover somewhat and hopefully gain back some strength. Since then she is still having a really hard time eating and keeping down solid foods. The doctors did an Upper GI scan to see if there was a problem there, but they didn't find anything. Has anyone else had a similar problem who could offer some advice? She keeps getting weaker, and we are not sure what to do. Any advice would be appreciated!

[michellep]

My husband had a difficult time eating as well. I gave him ensures about 3 or 4 times a day. He also ate soft foods and lots of water....make sure she has water! Let us know how things go ((hugs))

[CindyA]

Hi Mtienes,

I got this in my email today and thought of your post. It is a long read on here. It looked a lot shorter online. It is from LungCancer.About.com I posted the link at the bottom in case you rather read it from its source. SENDING YOU HUGS, HOPE AND HEALING THOUGHTS!

Loss of appetite, referred to by doctors as anorexia, is a common symptom during treatment for lung cancer (anorexia differs from the eating disorder anorexia nervosa, a psychological illness in which patients starve themselves). What causes anorexia, how is it treated, and what can you do to cope, to make sure you are getting the nutrition you need?

What Causes Anorexia (Loss of Appetite) During Cancer Treatment?

Many things can lower your appetite during cancer treatment. These include symptoms related to the cancer, side effects of treatment, and your body’s response to the cancer.

Importance

Most people with advanced cancer have some degree of anorexia. Decreased nutrition due to appetite changes can lead to weight loss, malnutrition, loss of muscle mass, and wasting (cachexia). Knowing the effect of poor nutrition on treatment response, oncologists are increasingly addressing the role of nutrition in cancer patients. Nutritional support has been shown to result in:

Fewer infections after surgery

Better control of cancer-related symptoms

Shorter hospital stays

Greater ability of cancer survivors to tolerate treatments

Better overall response to treatment

Improved quality of life for those living with cancer

Treatment

Several treatment options are available to help with appetite, and also help maintain your weight during cancer treatment. Some of these include

1. Nutritional evaluation/counseling - Many cancer centers are offering nutritional counseling and support for those living with cancer.

2. Treatment of underlying causes – Other symptoms related to cancer or treatment can add to poor appetite. It is important to share any of these symptoms with your oncologist so they can be addressed:

Mouth sores

Taste changes

Fatigue

Depression

Nausea or vomiting

Difficulty swallowing (dysphagia)

Shortness of breath

Pain

Medications – Some medications (such as pain medications) can interfere with appetite and may need to be changed, or the dosage altered

3. Supplements – Some oncologists will recommend nutritional supplements to boost your calorie intake

4. Medications – Your physician may recommend a medication to stimulate your appetite, or help with transit through your digestive tract. A few of these medications are:

Steroids such as Decadron (dexamethasone)

Megace (megestrol)

Reglan (metaclopramide)

Cannabinoids (Medical marjuana and Marinol)

5. Artificial nutrition – This includes Enteral nutrition (tube feeding), or parenteral nutrition (nutrients delivered to the body via a catheter into a vein in the arm or chest) – Your physician may discuss these options with you if you are unable to eat due to swallowing difficulties or other problems.

6. Complimentary therapies - Complimentary/alternative therapies (such as herbal supplements and meditation) are being looked at for their role in assisting with appetite in cancer survivors.

Coping

Cancer treatment not only decreases appetite, but you may become full more quickly when eating. A few tips may help you boost your calories when you don’t feel particularly hungry:

Eat small portions frequently instead of 3 large meals daily

Make your environment pleasing. Dine with family and friends. Play music. Use lighting that feels comfortable

Light exercise can sometimes stimulate appetite. Ask your oncologist for her recommendations

Eat nutritious snacks that are high in calories and protein – Good choices include nuts, cheese and crackers, ice cream, peanut butter, and puddings

Have food on hand that you enjoy and is easy to prepare

Find foods that are comfortable to eat if you have mouth sores or taste changes

Drink fluids between meals to avoid becoming full too fast

Fatigue is a big factor for many cancer survivors when it comes to cooking – Accept your loved one’s willingness to bring meals, freeze leftovers for another meal, and ask your friends if they would mind preparing meals ahead of time that you can freeze for a quick dinner

Eat whenever you feel hungry

Try different foods – Sometimes a change in routine can make food more “interesting” and tempting

When to Call the Doctor

Make sure you keep your doctor updated on your appetite, as well as anything that is interfering with your ability to eat. Call between visits if you:

Are unable to eat for 24 hours (sooner if you are unable to swallow fluids)

Have difficulty swallowing, or if eating is otherwise painful

Develop abdominal pain

Lose 5 pounds or more

If you note any signs of dehydration such as loss of skin tone, strong smelling urine, or are not urinating as frequently as usual

http://lungcancer.about.com/od/livingwi ... a.htm?nl=1

[mtienes]

Thank you all for your responses. Her problem hasn't been so much with being hungry or eating, she is good with that. She is just having trouble digesting the food and keeping it down. She is going to see a gastroenterologist, so hopefully they will be able to help figure out a solution. I'll keep you posted on what we find out.

I really appreciate the support on this site, it's nice to have a group who can understand what we are going through.

[mtienes]

For anyone who may be wondering, this week we found out why my mom was having so much trouble keeping down food. After a new pain started in her left side, she went to the hospital for an endoscope and ended up being admitted with high Potassium levels. They did an ultrasound there, and found that the tumors that had spread to her liver had never really responded to her chemo, and had grown much larger. Due to that, and the fact she is now so weak, it looks like there is not much left for the doctors to do. She is coming home from the hospital tomorrow and will be under in-home hospice care to manage her pain and keep her as comfortable as possible.

Obviously this is a worst case situation for my dad, brothers, and I. If anyone has any comments or advice for us, we would be glad to hear it. It's definitely going to be a rough holiday season, but we are normally spread across 4 states, and I am thankful that we will all be able to spend it together one last time.

[RandyW]

ANY UPDATES????? This just popped up as new post ...