Weight Loss - ASCO curriculum

Weight loss is common among people with cancer and is often the first sign of cancer that is noticeable. As many as 40% of people with cancer report unexplained weight loss at the time of diagnosis, and up to 80% of people with advanced cancer experience weight loss and general "wasting," called cachexia. Weight loss is more common in people with solid tumors than in people with blood cancers.

Weight loss is associated with extreme tiredness (fatigue), weakness, loss of energy, and an inability to perform everyday tasks. People experiencing cachexia often cannot tolerate treatments as well and may experience more intense symptoms.

Causes

Weight loss often begins when a person stops eating (called anorexia). In addition, cancer can cause changes to the immune system or metabolism that can result in weight loss and appetite loss. Nausea and vomiting, constipation, mouth sores, difficulty swallowing, loss of taste, and depression may also affect a person's appetite and cause weight loss.

Treatment

Controlling cancer-related weight loss is important for the comfort and well-being of a person with cancer. The following suggestions may help:

Increase food intake by about 450 calories per day.
Consider asking the doctor about receiving food directly to the stomach through a tube, which may help people with head and neck or esophageal cancers.
Eat light meals and avoid protein-rich foods before cancer treatment to help prevent aversions to these foods.

Nutrients given through an intravenous (IV) tube are not usually recommended, except in cases where a person is expected to recover and requires short-term nutritional support.

Doctors may recommend the following medications:

Megestrol acetate (Megace) is a progesterone hormone that can improve appetite, help with weight gain, and increase a person's sense of well-being.
Steroid medications can increase a person's appetite; improve his or her sense of well-being; and may help with nausea, weakness, or pain. Because of serious side effects, steroids should not be used for more than a few weeks.
Metoclopramide (Reglan) can prevent early satiety (feeling full without eating).
Pancreatic enzyme replacement (lipase) helps the body absorb fat.

Last Updated: September 15, 2005