Controlling Weight Loss

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Weight loss is a common problem in individuals with pancreatic cancer. It can be associated with treatment or with the cancer itself.

Weight loss due to insufficient calorie intake
Side effects or symptoms such as loss of appetite, malabsorption, nausea and vomiting can cause a patient to consume fewer calories than the body needs to maintain an appropriate weight.  The following sections provide strategies for dealing with these symptoms.

Overcoming poor appetite
Pancreatic enzymes
Nausea and vomiting

Tumor-induced weight loss
Tumor-induced weight loss, also known as cancer cachexia, is a complex problem. It affects the way the body uses calories and protein.  Cancer cachexia can cause the body to burn more calories than usual, break down muscle protein and decrease appetite. If a person is consuming regular meals and snacks but is losing weight, they may be experiencing cancer cachexia.

Most pancreatic tumors release compounds called cytokines into the blood.  These cytokines change the body’s use of nutrients (proteins, carbohydrates and fats).  In addition, cytokines cause the body to burn calories faster than they are replaced. In addition, appetite is suppressed causing the patient to decrease food intake. This process leads to thinner bodies, smaller muscles and fatigue.  Weight loss and malnutrition can have a significant impact on quality of life, daily functioning, response to treatment, length of hospital stays and complications such as infections.

What steps can I take to minimize tumor-induced weight loss?
Though we are gaining knowledge about cancer cachexia, little is known about how to control or stop the process.  Nutrition counseling, use of oral nutrition supplements and use of appetite-stimulating medications may help patients with tumor-induced weight loss.  Controlling tumor growth through treatment such as chemotherapy or chemoradiation therapy can also assist in controlling this type of weight loss.

The following tips may assist in controlling weight loss:

  • Consult with a registered dietitian for nutrition counseling.
  • Get plenty of rest.
  • Plan to eat 6-8 times per day including snacks in between meals.
  • Eat calorie-rich, nutrient-dense foods and try not to consume foods or liquids with little nutritional value, such as soft drinks.
  • Restrict or avoid any foods that may cause or worsen diarrhea.
  • Use nutritional supplement drinks, such as Boost®, Ensure® and Carnation Essentials®, as snacks or drink with medications that can be taken with food.
  • Ask the doctor or dietitian whether pancreatic enzymes may be helpful.
  • Check with the doctor to see if medications to stimulate appetite would be helpful in controlling weight loss.
  • Maintain adequate hydration.
  • Incorporate light physical activity into your day as it supports lean body mass, may enhance appetite and may decrease fatigue:
    • Aim for a total of 30 minutes per day of activity, such as walking.
    • Break activity into small increments of 5-10 minutes totaling 30 minutes per day.

Additional Resources
Academy of Nutrition and Dietetics
Oncology Nutrition Dietetic Practice Group

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