I have bowel cancer and am being treated with Oxaliplatin and Raltitrexed. I have totally lost my appetite and struggle to eat anything. I suffer with frequent bouts of diarrhoea and try to control this with Loperamide. I seem to have lost my sense of taste which makes the eating process even harder.
Can you recommend a way to recover my appetite. I have been recommended to try Fortisip shakes, but this would only be a short term fix.
Thank you,
Ian
Dear Orange15
Thanks for getting in touch with the Macmillan Support Line through our Ask a nurse Platform. I’m Linda, one of the nurses from our support line.
I see you have joined our bowel cancer forum, and hope you are finding this helpful. It might be worth posting your question on there too. Sometimes finding out the experiences of others can be really invaluable.
Issues with appetite and loss of taste can unfortunately be a common side effect of some cancer treatments. They do tend to be short-term and generally gradually improve after treatment ends. But there may be things that can help in the meantime.
Some people can have a coating over their tongue during treatment which can dampen down the way food tastes. It’s a good idea to check your mouth, gums and inside of your mouth to ensure it looks clean and healthy, otherwise let your chemotherapy team know, just in case this adding to your issues.
If you’re not sure what to look for you can ask the chemotherapy team or even book in with your dentist. If you don’t have a dentist it’s an idea to look on the NHS website for the country you live in and you should find details there of local services.
We do have some hints and tips on our website to help with mouth problems and taste changes, you can read about them here. And we also produce a booklet, The building up diet, which is available to read online or to order as a hard copy. This is full of ideas about increasing calorie intake to help with managing appetite problems.
Bowel issues can affect appetite, whether it’s loose motions or constipation. It can be helpful to keep a food diary to check how your body is coping with what you are eating. Everyone is different so there won’t be a specific eating plan to follow whilst you are on treatment, but it can be helpful for you to try and establish if certain foods make things worse or better. You might also find that there are times during the chemotherapy cycle when your appetite is better, so tracking this can help.
Bowel Cancer UK have this information that you can download as general guide.
You mention that Fortisip shakes have been recommended. I’m not sure who suggested these, if it was someone in your clinical team, but some people do find them helpful until their appetite and sense of taste improves. The company who produce them, Nutricia, have some recipes on their website to make them a little more encouraging to take.
Penny Brohn, another charity who support people affected by cancer, run regular nutrition café’s. These are led by their nutrition team, and you can attend their sessions by booking online. As well as nutrition they also offer lots of support with looking after yourself both during and after treatment.
Speaking with you oncologist and clinical nurse specialist (CNS), if you have one, is also a good idea. We would always recommend keeping them up to date with any symptoms or side effects that are affecting day to day life. If needed they may ask a dietician to assess you, to see what they can suggest.
I hope you find this helpful and if you would like to call us we may be able to make some further suggestions.
You can speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.
Best wishes/
Linda, Cancer Information Nurse Specialist
Ref LM/LJ
