Lack od appetite

Dear Gayle1966,

Thank you for getting in touch with us and welcome to our online community.  I hope you find it a helpful and welcoming place.  My name is Adrienne and I’m one of the Cancer Information Nurse Specialists at Macmillan.

I’m so sorry to hear how much the chemotherapy has affected your appetite and sense of taste.  Also about the nausea you are experiencing despite the domperidone.  I would strongly suggest getting in touch with your chemotherapy unit today to explain how much the nausea/gagging is affecting you and your ability to eat.  There are a plethora of anti-sickness medications available for you to try that might work better for you.  You may even be given a combination of different drugs to control the nausea. It’s important to take the tablets exactly as your nurse or pharmacist tells you as it’s easier to prevent sickness than to treat it after it has started.

Nutrition is really important when undergoing chemotherapy, in order to help build up your strength and withstand the effects.  You mentioned that you can tolerate a milkshake but I’m not sure if this is a supplement drink suggested/prescribed by your treatment team a dietician or doctor.  Nutritional supplements can help if you are losing weight and struggling to eat as they are high in calories and include vitamins and protein.  The nutrition needs of people with cancer can vary from person to person so it would be worth asking your hospital team if you can speak to a dietician.  They can assess you and prescribe the drink most suitable to you.

It's difficult to say how long you can go without solid food before it affects your recovery.  As I mentioned, nutritional needs do vary from person to person.  That being said, the better the nutrition, the stronger you are and evidence shows that this can help reduce side-effects and aid recovery.

The most important thing is that you get in touch with your chemotherapy unit so they can help get on top of the nausea and gagging.  Once that is under control, you can try some things to help with the taste changes you are experiencing:

• Try different foods to find out what tastes best to you. Keep trying different foods as your taste changes.
• Eat foods that you enjoy and ignore those that do not appeal to you. But try them again after a few weeks, because your sense of taste may have changed.
• Use seasonings, spices and herbs such as pepper, cumin or rosemary to flavour your cooking. But if your mouth is sore, you may find that some spices and seasonings make it worse.
• Try eating bland foods such as bread, potatoes and crackers.
• Try marinating meat.
• Cold meats may taste better served with pickle or chutney.
• Sharp-tasting foods can be refreshing and leave a pleasant taste in your mouth. These include fresh fruit, fruit juices and sugar-free sour or boiled sweets. Be careful if your mouth is sore as these may be painful to eat.
• If you no longer like tea or coffee, try lemon tea, herbal teas or a cold drink such as lemonade.
• Some people find that cold foods taste better than hot foods. If your sense of taste or smell changes, it may help to let your food cool before eating it.
• Serve fish, chicken, red meat and egg dishes with sauces. You could add these sauces to vegetables too. But be careful if your mouth is sore as some sauces, such as curry or sweet and sour, may feel painful to eat.
• If you notice a metallic taste in your mouth, try using re-usable plastic cutlery.
• Brush your teeth before meals.

We have a booklet called The Building-Up Diet which may be helpful for you to look at.  You can look at it online here or order a free hard copy by registering with Macmillan Orders.

It’s important to look after your emotional wellbeing as well as your physical Gayle1966.  There is no evidence that feeling anxious or sad can affect your recovery but by talking openly about how you are feeling can really help.  Please know that we have a fantastic breast cancer forum where you can receive peer support from people who are going through or have gone through a similar situation to yourself.  Breast Cancer Now also have Someone Like Me where you will be matched with a trained volunteer who has had a similar experience to you.

I hope you find this information helpful Gayle1966.  However, we often find that we can help more by exploring your concerns over the phone.  You can also speak with the Macmillan Support Line team of experts.  Phone free on 0808 808 00 00 (7 days a week, from 8am to 8pm), or you can send us an email, too.

Take care and best wishes,

Adrienne, Cancer Information Nurse Specialist

Ref:  AMc/GG

Thank you so very much for the advice and speedy response. I'm already finding lemonade helpful and will contact my team about antisickness change in meds. I'm truly so grateful. Thank you again.