Hello my brother was recently diagnosed with cancer of unknown primary, mainly the bowel ,stomach and ?? lungs and oesophagus. He's just finished his 2nd round of chemo and is really struggling to eat or drink,he is very reluctant to do his 3rd round due to the side effects .Just wondered if you've any advise about his diet,and if its worth asking his consultant about immunotherapy instead of chemotherapy. Thank you.
Hi glyndale
Thanks for getting in touch with us. My name is Tricia and I’m one of the Cancer Information Nurses on the Macmillan Support Line.
I am so sorry to hear about your brothers diagnosis of a cancer of unknown primary . That must be very difficult for you all.
His treatment options will have been initially decided by expert doctors in a MDT (Multidisciplinary team) meeting after looking at all the investigations that resulted in his diagnosis.
The treatment options will be dependent on various factors such as where the cancer is, the amount of cancer and where it has spread to and how your brother is regarding general health and fitness. There may be more than one option, and this could include immunotherapy but only his consultant would know if this treatment were suitable for your brother. They often need to do additional tests on the tissue to look for certain proteins or gene changes on the surface of the cancer cells to see what treatment would be suitable.
It sounds like he is really struggling with the side effects of chemotherapy. The cancer treatments do cause varying side effects that can differ in intensity from one person to the next. This happens with any cancer treatments including immunotherapy.
It’s important that he calls the 24-hour oncology/chemotherapy hotline if he feels unwell and has new or worsening symptoms while on chemotherapy.
Your brother’s consultant will want to know what side effects he is having and how it is influencing his thoughts about continuing with the treatment. So, it’s important that he discusses it at the next appointment. Sometimes adjustments can be made to the dose, the timing, the management of the symptoms or there may be an alternative chemotherapy that they can try that may be tolerated better.
Regarding his struggle with eating and drinking there are some things that might help such as eating little and often rather than trying to eat larger meals, having snacks, and if there is any nausea, trying to have that managed with medication.
If he is losing weight or not getting enough nutrition it might be beneficial for him to try to add energy and protein to everyday foods and look into having a building-up diet. He does need to be mindful if there are any foods he has been advised to avoid at all while on chemotherapy. He could ask his consultant or the chemo unit to see a dietitian if needed who can advise and get him nutritional supplements if needed (these can be prescribed for him by one of the team).
I hope you have some support from family and friends at this difficult time. It can be very difficult for someone living with cancer of unknown primary (CUP) but equally important that you are taking care of yourself when supporting someone with cancer and get support too. It can affect your feelings when a loved one has cancer .
There may be a Maggie's centre available locally and they can provide support for both the cancer patients and their relatives. There may also be other local cancer support services available including Macmillan Cancer Support Centres. There is also a Family and friends forum on the Macmillan online community that may be good support.
I hope this is helpful. Please don’t hesitate to get back in touch at any time.
Sending best wishes,
Tricia
Macmillan Cancer Information Nurse Specialist
You can also 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.
Ref: TT/KR
