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Caring for a patient with Cancer Cachexia

Everyday life includes spending much time shopping for, preparing and consuming food and drink. By connecting us with others, these activities have importance beyond fuelling our bodies. Preparing a meal for someone can be a way of showing care and sharing meals can be an enjoyable part of our social life.

When someone has Cancer Cachexia syndrome they lose muscle, become weaker, feel fatigued and may experience difficulty with eating and drinking. They may eat very little, feel full quickly, no longer enjoy their favourite foods, and want to eat at times of the day other than family meal times.

It can feel very rewarding to prepare food that is enjoyed by a partner, family or friends. But, when someone with cancer is unable to eat what has been prepared, it can be disappointing. For some carers, it can lead to feelings of helplessness or failure.

I think 'why am I cooking, why do I make all this dinner, why do I make all these dishes? I'll throw them all away. It's nice when the family comes and you cook, at least you know somebody is going to have an appetite and it's not that you're a totally useless cook. (John's wife)

When a person with Cancer Cachexia is seen to be losing weight, therefore muscle, it is understandable if they become weaker or describe fatigue. However, it can be more difficult to understand why they do not feel hungry, particularly as they may not be eating or drinking very much. It can take a lot of time and it can be very frustrating trying to find something they will try.

I don't know why she doesn't want to eat. She is just not eating. I look around the shops and think what I could tempt her with. (Vera's daughter)

As a carer of someone with cancer who is losing weight and has a small appetite, it can be difficult to know what to do for the best.

What can you do

Weight is a sensitive topic of conversation in both health and illness. Since people make judgments based on physical appearance, questions about eating choices can be experienced as being judgmental.

Most people haven't experienced loss of appetite that can accompany cancer and its treatment. It can be difficult to imagine having no desire to eat for days or feeling full after just one mouthful. When caring for someone with Cancer Cachexia it is helpful to try to understand their experience. Information leaflets and blogs written by cancer patients will give some insight. However, it is also important to get the person with cancer talking about their own unique experience and what they think might be helpful. This conversation might be difficult if one or both of you are feeling upset or frustrated by the problems associated with Cancer Cachexia. If so, it can be a good idea to involve a nurse or doctor.

Nurses, doctors and other members of the cancer care team are able to assess symptoms that may be contributing to eating problems and weight loss, such as constipation and sore mouth. They may be able to offer interventions to help. They will all have met many people living with Cancer Cachexia and will have seen how other people manage problems caused by the syndrome. Ask them for tips on how to best to manage fatigue and eating problems or what foods and drinks can help with symptom management. They are also likely to offer suggestions for staying as physically active as possible to in order to preserve muscle mass.

Jane Hopkinson

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