By Julie LG Lanford, MPH, RD, CSO, LDN
Wellness Director, Cancer Services
According to one study, nearly 60 percent of people facing lung cancer have lost significant weight by the time they are diagnosed. 
Having cancer and receiving treatment tends to increase the number of calories needed each day to maintain your body weight. It can be challenging to keep up with the increased need for calories, especially if you are dealing with symptoms and side effects such as nausea, shortness of breath, mouth sores, altered taste, and/or decreased appetite.
Unintentional weight loss occurs when your body is not getting sufficient calories to keep up with energy demands. In addition, many lung cancer patients experience shortness of breath, chronic coughing and mucus build-up, which may affect ability or desire to eat. The result can be weight loss, malnutrition and significant fatigue.
Good nutrition habits during treatment can help prevent malnutrition related to your treatment. Here are some tips for a few of the most common side effects people facing lung cancer are challenged with. Try the strategies to make sure that you provide your body with adequate calories for healing.
Increasing Appetite and Managing Early Satiety
If you experience poor appetite or quickly become full, the following tips can be helpful:
- Eat something within an hour of waking.
- Eat a small high-calorie, high-protein snack every two to three hours.
- Set a timer to remind you when to eat (or ask a caregiver to remind you).
- Don’t nap for longer than two hours so that you don’t sleep through snack time.
- Prepare easy-to-grab snacks such as hard-boiled eggs, blended foods such as (like smoothies or milkshakes), nuts, peanut butter sandwiches, or individual cups of fruit, yogurt or cottage cheese (or ask a caregiver to do this).
- Make meals more enjoyable by placing flowers on the table, eating with friends, or listening to music while eating.
- Use nutritional supplements at mealtimes if you can’t tolerate solid foods.
- Regular bowel movements are important. If you’re irregular, contact your treatment team to obtain a bowel management protocol that keeps you regular.
- If your appetite doesn’t improve, check with your doctor about medications to help increase appetite or gastric emptying.
- Be as physically active as possible.
If you’re experiencing unintended weight loss, these strategies may help you increase your calorie and protein intake, which can help the situation:
- Consume small, frequent meals.
- Don’t skip meals.
- Eat breakfast foods at any meal if you find them more appealing and easier to eat.
- Add 1 cup of dry milk powder to 1 quart of regular milk to make fortified milk.
- Add fat to foods (eg, melt butter and mix in to applesauce with cinnamon and sugar; add oil or butter to broths; add oil to noodles, bread, rice, and hot cereals).
- If you’re worried about consuming unhealthful foods, try adding healthful fats and sugars, such as avocados, monounsaturated sources of oil, coconut oil, nuts and nut butters, sunflower seeds, honey, maple syrup, and plain full-fat yogurt to what you’re eating. These can be good ways to add calories to fruit smoothies or green smoothies.
- Don’t eat your favorite foods when you are nauseated. Save those for good days.
- If you’re able to tolerate solid foods and are using nutritional supplements for extra calories, make sure you don’t use them as meal replacements, as you may miss out on important nutrients provided by solid foods. It’s best to consume 1/2 cup of such supplements after each meal or as snacks during the day. If you’re getting nutrition only from supplement drinks, ask your dietitian exactly how many cans you need to meet your calorie needs.
Fatigue is a common side effect for those facing lung cancer. There are no medications to address fatigue, but try these tips:
- Be as physically active as possible, including exercisinge whenever you can. Request a referral to an exercise or rehab program, if available.
- Rest when you feel the worst, and be active during the times of day that you feel the best.
- Make sure to get quality sleep.
- Ask friends and family to help by shopping and preparing meals so you can spend your energy on leisure activity.
- Stock the kitchen with easy-to-prepare and easy-to-eat foods.
- Eat small, frequent meals and snacks.
- Drink enough water because dehydration can increase feelings of fatigue .
The best way to know if you are getting enough calories and protein is to weigh yourself weekly. Also, remember to make sure you are providing your body with adequate fluids. If you lose more than 3 pounds in one week, it’s probably due to fluid loss. If your weight continues to drop from week to week, try to increase your calories until you start to maintain.
By working to provide your body with adequate nutrition during your treatment, you will optimize your bodies healing potential, minimize the side effects of treatment and improve your quality of life.
For more information on nutrition and cancer, visit www.cancerdietitian.com.
To find a Registered Dietitian who specializes in oncology, go to www.oncologynutrition.org and click on the ‘find an oncology dietitian’ link.
Julie LG Lanford, MPH, RDN, CSO, LDN is a registered dietitian and board certified specialist in oncology nutrition. She currently serves as Wellness Director at Cancer Services, Inc in Winston-Salem. Julie regularly writes, teaches and myth busts about nutrition and cancer at www.cancerdietitian.com.