Nutrition and advanced cancer

Advanced cancer means the cancer has spread from where it started to other areas of the body.

Problems with eating and drinking may arise or worsen when the cancer is advanced. It’s common for people with advanced cancer to lose their appetite. This often leads to weight loss and malnutrition.

Controlling nutrition-related symptoms is important for quality of life. During this time, it’s okay to focus on eating foods you enjoy. Soft food and clear liquids may be easier to digest.

For more on this, see Living with advanced cancer.

Learn more about:

• Nausea and vomiting
• Mouth problems
• Blockage in the bowel
• Cachexia

Listen to our podcast on Appetite Loss and Nausea, or to our podcast series on Advanced cancer

Nausea and vomiting

Many people with advanced cancer have problems with ongoing nausea and vomiting.

Nausea and vomiting may be caused by pain medicines, cancer growth, blockage of the bowel, slower digestion, or high calcium levels in the blood (hypercalcaemia). Feeling tired or anxious may make the nausea worse. The suggestions listed here may help reduce nausea and vomiting.

Mouth problems

People with advanced cancer may have a dry mouth or a sore mouth and throat. These problems may be caused by drinking less or by some types of treatment. Learn ways to ease a dry mouth. If chewing and swallowing become difficult, it may be necessary to introduce a texture-modified diet.

Blockage in the bowel

Surgery in the abdominal area sometimes causes the bowel to become blocked (bowel obstruction). This can also happen if the cancer comes back.

Because waste matter (faeces) cannot pass through the bowel easily, symptoms may include feeling sick, vomiting, or abdominal discomfort and pain. To relieve symptoms of a bowel obstruction, you may have a small tube (stent) put in that helps keep the bowel open. The stent is inserted through the rectum using a flexible tube called an endoscope.

Cachexia

People with advanced cancer may develop a muscle wasting syndrome known as cachexia. This means the body isn’t using protein, carbohydrates and fats properly. Symptoms include:

• severe loss of weight, including loss of fat and muscle mass
• feeling sick (nausea)
• feeling full after eating small amounts
• anaemia
• weakness and fatigue.

Your doctor or dietitian will discuss the best way for you to manage cachexia. They may suggest a diet high in energy and protein, nutritional supplements, or medicines such as appetite stimulants.

If you continue to have problems maintaining your nutrition, your treating team may recommend feeding via a tube in the nose (nasogastric or NG tube) or stomach (often known as a PEG tube). However, each person is different and, depending on your situation, tube feeding may not be recommended.