Diagnosed
Nutrition

Malnutrition

Malnutrition occurs when there's an imbalance of energy, protein or other nutrients. Malnutrition is common in people with cancer and can impact your health and how your body responds to cancer treatment and recovery. It's possible to be malnourished even if you're overweight.
 
Many factors can increase your risk of malnutrition, including:
  • certain cancer types, such as head and neck, lung and gastrointestinal cancers
  • increased nutritional needs from cancer and treatments such as chemotherapy, radiotherapy and surgery
  • side effects from cancer treatments
  • medications
  • hospitalisation
  • stress, anxiety and fatigue
Many of the eating problems discussed can contribute to, or be signs or symptoms of, malnutrition and can lead to a reduced response to cancer treatments, increased side effects and possibly reduced survival.
 
Malnutrition can also lessen your strength, function and quality of life. Eating well can assist your health and progress before, during and after cancer treatments.
 
Regardless of where you have your treatment, at diagnosis and at frequent points throughout your treatment journey, you should be asked by hospital staff about your risk of malnutrition. You should be asked:
  • Have you lost weight recently without trying? This refers to the past six months and the amount you've lost will be measured.
  • Have you been eating poorly because of decreased appetite? Are you eating less than three quarters of your usual meals for any unintentional reason?
If you answer yes to one or both of these questions, you may be at risk of malnutrition. If this is the case, it's important to be referred to a dietitian for individualised advice.
 
Identifying your risk of malnutrition early is key to tackling it in the best way to improve your overall health. Malnutrition and weight loss can be prevented. It should not be considered an expected side effect from cancer or treatments. Speak to your doctor or dietitian about ways to lower your risk.

Loss of appetite
Loss of appetite is a common problem that may be caused by many things including the effects of cancer on the body, the effects of treatment or other side-effects such as feeling sick or the smell of food, or feeling down or upset. You may just not feel like eating. There are many ways to make mealtimes more appealing if you've lost your appetite.
  • Try to keep to a regular eating pattern. You may not feel hungry but your body still needs nourishment in order to maintain your weight.
  • A very full plate of food may put you off eating – try having your food on a smaller plate to keep the portions small.
  • Eat what you feel like, when you feel like it. For example, have cereal at dinner time and a main meal at lunch.
  • Try to keep a variety of food in your diet as this may help improve your intake.
  • Choose full–fat food whenever possible. These may be labelled as ‘full cream’ or ‘thick and creamy’ rather than ‘light’ or ‘diet’ or ‘low fat’.
  • Add high energy and protein food to your fruit and vegetables. For example fruit with yoghurt/mayonnaise/salad dressing/ice cream/chocolate dip, fruit juice with milk/ honey/ sweeten jelly/ coconut milk/ sago, and cut up vegetables with dip stir-frying vegetables.
  • Have a range of ready prepared food and snacks on hand for times when you don’t feel like preparing food. Cook larger quantities in advance and store in the freezer, or ask family and friends to prepare meals if you don’t feel like cooking. Remember to practice good food hygiene.
  • Sip fluids throughout the day, choosing ones that add calories and other nutrients such as fruit juices, milk, milkshakes or commercial supplements.
  • Gentle physical activity can stimulate appetite. For example, take a short walk around the block or even around your backyard.
Make meals as enjoyable and social as possible – you may want to play music, turn off the TV, light candles of invite friends to join you.
 
Reviewed By:
Jenelle Loeliger, Head - Nutrition Department, Peter MacCallum Cancer Centre, VIC; Kate Aigner, Cancer Information Consultant, Cancer Council Helpline ACT; Ian Anderson, Consumer; Dr Anna Boltong ( Clinical Dietitian), Unit Head, Cancer Information and Support Service, Cancer Council Victoria, VIC; Clare Hughes, Nutrition Program Manager, Cancer Council NSW; Bridget Kehoe, Public Health Coordinator (Nutrition and Physical Activity), Cancer Council QLD; Steve Pratt, Nutrition and Physical Activity Manager, Cancer Council WA; and Roswitha Stegmann, Helpline Nurse, Cancer Council WA.