doc says gain weight! chemo &food aversions

[aqua902@mindspring.com]

Hi ladies, it's been while, I've been on various chemos since 2002,HER2+++ with some I've lost appetite,but not much weight. I have had a very difficult time with Doxil this year. I have little appetite, can't stand the smell of cooked foods. Tried meds, but not very helpful.
I have chronic bronchitis and a raised diaphram(complication of sugery-nicked phernic nerve, making it more difficult. Doc lowered Doxil, and gave me an extra week to rest
between rounds. My counts have been good, but I am on Neupogen for the first week,
Any experience and/suggestions? Any tricks to getting an appetite. I need to put on
about 20 pounds, with limited sugar and fat, gall bladder issues.

Susan M(PA)

[Jackie07]

Susan,

When I had chemotherapy the first round in 2003, I experienced similar situation. Though not as bad since I had already been underweight and staying home (had lost my job) had helped with my weight some.

One of my church friends brought me Lin-chih soup, a Chinese herb remedy made with dried chunks of a huge mushroom. Most mushrooms grow and die in short time period. The Chinese had observed since ancient time that this particular type of mushroom is not just huge, it stays vibrant for a long, long time.

Though it is hard to prove whether or not 'Ganoderma Luciderm' cures cancer or prolongs life (my friend's mother survived lung cancer three years longer than her doctors had predicted) I can vouch for the effectiveness of this 'miracle herb' (its namesake) in increasing my appitite and helping me gain weight during chemotherapy.

The 'soup' my friend brought me (and then instructed me how to prepare it) was very bitter. For whatever reason, I was able to eat 'regular' meal right after I drink it. By the time I had the recurrence 4 years later (the surgical oncologist was too confident on her surgical skills and the radiologist was too confident on their 'reading' skills, plus the medical oncologist did not take Her-2 into account...) there was the mushroom powder in capsule form availalbe in the market that I could purchase.

The one I used is produced by 'Chang Gung Biotechnology', a company affiliated with one of the largest hospitals in Taiwan. Chang Gung ['long-living'] Memorial Hospital had been built by the richest man there, a shipping tycoon of East Asia, in honor of his mother.

The agent I purchased them from was based in New York. The Website printed on the bottle is www.cgb.com.tw (http://www.cgb.com.tw)

[Rich66]

Dunno. Would be hesitant to add much esoteric elements to chemo. In the last week I've seen suggestion that steroid pre-meds and maybe opiate pain relievers might interfere with chemo. Fairly common supplements can be of question. Some nutrition stores have weight gain supplements but hey may contain soy which conflicts with ER+ cancer. I think Megace is a common app stimulant for cancer patients. Maybe mirtazipine. GNC type nutrition stores have weight gainer supplements but you have to watch what's in them. The gall bladder issue does complicate things reagarding fats. I believe muscle weighs more than fat so weight training might help. To start, you might list your cancer characteristics in your signature.

[TanyaRD]

Hi Susan. Rich brings up a good suggestion about appetite stimulation. If you have never been on an appetite stimulant and have struggled with the symptom for a while it could be a good time to try something. We commonly use Megace, Marinol and sometimes Remeron for appetite stimulation. Megace probably works the fastest but cannot be used if you have a history of blood clots (DVTs). Marinol also works for nausea right away but the appetite stimulation can take a couple of weeks. Remeron is an antidepressant starting at the 45mg dose but we will sometimes use a 30mg dose at bedtime for appetite and see decent results.

As far as food goes the goal will be to maximize calories in a volume you are able to tolerate. It is difficult to eat large volumes of food/fluids when you have no desire to eat. I encourage my patients to try eating every 2-3 hours. It doesn't have to be anything big but maybe 4-6 crackers with peanut butter or cheese (low fat if a lot of trouble with fat). Cottage cheese and fruit or other cool foods are often well tolerated because there is no steam (or smell) coming off the food. Sometimes liquids are better tolerated too. Of course oral supplements are another option. I have recently been using a product called Unjury (unjury.com). They offer whey protein based protein supplements and one of them is chicken soup flavored which is actually very palatable.

If there is a Registered Dietitian available at your clinic it can be advantageous to meet and develop the best plan for your needs.

[BonnieR]

I had issues with lack of appetite and weight loss during treatment. I drank alot of canned Ensure. Had small frequent snacks of low fat cheese, peanut butter, soups. Even low fat milk shakes. Try to think of calorie dense foods. It was a good suggestion that you find a dietician who you can consult with especially because of your special needs.
ETA: Keep the faith.

[ElaineM]

I would like to suggest soups and smoothies. You can buy some frozen fruits if you don't feel like standing and cutting things. Throw them in a blender with a little water, dried milk, yoghurt, almond milk, or soy milk and maybe a little protein powder from a health food store. you can even put the results in small cups and freeze them for refreshing snacks anytime. You can also carry a few crackers, a plastic container of cereal with dried milk (Just add water when you are ready to eat it.), a plastic bag with cereal like cherrios and few nuts, or a peanut butter cereal bar. Most of these things are easy to carry around in your pocket or bag. I always carry a container of fresh water and a snack wherever I go.

[Becky]

First, I would try yogurt - maybe even one of those newer ones like Activa. It will help replenish the good bacteria that help with food digestion. If you can't eat that cuz you don't like it, I would go and get a good probiotic supplement instead. After 2 weeks or so, that should be sufficiently replenished.

Try easy to eat foods that also have sufficient calories. Bananas come to mind as do avocados. Can you eat nuts? You can buy them unsalted too. A hearty handful everyday adds a good 300 calories. Protein is also very important - eggs, meats and fish. You can also supplement with Boost or Ensure - just to make sure you are getting enough. Puddings especially rice or tapioca are also good choices as there is some grain in those (and they are yummier). A nice chuck of good chocolate every now and then is also good.

There is an abundance of winter squashes available now that you can make a butternut/ginger soup. Ginger has anti-nausea effects and may also be a help to you. It also aids in digestion.

I will keep thinking.

[TanyaRD]

Excellent suggestions!