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Diet and Nutrition By popular demand our nutritional message board. This board will be monitored by a Registered RD who is certified in oncology by the American Dietetic Association

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Old 11-06-2014, 09:06 AM   #1
catalina
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Join Date: May 2014
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My wife has no appettite

She was diagnosed 2 years ago with HER2, ER-, stage 4 with liver mets. She responded very well to chemo and had a full pathological response. She had headaches last summer and they found 12+ CNS lesions. She was treated with Whole Brain Radiation of 40 GY's, plus Tykerb and then gamma knife again in May due to progression.

She is off the Tykerb now because it did not seem to have any affect.

During the whole treatment regime she only missed 1 week of work. She is a strong, stubborn fighter, but it is taking a toll.

She now has no appetite, and is slowly losing weight. The Dr's rescanned her and found no progression, so they think this is the cumulative effects of the WBR and Gamma Knife. Her sleep schedule is disrupted as well.

She is resistant to supplements, shakes or pills. Did I say she was stubborn? Once favorite foods are not palatable to her, and she says that the odors of food cooking make her less hungry. She is drinking water ok, but can only stomach 6 ounces at a time.

I have tried small amounts of food, nuts, boiled eggs, peanut butter, fruit etc. in her lunch but she frequently does not eat it. The more I push her to eat the more she resists.

What can I do to get her nourishment?
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Old 11-06-2014, 11:54 AM   #2
donocco
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Re: My wife has no appettite

There is a strong medication to stimulate appetite called Megestrol. There is also a weaker one that might be effective. It is an antihistamine-serotonin antagonist called Cyproheptidine. It was found to stimulate the appetite and growth rates of asthmatic children being given the drug as an anti-allergy drug. The dosage is 4 mg 2 or three times a day. The main side effect is drowsiness. At least in theory it could interfere with the serotonin based anti-depressants like Prozac, Celexa Zoloft etc etc. You will need a prescription for it so talk with her doctor. Hope this helps a bit.

Paul
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Old 11-08-2014, 02:17 PM   #3
waterdreamer
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Location: Thousand Oaks, California.
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Re: My wife has no appettite

Something else that will stimulate her appetite is Marijuana Oil. You should research Rick Simpson Oil - it has also helped several people with treating their cancer. If she has low blood pressure, I would be very cautious as it can cause low blood pressure. It is best taken at night, rubbed into the gums and the serving size is about half a grain of rice. She will sleep well, and it will increase her appetite. It may also be effective against the cancer
Please keep us updated.
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Breastfeeding when diagnosed with Her2+ May 2008
Oct 2008 Double mastectomy 22/28 lymph nodes positive
Decline chemotherapy (decision I regret)
Nov 2009 Mets to lungs and bones.
Dec 2009 Start Taxotere and Herceptin, T1, T3 heal completely and lungs are clear, T2 and first rib have lytic lesions. First rib becomes sclerotic. Considered stable.
May 2011, Onc calls progression and I cross over from comparison arm of clinical trial to TDM-1
Brain scan in Sept 2011 showed small tumor in right cerebellum, did Novalis radiation.


Feb 2013 < 1cm tumor in left frontal lobe. Did Novalis in March and latest scan shows no sign of brain metastasis.
Aug 2013 did 36th round of TDM-1 Due to TDM-1 side effects, shortness of breath, and difficulty getting my balance when getting out of bed, agreed with my oncologist to stop TDM-1.
Took a six week break, bone scan showed small uptake on left first rib. CT showed hypodensities in liver (too small to biopsy) and small nodule in lungs (mediastinal).
Started Navelbine weekly. Did one round with Herceptin.
Skipped next 2 rounds, due to neutropenia. Next chemo 7th Nov - have had 3 Neupogen shots, so WBC should look better... Did not tolerate Navelbine well.
December 2013 scans show no sign of active cancer.
March 2014 - currently only on Herceptin - brain MRI clear, PET/CT two nodules in right lung show uptake
May 2014 - stop Herceptin.
Sept 22, 2014 Brain MRI clear :) PET/CT Progression in lungs.
Sept 2014, Xeloda, Tykerb and Herceptin.
Nov 2014 - Decide to take a break from all treatment.
May 2015 - Brain met radiated with Novalis
July 2015 - Have progression in right lung.
Sept 2015 - Perjeta and Herceptin alone after a 9 month break from all treatment.
Nov 2015 - Thoracentesis 1500ml removed from right lung.
Dec 2015 - Two tiny 1mm brain mets radiated in right cerebellum.
Feb 2016 - Thoracentesis 2200ml drained from right lung
Feb 2016 - Stopped Perjeta and Herceptin and started back on Kadcyla as I had no previous progression on it. After 1 cycle of Kadcyla markers begin to drop. On second cycle add Keytruda.
March 2016 - Thoracentesis 1650ml drained from right lung.
April 2016 Thoracentesis 1500 ml drained from right lung.
June 2016 CT scan shows progression in right lung, as well as moderate pleural effusion requiring Thoracentesis.
June 2016 Decide to stop Keytruda, and will do chemosensitivity test through Rational Therapeutics. Plan to continue on Kadcyla for next two cycles.
July 2016 - Start weekly Abraxane with Herceptin. WBRT with hippocampal sparing, Taking Namenda. 15 sessions over 3 weeks.
Aug - Dec 2016 - 2 infusions of Navelbine, very hard on my body and still dealing with anasarca (generalized edema) 1 infusion of Havalen
My doctor wants to put me on hospice.
Dec 23rd 2016 - I am granted compassionate use of Neratanib.
May 31st 2017 - still on Neratinib, feeling good.
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Old 11-25-2014, 10:41 AM   #4
TanyaRD
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Re: My wife has no appettite

Catalina,
Poor appetite can be difficult to manage and is frustrating for both the patient and the caregiver. Here are some tips that may help. Also, Megace or Marinol appetite stimulants may be a good idea to discuss with her oncologist. Sometime, Remeron may also be appropriate to help stimulate appetite. These drugs can take up to 4 weeks to start working so don't quit them thinking they aren't working.

Cool foods are often better tolerated because their is not as much odor.
Try cool canned fruit, cottage cheese, hard boiled eggs, Greek yogurt, meat salads like chicken, tuna or egg for extra protein
If her mouth is not sore then tart or citrusy or vinegary foods may taste appealing. Sometimes if the taste is a little off these strong flavors help to even things back out. I've actually had patient have success with eating a dill hamburger slice pickle before a meal to help perk up the taste buds. (sounds weird but sometimes weird works!!!)
Smoothies or homemade milkshakes using peanutbutter, powdered milk (for protein), fruit, etc may be well tolerated.

Best wishes,
Tanya
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Old 11-25-2014, 11:06 AM   #5
TanyaRD
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Re: My wife has no appettite

Catalina,
I just thought of one more thing. If your wife is complaining of supplements tasting too sweet you may add a little coffee or buttermilk to help cut the sweetness.
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Old 12-30-2014, 01:58 PM   #6
Dakini52
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Location: Edmonds, WA
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Re: My wife has no appettite

I appreciated the response siting Marijuana oil. When I was going thru heavy chemo treatments early on in my case, I discovered that Marijauna was extremely effective in helping me maintain my appetite, nausea level and sleep regiment. I continued working throughout chemo, surgery and radiation only missing a couple of weeks for surgery. While this is still an unorthodox treatment it was highly beneficial for me.
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Diagnosed June, 2006 HER2+++, ER- PR-, Grade 3, Stage IIB. Modified radical mastectomy, radiation, chemo, Herceptin, Tykerb 1 year. [*]In remission until 2/2010. Small tumor detected on chest wall during routine scan. 2/2010 surgery to remove tumor, started Herceptin/Tykerb, follow up radiation. [*]12/26/2010 - Off Tykerb due to allergic reaction[*]12/16/2014 - Have continued on Herception for almost 5 years now and remain NED. Discussion with onc re adding Perjeta to the Herceptin as another way of preventing recurrence. Still in discussion phase. 12/26/14 Onc applying for approval for Perjeta.
Perjeta approved and I received one infusion. It had an immediate impact to my lungs and I experienced difficulty breathing so.....I'm going to be sticking with just Herceptin. Still looking for a good vaccine program to enroll in.

Debbie K
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