Weight loss: A common problem of people with stomach cancer

The article was consulted with Specialist Doctor I Dong Xuan Ha - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Ha Long International General Hospital.

Many people with stomach cancer lose weight due to poor nutrient absorption. Cancer and its treatment can not only make you nauseous and lose your appetite, but it can also interfere with your body's ability to get the calories and nutrients it needs from food. So how to improve weight loss in people with stomach cancer?

When you have stomach cancer, you want to keep your body as healthy as possible during treatment. And that means getting good nutrition and maintaining a normal weight.
Rapid weight loss is a very common problem for people with stomach cancer. Stomach tumors can block the passage of food into the stomach from the esophagus or from the stomach into the intestines. This can make it difficult for a person to eat. As cancer progresses, the body's ability to use energy from food is altered. As a result, energy is burned at a faster rate. This increased energy use combined with lower nutrient intake leads to weight loss.
There are other factors that can lead to weight loss in people with stomach cancer:
People with stomach cancer often lose their appetite and feel like they don't want to eat. After stomach cancer surgery, you may not be able to eat many meals and may feel full after eating small amounts of food. This is usually related to the amount of stomach removed. The remaining part of the stomach or small intestine may not be able to properly digest the food or be unable to absorb fats and nutrients from the food. This depends on the type of surgery and the extent of the gastrectomy. Dumping syndrome can make it harder to maintain weight. Dumping syndrome is a condition in which food or liquid moves through the stomach and small intestine too quickly. Dumping syndrome can occur when part or all of the stomach is removed. It is important to maintain your weight even if your appetite has changed. Proper nutrition helps the body fight disease and cope with the effects of stomach cancer treatment.

If weight loss is a problem, the following tips may help:
Don't skip meals. Try to eat often, even if it's just a few bites. Go for each drink by choosing foods and drinks that are high in protein and calories. Add whole milk or cream to cooked cereals or soups, use sauces and gravies on meats and vegetables, or add butter or margarine to potatoes. When you don't want or can't eat solid foods, drink high-calorie, high-protein beverages (like milkshakes, smoothies, or commercial liquid supplements) or eat semi-solid foods (like puddings) or yogurt). Also, drink small amounts of high-calorie, high-protein drinks between meals. Keep a variety of nutritious foods high in protein and calories, as well as quick and easy snacks, ready to eat when you arrive. Examples include milk or milkshakes, instant breakfasts, ice cream, cheese and crackers, muffins, peanut butter, eggs, nuts, yogurt and pudding. If the weight loss becomes severe, the health care team may recommend the use of a feeding tube. A food tube is a thin, flexible tube that is placed into the stomach or intestines. Once the tube is in place, liquid nutritional supplements can be given through the tube (enteral feeding). A feeding tube can help people meet their nutritional needs when they find it difficult to eat, especially when they are experiencing rapid weight loss. Learn more about feed pipes.

You may feel full after eating a small amount of food. This can happen whether you have surgery or not. Surgery for stomach cancer reduces the size of the stomach and can cause scarring in the stomach wall. Surgery can also damage the vagus nerve, which relaxes the stomach wall as food enters the stomach. This will improve as the rest of the stomach stretches or as the body adapts to changes in the digestive process. Even without surgery, your stomach can empty much more slowly, helping you feel fuller for longer.
If feeling full after eating a small amount is a problem, the following tips may help:
Try to eat small meals or snacks about 6 times a day. This is often easier than trying to eat 2-3 large meals a day. Avoid drinking liquids with meals, especially carbonated (carbonated) drinks. These liquids can fill the stomach quickly. Drink high-calorie or high-protein liquids between meals. Limit your intake of high-fiber foods, such as whole-grain breads and cereals, as they tend to make you feel full sooner than other foods.

If your doctor says you need to take in extra calories, these strategies will help.
Replace low-calorie foods with high-calorie foods. Choose drinks like hot chocolate, milkshakes, and fruit juices instead of water, tea, or diet sodas. Add heavy cream to your coffee instead of milk. Add butter, oil, margarine, sauces, salad dressings, sour cream, and peanut butter to foods when you can.
Prepare ready-to-eat dishes on hand. You may not have much energy for cooking right now. At home and work, keep high-calorie foods nearby, like cheese, nuts, dried or canned fruit (in heavy syrup form).
Do not fill with liquid. If you drink too much with a meal, you may not get enough calories. Instead, try to drink it 30 minutes before or after a meal.
Ask your doctor or dietitian about nutritional supplements. They can be a good way to increase your calorie intake. You may find that drinking is easier than eating right now.

Cancer and its treatments can make you feel nauseous, so you may not want to eat much. Try the following strategies to settle your stomach:
Eat smaller meals and eat more often. Six to eight small meals a day can be easier to handle than three regular meals. When you are hungry, eat. When you have a strong craving, take advantage of it. Many people with cancer say they feel hungrier in the morning, after they've slept. Eat food from the fridge. Hot meals can have a stronger smell, making you feel nauseous. But if you eat foods cold or at room temperature, they can be more appealing. Record what you eat. If you feel nauseous after a meal, find out if specific foods are triggering your symptoms. For a few weeks, write down what you ate and how you felt that day. Then look back and see if you can figure out which foods are giving you trouble.

If you are being treated for stomach cancer, weight loss may still be an issue as you recover. For example, if part of your stomach was removed during surgery, you may not be able to digest food as well as you used to. Your doctor will give you instructions on how to eat, but you may need to:
Eat smaller meals more often Take vitamin supplements Take liquid meals to increase calories Work with a dietitian Your doctor will is an important source of information on how to tailor your diet. But it's also a good idea to work with a dietitian.
Dietitians can offer advice tailored to your needs and suggest strategies for eating during and after treatment. If you don't already have a dietitian on your treatment team, consult your doctor.
If you have a need for consultation and examination at Vinmec Hospitals of the national health system, please book an appointment on the website (vinmec.com) for the best service.

References: cancer.ca, nutrition-and-stomach-cancer, webmd.com