Diet problems with cancer
Diet problems can happen when you have advanced cancer.
Advanced cancer means that cancer has spread from where it first started. A cure may not be possible if you have advanced cancer. Your doctor will offer treatments that can help to control your symptoms.
Problems with eating and drinking may get worse when your cancer gets more advanced.
Some of the common diet problems in advanced cancer are:
a blockage in the bowel
constipation
not enough fluid in your body (dehydration)
wasting syndrome ( )
Sometimes cancer in the tummy (abdominal) area can grow so that it partly or completely blocks the bowel. This can happen with ovarian, bowel or stomach cancer.
Other causes of a blocked bowel are:
tissues that stick to the bowel (adhesions) after previous surgery
thickening of tissue around the bowel that is a late side effect of radiotherapy
Your doctor may call this a bowel obstruction. The waste from the food you have digested can't get past the blockage.
This causes symptoms such as:
feeling bloated and full
loss of appetite
tummy (abdominal) pain which can be crampy
feeling sick
vomiting large amounts
constipation
a hard tummy (abdomen)
bleeding from the back passage when the blockage is in the large bowel
There are several ways of dealing with a blocked bowel.
Your doctor will admit you to the hospital if you have a completely blocked bowel. You stop eating and drinking until your bowel is working normally again. You have fluids through a drip into a vein (intravenously). This prevents you from getting dehydrated.
You will also need to have a tube into your nose and down into your stomach. This is called a nasogastric tube (NG tube). Sometimes the tube is put into your stomach through an opening on the outside of your tummy. This is called a venting gastrostomy. These tubes aim to drain fluids and stops you feeling sick. This treatment gives your bowel time to rest.
Sometimes, with rest, swelling in the bowel can go down, and this can fix the blockage, but not always.
It is sometimes possible to have an operation to unblock the bowel. This relieves symptoms for a longer time.
After the operation your surgeon might repair the bowel by stitching the ends back together. Sometimes it isn’t possible to do this and you may need to have a colostomy or ileostomy (stoma). A stoma is an opening from the bowel onto the abdomen. Your poo comes out of this opening into a plastic bag that sticks over it.
This is quite a big operation to go through if you have advanced cancer. It's not easy to say how much you will benefit from the operation. Speak to your doctor and family before having this operation to help you weigh up the possible risks and benefits.
Sometimes you can have a metal tube (stent) through the blockage.
The surgeon puts a tube with a light at the end (colonoscope) into your bowel through the back passage (rectum). This is called a colonoscopy.
The surgeon uses the colonoscope to see where the blockage is and pushes a stent through it. The stent expands and holds the bowel open so poo can pass through again. The stent stays in place to keep the bowel open.
The stent can relieve the blocked bowel and avoid the need for a big operation. This procedure might not be suitable for everyone. Talk to your specialist about it.
Instead of an operation, medicines can sometimes help to control symptoms of a blocked bowel. Unfortunately these types of treatment will usually only control your symptoms for a while.
A drug called hyoscine butylbromide (Buscopan) stops muscle spasms and reduces pain. You can also have painkillers and anti sickness medicines.
You might also have a drug called octreotide. Octreotide reduces the amount of fluid that builds up in your stomach and digestive system. It can help to control sickness.
Some people might have steroids. Steroids can help to reduce the inflammation of your bowel. They can also help to control sickness.
Your healthcare team might recommend that you lower the amount of fibre in your diet. Only do this if your healthcare team have asked you to do it. This can sometimes help some people with a blocked bowel. By doing this, you reduce the amount of stool.
Constipation means having difficulty going for a poo (stool, bowel movement). You might:
not have a poo for a few days or more
have hard or lumpy poo
difficulty or having to strain more when you open your bowels
It is a common problem in advanced cancer. Some causes are:
not being physically active
a low fibre diet
depression
the side effects of some pain, anti sickness and chemotherapy drugs
spinal cord compression
You can feel very sick with constipation. You might feel embarrassed about it too. But do ask for help. Hospital and community nurses know how to deal with constipation. They can tell you how to prevent or relieve it.
Constipation is much easier to manage if your doctor treats it early. Adding fibre to your diet and plenty of fluids can help. But you may also need to take a laxative. Your doctor can prescribe one.
Not having enough fluid in your body is called dehydration.
Being dehydrated can make you feel sick, confused and tired. You might not feel like eating or drinking much when you have advanced cancer. So it can be hard to prevent dehydration.
If possible, try to drink every hour or two, even if it is only sips of your favourite fluid. You could try sucking ice cubes if you are finding it difficult to drink.
Your doctor might give you some fluids through a drip to help. But this is not always the best solution if you are in the late stage of your cancer.
The Royal Surrey NHS Foundation Trust have a video called 'What should I eat if…I just don’t feel like drinking? Tips to support you when you are struggling to drink with cancer'.
Watch this Royal Surrey NHS Foundation Trust video with tips for drinking on YouTube
Cachexia is a problem for many people with advanced cancer. It is also called wasting syndrome or anorexia cachexia syndrome. Anorexia means loss of appetite.
Cachexia is more than only loss of appetite. It is a complex problem and difficult to control. It involves changes in the way your body uses proteins, carbohydrates, and fat. You may also burn calories faster than usual.
Cachexia in advanced cancer can be very upsetting. You might feel very weak and less able to do things. Doctors try to reverse the effects of cachexia. They use appetite stimulants, steroids and in some people, tube feeding. But improvements are only temporary.
If you have cachexia, it might be helpful to eat whenever you can face it. Eating might not reverse the problem but can help to stabilise weight loss. This will help you feel better emotionally. It can also give you more energy and improve your quality of life.
You and your loved ones can try the following suggestions to help with cachexia:
Try eating in the mornings. People tend to feel more like eating in the morning than in the evenings.
Try to regularly eat small meals and snacks that are high in energy.
Don't worry too much about what you eat. If you feel like it, have it.
Ask the hospital dietitian for hints on how to prepare simple foods that are easy to digest.
Drink small amounts as often as you can if you don't feel like eating. Or try drinking high energy supplements between meals.
Try to still eat with your family or friends at the table. The social gathering with loved ones and the support they offer can help you to cope better.
The Royal Surrey NHS Foundation Trust have a video called 'What should I eat if...I am losing muscle and strength? Tips to support you when you have muscle loss with cancer'.
Watch this Royal Surrey NHS Foundation Trust video about losing muscle and strength on YouTube
Last reviewed: 27 Mar 2024
Next review due: 26 Mar 2027
Cachexia is a complex change in the body, causing you to lose weight despite eating normally.
Most people have surgery for colon cancer that hasn't spread. The operation you have depends on the position of the cancer in the bowel.
You may need drip or tube feeding if you need extra nourishment as a result of weight loss or your treatment.
Medicines, soft diets, adding calories to your diet or tube feeding are some of the ways to manage diet problems.
Having diet problems when you have cancer can affect you emotionally. But there are things you can do to help you cope.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
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