Key points

  • Anorexia (loss of appetite / early satiety) and cachexia occur commonly together in cancer and other advanced diseases, and affect performance status.
  • Cachexia and anorexia are strong independent prognostic predictors.
  • Once fully established, or in late disease, cachexia is not reversible by nutritional interventions.
  • Cachexia affects the person’s ability to tolerate treatment of cancer.
  • Clinicians need to recognise the profound social, cultural and emotional importance of food and provide individualised support to patients and families.


  • Consider potentially reversible causes - including nausea, depression, medication side effects, mouth problems.
  • Consider overall prognosis and stage of disease in deciding a management approach.

Approach to management

  • Multidisciplinary intervention (nutrition, exercise, occupational therapy and pharmacological intervention) may help selected patients.
  • Assist with adaptation to the symptom – including dietary modification, appropriate nutritional support, and psychological support.
  • When prognosis is getting short: encourage transition to eating for comfort.

Prescribing guidance - Appetite

Anorexia, Cachexia and Asthenia
Evidence based, free online prescribing guidance

See also Oral problems, Nausea and Vomiting

From: Palliative Care Adult Network Guidelines Plus

Evidence summary - Appetite

Appetite Problems
Summarises the palliative care literature

From: CareSearch

Patient information - Appetite

Nutrition and Cancer - A guide for people with cancer, their families and friends. (479kb pdf)
Includes practical advice, hints and recipes for people with reduced appetite

From: Cancer Council SA

Last updated 04 August 2020