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Appetite

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.

Assessment

  • 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

Palliative Care Guidelines Plus (UK)

Evidence based, free online prescribing guidance
Anorexia, Cachexia and Asthenia
See also Oral problems, Nausea and Vomiting

From: Palliative Care Adult Network Guidelines Plus


Evidence summary - Appetite

CareSearch Clinical Practice pages

Summarises the palliative care literature
Appetite Problems

From: CareSearch


Patient information - Appetite

Cancer Council SA

Nutrition for people having cancer treatment. (132kb pdf)
Includes practical advice, hints and recipes for people with reduced appetite

From: Cancer Council SA


Last updated 16 February 2017