Eating Disorders and Cancer
Prevalence of Cancer
Most people can’t imagine hearing their doctor say the words – “you have cancer.” Every year 12.7 million people in United States discover they have cancer and according to The National Cancer Institute “almost all” people with advanced cancer develop anorexia, one form of eating disorder.
Cancer and Cachexia
When someone with a chronic illness develops an eating disorder it’s called cachexia (ca·chex·i·a), or wasting disorder. The disorder has two different forms – the first occurs when the patient eats normally but their body no longer uses the nutrients from the food they consume. The latter develops when the patient stops eating because their illness has caused them to lose their appetite. Either form can evolve into anorexia if the patient starves themselves deliberately.
Cachexia affects 50 to 80 percent of cancer patients and accounts for up to 20 percent of cancer deaths. Additionally the eating disorder is associated with poor quality of life and has a mortality rate of 80 percent. Many other cancer patients die with but not of cachexia. According to data from the Nationwide Inpatient Sample in United States, it is estimated that the annual prevalence of cachexia admissions to community hospitals in the United States is over 160,000 cases. The median duration of stay for the patients suffering from the disease was six days – double the median stay for patients without cachexia. The median cost for these visits was $10,000, which is $4,000 more than for non-cachexia patients.
Cancer patients with eating disorders (cachexia) may lose up to 20 percent of their body weight when suffering from the disease. Unfortunately, there is no cure for the disease – unlike malnutrition which is reversible with an adequate amount of food. The only way to manage cachexia is through managing underlying cancer.
While there is no easy fix for patients who suffer from cachexia, some doctors recommend the use of corticosteroids to increase their appetite. Additionally, the medication has been shown to increase a patient’s mood. Medical marijuana has also been implemented in the hopes of increasing hunger to encourage weight gain in underweight patients. Some doctors also work with a nutritionist to determine a vitamin regime and specific foods a patient with cachexia should be eating to maximize protein intake in the hopes of mitigating the disease.
Patients with cancers of the lung, such as the rare mesothelioma cancer, pancreatic, and upper gastrointestinal cancers are more likely to develop anorexia. It remains the most commonly diagnosed cause of cancer patient malnutrition.
Acknowledging the issues of depression and anxiety can go a long way to improve the patient’s willingness to both eat and battle their cancer. Talking with a therapist about their current health situation can help to lift the emotional burden felt by the patient. However, it is up to the patient
to first recognize that they are battling a depressive episode in addition to their cancer diagnosis. Mental health issues often take a back seat while a course of treatment is planned which can be a dangerous situation.
Having the resources readily available if/when they become necessary is paramount. Mindfulness-based cognitive therapy (MBCT) and cognitive behavioural therapy (CBT) are just two of the options that may be suitable for patients presenting with Eating Disorders and Cancer.
In an effort to encourage patients to maintain healthy eating habits to circumvent the cachexia, studies have shown success with simple changes.
Possible adjustments include focusing on ambiance surrounding the patient’s meal, extra consideration to the patient’s food preferences, and attention to a pleasant social setting when serving meals. There is also value in eating with a family member, friend, or fellow patient and, if the patient likes, serving wine. The wine may improve the mood of a patient, stimulating both appetite and social interaction.
Generally speaking, it is important to stress to the patient that proper nutrition is an essential part of managing their cancer. However, when having these conversations, be sure to remember that they are suffering, and avoid judgemental or harsh tones. Love and support can make a world of difference to someone who is fighting for their lives.