Food and Nutrition with Advanced Cancer

As a person becomes sick, they may not eat as much. This can be hard for a loved one to watch and understand. Food may harm rather than help at this stage. Your loved one is not suffering from a lack of nutrition. Their body is changing and does not need as many calories as someone who is active and healthy. At this time, your loved one produces something called “ketones” that can lead to euphoria and comfort.

Forcing foods and fluids will not enhance or prolong life. It can be harmful to push foods and can be stressful to both you and your loved one.

What should the patient do?

• Eat when you have the most energy in the day.
• Eat small snacks throughout the day to keep your energy up.
• Choose high-calorie foods including those with high protein and fat content. These can include high-fat dairy products, oral nutrition supplements, crackers and cheese or peanut butter.
• Don’t fill up on vegetables or salads because they do not provide many calories or protein.

What should the caregiver do?

• Take your cue from the patient. Rather than forcing your loved one to eat, offer their favorite foods when they are most alert and awake.
• Support your loved one by suggesting bland, soft moist comfort foods that are easy to digest such as cream-based soups, yogurts, puddings, hot cereals, mac and cheese, ground meats with mashed potatoes and gravy.
• Encourage sips of water or juices. Moist fruits such as watermelon are soothing and can be helpful to keep the mouth wet.

Why is it important not to overfeed?

The gut slows down making it difficult to swallow or breakdown foods.

• Forcing food can cause bloating, nausea, cramping and congestion.
• It can be uncomfortable for the patient if the esophagus is slowing down. Food may become stuck which may lead to a heavy feeling on the chest.

Keep in mind that at the end of life, the kidneys do not work as well and start to shut down. The body is not able to produce as much urine and the body starts to hold onto extra fluid, which can back up into the lungs and the legs/arms. Offering more than 1 quart of fluid can lead to swelling or fluid in the lung.

Some patients have trouble swallowing (dysphagia). Trouble swallowing and a weakening of the lungs can lead to food getting caught in the lungs. This can cause choking and aspiration pneumonia.

Changes at the end of life can be challenging for all of those involved. By not forcing food your loved one will be more comfortable. If you have any concerns you can always ask to speak to a registered dietitian or the medical team.