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Diet in advanced cancer

Diet problems can happen when you have advanced cancer. But there are treatments available that can help with controlling your symptoms.

Advanced cancer means the cancer has:

  • spread from where it started in the first place
  • come back some time after you were first treated

If you have advanced cancer, it may not be possible to cure it. Your doctor will offer treatments that can help to control your symptoms.

Diet problems in advanced cancer

Problems with eating and drinking may get worse when your cancer gets more advanced.

Diet problems in advanced cancer are different from those related to cancer treatment. Your doctor and dietitian will manage it differently.

The main aim is for you to have a better quality of life by controlling the symptoms you have.

A blockage in the bowel

Symptoms

Sometimes a cancer in the tummy (abdominal) area can grow so that it partly or completely blocks the bowel. This can happen with cancers like ovarian cancer or stomach cancer, 

Your doctor may call this a bowel obstruction. The waste from food you have digested cannot get past the blockage. 

This causes quite a few symptoms such as:

  • feeling bloated and full
  • colicky type pain
  • feeling sick
  • vomiting large amounts
  • constipation
  • hard abdomen

Below are several ways of dealing with a blocked bowel.

A drip and a tube into your nose

Your doctor will admit you to hospital if you have a completely blocked bowel. You stop eating and drinking until your bowel is working normally again.

This means you have fluids through a drip into a vein (intravenously). It 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). It drains 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.

Surgery to unblock the bowel

It is sometimes possible to have an operation to unblock the bowel. This relieves these symptoms for a longer time. 

It might be possible to close up the bowel again. Or the bowel may open onto the outside of your tummy (abdomen). This is called a stoma. Your stools come out of the opening into a plastic bag that sticks over the stoma opening.

Speak to your doctor and family and friends before having this operation. It is quite a big operation when you are already feeling low. No one can say how much you will benefit from the operation. The cancer may not come back to block the bowel again.

A tube into your bowel to relieve the blockage

Avoiding a big operation might be possible. Sometimes your doctor can put in an endoluminal stent.

You have a metal tube (stent) put through the blockage. It helps to keep your bowel open. The doctor puts it in using an instrument called a laparoscope. This is a long tube with an eyepiece at one end. It's a bit like a telescope. 

First, you have a small cut made in your tummy (abdominal) wall. The doctor puts the laparoscope inside and moves it into the position of the blocked bowel. The doctor can see inside through the laparoscope and can position the stent in the right place.

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.

Octreotide to help stop fluid build up

Instead of an operation, you can sometimes have a drug called octreotide. It helps to control the symptoms of a blocked bowel.

Octreotide reduces the build-up of fluid in your stomach and digestive system. It can help to stop you feeling and being sick.

Unfortunately this type of treatment is only a temporary measure.

Low fibre diet

Lowering the amount of fibre in the diet seems to help some people with a blocked bowel. By doing this, you reduce the amount of stool.

Relieving constipation

You can feel very sick with constipation. You might feel embarrassed about it too. Do ask for help. Hospital and community nurses know how to deal with it. They can tell you how to prevent or relieve it.

The longer you leave it, the more problems it can cause.

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.

Don't take laxatives or increase your fibre intake if you have constipation with severe abdominal pain and vomiting. Your bowel may be blocked and too much fibre will make it worse. Contact your doctor as soon as possible.

Increasing fluid in your body

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.

But if possible, try to drink every hour or two, even if it is only sips. 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 final stage of your illness.

Wasting syndrome (Cachexia)

Cachexia is a problem for many people with advanced cancer. It is also difficult to control.

You might be eating well but still be losing weight. Your muscles may begin to waste away.

Doctors try to reverse the effects of cachexia. They use appetite stimulants, steroids and parenteral nutrition (PN). But improvements are only temporary and don’t increase how long you live.

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 small meals and snacks often.
  • Don't worry too much about what you eat. If you feel like it, have it.
  • Ask the hospital dietician 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.
Last reviewed: 
13 Oct 2017
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    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

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  • Nutrition and Cancer
    Edited by Clare Shaw
    Wiley-Blackwell, 2011

  • The Royal Marsden Hospital Manual of Clinical Nursing Procedures (9th Edition)
    Editors: L Dougherty and S Lister
    Wiley-Blackwell, 2015

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    National Institute for Health and Care Excellence (NICE), March 2004

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