Advanced cancer refers to cancer that can usually no longer be cured. At this stage, the goal of care is to preserve the dignity and quality of life of the person with cancer. Care is aimed at:

• relieving symptoms such as pain
• easing fear and anxieties
• helping the patient stay independent as long as possible and as comfortable as possible and also control the cancer when possible

People with advanced cancer may have a number of nutrition-related problems. These include:

• poor appetite
• constipation
• feeling full when eating
• dry mouth
• nausea
• vomiting
• taste changes
• gas
• bloating
• trouble swallowing

If you are having trouble with side effects of advanced cancer, ask your doctor, nurse, dietitian, or hospice care team member about medicines and ideas to help you.

Remember that the goal of any diet change is to provide comfort and help you manage eating-related symptoms. Eat anything you want to, but try to focus on foods that are nutritious. Although good nutrition will not cure cancer, it helps to:

• make you feel better
• keep up your strength and energy
• keep up your weight and your body’s store of nutrients
• make it easier to handle treatment-related side effects
• decrease your risk of infection

Near the end of life

Food keeps us alive. When cancer becomes advanced, patients often have no appetite and may lose a lot of weight. These symptoms are most often caused by the cancer itself and the patient cannot control them. .Although patients may understand the importance of eating and may want to eat to help themselves, they cannot force themselves to eat. In the final days of life the body cannot use the food or fluid, and continuing them may increase the patient’s discomfort. This is not a time for food to become a source of stress between patient and family. Usually, care related to hydration and nutrition in the final weeks of life includes treating dry mouth and thirst, and helping the patient’s family understand and cope with their feelings about stopping nutrition.

Nutrition suggestions for people with advanced cancer

• Make the most of days when you are feeling well and your appetite is good.

• Keep nutritious foods and drinks handy, so they're ready when you feel like eating.

• Eat small, frequent meals and snacks every 1 to 2 hours. If eating a whole sandwich seems like too much, for example, try eating it in quarters throughout the day.

• Eat high-protein, high-calorie foods.

• Avoid liquids with meals (unless needed to help with dry mouth and swallowing) to keep from feeling full early.

• Avoid the smell of foods while they are being prepared.

• Eat the foods you like most.

• Eat with others and at a table if possible. Make eating as much of a pleasure as you can; removing medical equipment and supplies say help improve appetite.

• If you can, try some type of activity before meals to help increase appetite.

• Don’t force yourself to eat.

• Try to maintain your present weight, but don't feel pressured to regain weight if you have already lost some.

• Drink enough fluids to help keep your bowels moving regularly. If constipation is a problem, ask your doctor or hospice team to recommend stool softeners or laxatives, especially if you are taking medicine for pain.

If you're having trouble swallowing, or if soft or liquid foods are easier to eat when you're feeling weak or tired, just eat or drink them. Ask your nurses or dietitian to help you know which soft foods and liquids give you as many calories and nutrients as solid foods.

Liquid or powdered nutritional supplements can help, especially when you don’t feel like eating. Take all of your medicines exactly as prescribed. Tell your doctor, nurse, or hospice care team members about any problems or questions you have. Making changes in your medicines can cause new problems that may make any discomfort you are having worse. Your doctor may be able to suggest a simple change in the dosage or timing of your medicines that will correct problems you might have.

For information on nearing the end of life or hospice care, please call us at 1-800-ACS-2345, or visit our Web site at www.cancer.org.

Revised: 02/04/2008