[victordeltaParticipant]

My wife was diagnosed with Myeloma about six months ago and is currently preparing for a Stem Cell Transplant (once her previously healthy liver recovers from the initial chemotherapy).

As many others say, one of the worst problems for her at the moment is a total lack of appetite or interest in food, and having to virtually force herself to eat anything (something she has always loved in the past). Complan etc is helping to avoid actual weight loss.

I just wondered if any others, who have experienced this, have any tips to offer beyond the much quoted ‘little and often’, in case there is more I can do to help her. I did wonder if hypnosis might be beneficial but, if so, I suspect others would already be recommending it.

[richfsModerator]

Hi Victor,

Myeloma UK have just trained some peer-volunteers to assist on this forum. I am one such person and was treated for myeloma in 2019 with VTD and a stem cell transplant.

I am sorry to hear of your wife’s diagnosis and appreciate your role in caring for her and helping to manage her treatment. My wife was so helpful to me through my treatment.

Personally, I found that as the chemotherapy affected my sense of taste, I went off sweet food altogether but was often keen to eat savoury. Some weeks I ate nothing but cheese straws, then I’d go off those and only eat crisps. Lots of people will tell you to listen to your body and eat whatever you fancy – there’s certainly some truth in that. It’s hard to explain how the change of smell or taste can put you off food, but you may be able to find things that your wife can enjoy eating.

I found that exercise was so helpful throughout all of my treatment, and I’m sure this improved my appetite. Long walks were the order of the day.

After the stem cell transplant, I found that my appetite was very low. Gigner-nut biscuits were good as they also help with nausea, other than that tasty food like curry was actually easier to eat as everything else seemed so bland.

I’ll see if I can find anything from others and will get back to you.

Best wishes to you and your wife, hang in there and know that the treatment can be very effective,
Rich.

[victordeltaParticipant]

Rich

Many thanks for your helpful response which I’ll discuss with my wife. I certainly agree with you on the subject of exercise – we try to walk at least several miles every day. If you do have any further thoughts or ideas, please post again.

Victor

[richfsModerator]

Thanks Victor, seems like the main advice out there is little-and-often and take some exercise before meals, which you already know.

Some other tips I saw on other websites are interesting, especially to have high-protein, high-calorie snacks on hand for when your wife does feel like something. Also, making mealtimes more attractive by using nice plates or table settings, or watching something fun on TV at the same time. As a patient myself, when I was exhausted and in pain and didn’t feel like eating, any little encouragement was beneficial.

I’d also say that you mustn’t be hard on yourself if you can’t find things that your wife wants to eat, or feel frustrated if you’ve cooked something nice that she then can’t face eating. Sadly this is one effect of the treatment. The encouragement is that it will pass, and the time when your wife will start craving food and enjoying eating again will come.

I’m from the West Country so found pasties (cheese and onion for me as I’m vegetarian) very good for keeping my weight up!

The following is from https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/eating-problems/poor-appetite.html

<b>What the patient can do</b>

Here are some hints that may help if you are having changes in your appetite:

• Eat several small meals or snacks throughout the day, rather than 3 large meals.
• Avoid drinking liquids with meals, or take only small sips of liquids while eating to keep from feeling full early (unless you need liquids to help swallow or for dry mouth). But remember it’s important to stay hydrated, so it might be best to drink most of your liquids between meals.
• Make eating more enjoyable by setting the table with pretty dishes, playing your favorite music, watching TV, or eating with someone.
• Be as physically active as you can. Start off slowly, and increase your activity over time as you feel stronger. Sometimes a short walk an hour or so before meals can help you feel hungry.
• Keep high-calorie, high-protein snacks on hand. Try hard-cooked eggs, peanut butter, cheese, ice cream, granola bars, liquid nutritional supplements, puddings, nuts, canned tuna or chicken, or trail mix. (See the table of high-protein foods in Eating Well During Treatment.)
• Review the tips on adding calories and protein to foods and include these in meals and snacks throughout the day.
• Eat your favorite foods any time of the day; for instance, if you like breakfast foods, you can eat them for dinner.

<b>What caregivers can do</b>

• Try giving the patient 6 to 8 small meals and snacks each day.
• Offer starchy foods, such as bread, pasta, or potatoes, with high-protein foods, such as fish, chicken, meats, turkey, eggs, cheeses, milk, tofu, nuts, peanut butter, yogurt, peas, and beans.
• Keep cool drinks and juices within the patient’s reach.
• If the smell of food bothers the patient, serve bland foods cold or at room temperature.
• Create pleasant settings for meals, and eat with the patient.
• Offer fruit smoothies, milkshakes, or liquid meals when the patient doesn’t want to eat.
• Try plastic forks and knives instead of metal if the patient is bothered by bitter or metallic tastes.
• Don’t blame yourself if the patient refuses food or can’t eat.
• Be encouraging, but try not to nag or fight about eating.
• If the patient can’t eat, you might want to offer just your company. Or offer to read to them or give them a massage.

This site has some interesting tips about increasing calories – https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer/art-20045046

<b>Increasing calories</b>

During illness, treatment or recovery, your need for calories and protein may be greater than usual. The following suggestions can help increase the number of calories you consume:

• Add butter or oils to foods. Use butter or margarine generously on potatoes, bread, toast, hot cereal, rice, noodles and vegetables and in soups. Put olive oil or another oil on bread, rice, pasta and vegetables.
• Spread peanut butter or other nut butters — which contain protein and healthy fats — on toast, bread, apple or banana slices, crackers, or celery. Dip pretzels in peanut butter.
• Use croissants or biscuits to make sandwiches.
• Add powdered creamer or dry milk powder to hot cocoa, milkshakes, hot cereal, gravy, sauces, meatloaf, cream soups or puddings.
• Add sliced avocado or guacamole to salads and sandwiches.
• Add seeds, such as sunflower and pumpkin seeds, to salads, stir-fries and casseroles.
• Add ground flaxseeds to yogurt, smoothies, hot cereals and casseroles.
• Top hot cereal with brown sugar, honey, dried fruit, cream or nut butter.
• Top pie, cake, gelatin or pudding with ice cream, whipped cream or cream.
• Use fruit canned in heavy syrup. It has more calories than does fresh or juice-packed fruit. If you prefer fresh fruit, add sugar and cream.
• Drink beverages that contain calories, such as fruit juice, lemonade, fruit-flavored drinks, malts, floats, soda pop, cocoa, milkshakes, smoothies and eggnog. Nutritional supplement drinks are convenient options.

Finally, Cancer Research UK has thoughts about making foods more appealing when you have taste changes – https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/side-effects/appetite-taste-changes

<b>Tips for taste changes</b>

• Avoid foods that taste strange to you, but try them again every few weeks as your taste may have gone back to normal.
• Choose foods that have strong flavours if all your food tastes the same. Try adding garlic, lemon juice, herbs and spices, and marinades.
• Marinate foods overnight or for a few hours (even 10 minutes will make a difference). Make a marinade with a couple of tablespoons of olive oil, and whichever herbs or spices you fancy. Add a splash of wine or some lemon juice if you like.
• You could use a dry marinade – sometimes called a rub. Mix up spices and herbs and slap onto uncooked meat or fish with clean hands.
• Avoid hot (spicy) foods if you have a sore or infected mouth.
• Gravies and bottled sauces can help to add flavours to a meal.
• You might find you prefer stronger versions of your favourite foods such as smoked ham or bacon or strongly flavoured cheese.
• You may prefer to avoid your favourite foods and drinks altogether during chemotherapy so there is no danger of going off them for good. This is particularly useful for children.
• Use plastic utensils if food tastes metallic. It can help to reduce the metallic taste.
• Avoid very cold or hot foods.
• Use chutney, pickle or relish to add flavours to food.
• Italian dressings, sweet and sour sauce and sweet fruit juice will enhance flavours.
• Keep your mouth clean and brush your teeth well.
• Tart foods have a strong taste. Consider lemons, limes, oranges and gooseberries, lemon yoghurt, lemon cheesecake, orange mouse, lemon sorbet and stewed gooseberries (avoid if you have a sore mouth).

I’m sure others will add some thoughts about what they found useful!

[kh0305Moderator]

Hi Victor,
I’m also a volunteer on the forum and have been experiencing the same issues recently with my dad who is currently going through treatment for his first relapse. He lost a lot of his taste and was suffering with digestive issues as a result of the treatment which meant he’s lost a lot of weight and has gone off food, which like your wife, he used to love. We also used complan to try and stem the weight loss as much as possible and we also kept a food/symptoms/activity diary to identify the times when he was eating more/less and when he felt worse so we could then identify the foods that he tolerated better vs those that made him feel poorly and so could adapt his diary accordingly. This did help a bit. As you say, the little and often is definitely better than the big meals and try adding in extra calories such as using olive or seed oils as dressings and buttering crackers/bread if your wife can tolerate these. Like Rich mentioned, dry foods and ginger can help with the nausea and peppermint tea can also be quite helpful. We found liquids such as soups and milkshakes easier to tolerate. As dad’s palate had changed, foods he previously enjoyed just didn’t taste the same any more so we found it best to keep away from his favourite meals as it was disheartening for him not to enjoy them, and look at stronger flavoured foods, foods he wouldn’t have previously eaten and those that didn’t create as much of the metallic flavour in his mouth (this was just through trial and error). Eating when distracted e.g. while watching TV can also help as there is less focus on the food itself. I hope this is useful and your wife is finding more of an appetite. Good luck with the treatments x

[victordeltaParticipant]

Many thanks for your post. All very helpful.

[richfsModerator]

Sorry Victor, my follow-up message got caught up in the internals of the forum due to the links I’d added, but it’s now appeared above! Do let us know how you and your wife are getting on.

Rich 👍

[victordeltaParticipant]

Rich

Many thanks for your second post which I received by email at the time and was puzzled that it wasn’t also shown on the forum. Now all is explained! Lots of good ideas above, which we will follow up in slow time. Just at the moment, variety and distraction seem to be working best. Thanks again.

Victor

[suenewhotmail-comParticipant]

Hi Victor, I sympathise with your wife because I too suffered enormously from nausea and loss of appetite after I received chemotherapy. I listened to all the general advice about little and often, ginger tea, ginger biscuits, etc etc but nothing really helped. I couldn’t face putting even the smallest piece of food in my mouth and would go all day until about 6 o’clock without eating until I forced myself to have something. Needless to say I lost a huge amount of weight. This went on for months until I was referred to an amazing doctor at our local hospice. Over a period of months he prescribed several different medications until we found the one that eased my symptoms and helped to increase my appetite. From time to time I still feel a bit nauseous but nothing like before. At last I can enjoy a meal with my family and can face cooking again.

Good luck with finding the solution for you.

Kind regards
Sue Emmerson

[sachbarnesParticipant]

`hi sue, which medication helped with appetite? tx

[Author]

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