Weight Gain or Loss During Ovarian Cancer and Chemotherapy

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Weight Gain During Chemotherapy

For women being treated with chemotherapy for ovarian cancer, changes in weight is a topic that often comes up. Some women tell me they look forward to losing weight while undergoing treatment. However, weight loss during chemotherapy is not a guaranteed phenomenon. In fact, many women undergoing ovarian cancer chemotherapy actually gain weight during their initial chemotherapy treatments and in the period of time following treatment.

Weight gain during treatment is probably due to a variety of factors. Some chemotherapy drugs, including the class of drugs called taxanes [drugs such as Taxotere (docetaxel) and Taxol (paclitaxel)], cause the body to retain fluid, which is called edema. Hunger may increase while on chemotherapy, either due to the chemotherapy itself or medications given with chemotherapy to prevent nausea. Physical activity may be reduced, often due to fatigue. And for women with ovarian cancer, if menopause is a result of ovarian cancer surgery and/or chemotherapy, this can be a cause of weight gain. Depression can also cause weight gain (or weight loss).

During treatment is often not the time to start dieting in order to lose weight, but often, weight gain can be a stressor for many women. If you are struggling with weight gain related to treatment, please discuss it with your oncologist or with a registered dietician.

He or she can help to figure out the reason for your weight gain and perhaps come up with safe and healthy ways to manage it.

Weight Loss During Ovarian Cancer

While weight gain is more common for women who are undergoing chemotherapy for ovarian cancer, losing too much weight can become problematic for some patients undergoing cancer therapy.

Weight loss can also be a problem for some women living with incurable cancer, especially if the cancer is not responding to treatment.

Losing too much weight can lead to undernutrition – or even frank malnutrition. In addition to loss of body fat, patients who losing weight often lose lean muscle mass. Too much involuntary weight loss (or voluntary, for that matter) can increase health risks and lead to an increased risk of mortality. That’s not a good thing.

The reasons for weight loss can be multiple. Cancer can cause certain chemicals, called cytokines, which can decrease appetite and lead to weight loss. Sometimes the cancer can be in an area that causes eating to be difficult. For example, ovarian cancer can sometimes cause compression of the gastrointestinal tract, leading to feeling full more quickly or having a difficult time swallowing food. Depression and anxiety can also cause weight loss by causing loss of appetite. Side effects from treatment – such as nausea or vomiting, diarrhea, or taste changes – also may cause poor appetite or an alteration in diet that leads to weight loss.

It’s important to discuss weight loss with your oncologist or with the registered dietician. Your oncologist and/or dietician can help figure out why the weight loss is occurring and offer strategies to overcome it. For example, if nausea from chemotherapy is the problem, there may be additional anti-nausea medications that can be prescribed, either before or after each chemotherapy treatment. Sometimes, prescription medications can be given to help stimulate or boost appetite.

Before taking a prescription appetite stimulant, there are other interventions that can be tried first. To put on weight, a patient could try relaxing any dietary restrictions she may have put on herself in order to eat “healthier” during chemotherapy. Eating a healthier diet — with whole grains, lean proteins, plenty of vegetables and fruits – is a wonderful thing, whether you have cancer or not. But, if your diet modifications have restricted calories too much, this could worsen weight loss. The cancer treatment time is generally not a time for dieting, and it is possible to make lifestyle changes in one’s diet while still maintaining an appropriate weight. This, of course, should be discussed with your physician.

Other, simple strategies for keeping weight loss to a minimum include the following, all of which can increase calories and protein in your diet:

  • Eat more eggs. One large egg contains 6 grams of high quality protein that is easily digestible and inexpensive, especially when compared to the much pricier protein supplements. Not only are eggs a conveniently self-packaged protein source, but they contain 10 to 20% or more of choline (important for cell metabolism), selenium (an antioxidant), riboflavin, vitamin B12, and phosphorus.
  • If nut allergies are not a problem, incorporate more nuts into your diet. Just one ounce of pistachios or almonds contains 6 grams of protein. If swallowing is uncomfortable, then nut butters are a good alternative.
  • Add a glass of whole milk to your meals.
  • Protein shakes (such as Ensure or Boost) are an easy solution, but these supplements can be financially taxing if you’re on a limited income. Finding a flavor that you like is important.

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