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Will I lose weight during chemotherapy?

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Updated July 23, 2012

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Question: Will I lose weight during chemotherapy?
I am 46 and was recently diagnosed with breast cancer. After my surgery, I will start six rounds of chemotherapy. Many of my friends say that I will lose weight because of the chemotherapy. I am a little bit overweight (about 30 pounds), so it would be a welcomed side effect!

I have never known anyone to gain weight while being treated for cancer, but I am still wondering if my friends are correct. Will I really lose weight during chemotherapy? If so, how much do people lose on average?

Answer: Weight loss may seem like the silver lining of chemotherapy for some people, but not everyone loses weight with cancer treatment. Cancer patients on television and movies often appear gaunt and emaciated, giving the false idea that all people with cancer lose a lot of weight during treatment. The truth is that everyone responds differently to chemotherapy and there are a few different factors that play a role in how treatment will affect your weight. In fact, there some people who actually gain weight during treatment. Because every person responds differently to chemotherapy, there is no way to average weight loss or weight gain.

When people do lose weight during cancer treatment, it likely due to the inability to maintain good nutrition. Chemotherapy side effects can cause loss of appetite, and the stomach upset (nausea and diarrhea) can greatly affect your eating habits, ultimately leading to weight loss. The cancer itself can also cause a loss of appetite.

Taste and smell aversions can also lead to eating less, as well. Food can taste different because of cancer treatment. Some experts recommend avoiding your favorite foods during chemotherapy because they may taste different, creating an aversion -- even post-treatment. The smell of food cooking can also cause a loss of appetite.

Mouth sores can be a common side effect of chemotherapy and can impede eating. Certain foods can be irritating to the mucous membranes on the inside of your mouth. Sour, spicy, or salty foods can be painful to eat.

The goal during chemotherapy is to keep your weight stable. If you are overweight, this is not the time to try to lose weight. You can, however, focus on eating healthier, which hopefully will carry over post-treatment and allow you to reach your weight loss goals. If your doctor allows it and you feel up to it, exercise a few times a week. Walking, yoga, and other forms of exercise can be enjoyed by many cancer patients during treatment. Exercise is a great stress reliever, mood elevator, and may even reduce your fatigue!

Working with a dietitian who has experience with cancer patients is extremely beneficial. He or she will understand the unique nutritional needs of a person with cancer and the challenges they face during treatment. Most cancer centers have a nutritionist on staff to help patients meet their dietary goals during chemotherapy. If your cancer center does not have a dietitian, your doctor will likely refer you to one or you can always ask to be referred.

Good nutrition is essential during treatment. If your caloric intake is too low, it can negatively impact your health. You need an adequate amount of calories and a balanced diet to combat fatigue, maintain a healthy immune system, cope with treatment side effects, and to also recover from any surgeries you may have as treatment. Poor nutrition can lead to low blood cell count disorders, such as anemia, neutropenia, and also thrombocytopenia. Low blood cell counts can result in discontinuing therapy until levels are restored to an adequate level.

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