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According to cancer researchers, approximately 60 percent of all people diagnosed with lung cancer experience weight loss. As one MyLungCancerTeam member wrote, “I can’t seem to gain weight. I lost a good bit of weight before I was diagnosed, plus the treatments didn’t help.”
Considering all the different causes of weight loss in cancer, experts have suggested that weight can be an indicator of health outcomes and quality of life.
Researchers have also found that the effectiveness of radiation and chemotherapies improved when a person was able to maintain a healthy weight. Reach out to your health care team to decide on treatment options that may help you curb weight loss or even help you gain weight.
Understanding the origin of weight loss for people with lung cancer can be difficult. There is no one cause in this case — multiple factors can play a role in your weight loss. That complexity causes health care teams to take a multivariate approach by examining the side effects of your treatment, the current symptoms of your lung cancer, and the role they play in weight management.
In basic terms, weight gain and loss are based on the difference between calories in and calories out. If you can sustain a net-zero energy balance (calories in = calories out), your weight will remain steady. However, people managing the symptoms of lung cancer can experience complications with the ability to take in energy. With the added strain on the body from lung cancer and its treatments, the energy balance shifts negative, and thus weight is lost.
People with lung cancer also experience more tumor-mediated resting energy expenditure. Essentially, people with lung cancer expend more energy at rest as their bodies try to regulate their condition. With the added strain on the body from lung cancer and its treatments, the energy balance shifts negative, and thus weight is lost. Another factor is cancer’s use of glucose for its own needs, which takes away calories from the rest of the body.
Weight loss can occur at any time throughout your diagnosis. In 40 percent of all initial cancer diagnoses, a person has already shown signs of weight loss. This finding has led some oncology experts to consider weight loss when analyzing the prognosis (course) of a person’s lung cancer. However, like the other general symptoms, weight loss usually does not start until the lung cancer has begun to reach an advanced stage (i.e., a metastatic form of cancer).
Continue reading to find out the coinciding symptoms to consider while managing weight loss.
Loss of appetite (clinically referred to as anorexia) is considered one of the main factors contributing to malnutrition in a lung cancer diagnosis. As one MyLungCancerTeam member wrote, “I have gone from 220 pounds to 161. No appetite. Food doesn’t appeal to me.”
This lack of an urge to eat is harder to overcome when people with lung cancer experience eating complications, like difficulty with chewing and swallowing. It’s common for people with lung cancer to fall into a negative feedback loop — they develop fatigue and weakness due to not eating enough, and this exhaustion makes it more difficult to eat.
Pain can also cause a loss of appetite in people with lung cancer. It is difficult for some people to enjoy a meal when they are in constant pain, which may account for unexplained weight loss.
If body weight isn’t managed properly throughout a diagnosis, a person with lung cancer may experience a condition known as cancer cachexia. Cancer can produce substances that suppress hunger. This can occur in advanced stages of lung cancer, causing a person’s body to lose the ability to ingest and use nutrients in food. Although much is yet to be learned about cachexia, researchers have observed that long-term anorexia may be a factor in the development of a dual-part syndrome called cancer-related anorexia/cachexia syndrome.
When lung cancer cells spread (metastasize), they may move to the neighboring bones around the lungs (a process known as bone metastasis). For people with non-small cell lung cancer, this metastasizing may result in hypercalcemia (excess calcium in the bloodstream).
As cancer cells begin to occupy space in the bones’ structures, or affect the bones through substances that they secrete, the bones may release a large amount of calcium to the bloodstream. This excess in calcium levels may also cause various gastrointestinal issues, like nausea and vomiting, making it difficult to eat.
As your health care team begins lung cancer treatment, it is important to be aware of the side effects that may come with your specific treatment plan.
The objective of advanced lung cancer treatments (like chemotherapy or radiation therapies) is to target rapidly dividing cancer. However, some of your healthy cells may sustain temporary collateral damage while undergoing treatment. For this reason, it’s typical for people with lung cancer to have serious fatigue during the rest periods of a given medication cycle, which could lead to weight loss because it makes food preparation and eating more challenging.
Various other treatment-related side effects may complicate eating properly and, consequently, cause weight loss. Many people diagnosed with lung cancer may experience nausea, vomiting, constipation, and/or diarrhea. Some lose their sense of taste or certain foods may have an unpleasant flavor. Chemotherapy, in particular, has been known to worsen conditions like anorexia.
As one MyLungCancerTeam member wrote, “I had no appetite, and everything had no flavor when I was going through daily radiation and chemo for six weeks. I used to have to make myself eat. Happy to say, about three weeks after treatment, my appetite returned!”
An unexpected drop in regular weight can overwhelm people as they deal with lung cancer. Many members of MyLungCancerTeam have voiced their struggles when grappling with weight loss. As one member wrote, “Feeling stressed a bit today. I finally got a scale to check my weight progression. I was stunned when I saw 114.5 pounds. Much lower than I anticipated.”
With the additional stress of weight loss and an energy imbalance, it’s common for people with lung cancer to experience fatigue. It’s no wonder that people may forget or be unable to manage their diets when they are battling pain and exhaustion from their diagnosis.
The friends and family members of those diagnosed may have a tough time watching their loved ones deal with appetite issues and weight loss. As one MyLungCancerTeam member noted, “Sometimes, I think this disease is harder on my loved ones than myself. I myself get all the empathy, sympathy, prayers, and love galore ... they get the leftovers if some folks acknowledge their grief at all.”
It may be difficult for your friends and family members to react to weight loss caused by lung cancer. Let them know that you appreciate their support, and if they say negative things about your weight, share with them how you feel.
There are many different ways for people with lung cancer to manage their weight loss, both on their own and with their health care teams.
Your health care team may call upon oncology-registered dietitians to help you prevent unwanted weight loss. Setting up a nutrition plan with your dietitian can help you work to maintain a healthy body weight throughout your diagnosis.
You may want to use calorie additives that could make your meals more calorie-dense. Milk powder can add calories without affecting the taste too much. As one MyLungCancerTeam member stated, “I had a great dietitian at my oncologist’s office who helped me with high-calorie shakes and a list of spices that helped flavor food for me, and I had no weight loss. It might help to have a visit with one.”
A dietitian may urge a person with cancer to eat more of their favorite food, and the more calories, as tolerated, the better. This is not the time to restrict oneself to “healthy” vegetables and fruits.
There are also some at-home remedies that you may want to try. Some experts recommend ginger-containing foods or drinks, for instance, to help reduce nausea.
Although many clinical trials still need to be conducted, medical marijuana may help reduce nausea in people with lung cancer. As a cautionary note, it might be best to consult with your oncologist about the risk factors of smoking cannabis as opposed to alternative methods of consumption, like edibles (foods or beverages containing cannabis extracts), or taking it as prescription medications, such as Marinol. In addition, be aware of the laws around marijuana in your state.
To help you take an active role in your weight management, it may be a good idea to keep a cancer diary to log your day-to-day life with lung cancer. Not only does this allow you to create an artifact of your thoughts and feelings along the way, but it also helps you provide your health care team with data about your weight, appetite, and other symptoms.
Write down the date every time you make an entry in the journal. By considering where you are in the cycle of your treatment, your doctors may be able to distinguish weight loss symptoms caused by lung cancer versus treatment-related weight loss.
If the idea of journaling seems off-putting, you can think about your writing as a narrative that details your journey through battling lung cancer and the resulting weight loss. The form of the diary can be completely up to you. You may prefer to write a daily symptom log, or if you find the inspiration, you can take a more artistic approach.
For example, a member of MyLungCancerTeam said that journaling — particularly with poetry — is a therapeutic process for them: “I write to cope. It’s therapy for me.”
MyLungCancerTeam is the social network for people with lung cancer. Here, you can ask questions, share advice, and read about the experiences of others managing day-to-day life with their diagnosis.
Have you lost weight throughout your lung cancer diagnosis? How have you managed it? Share your story in the comments below or by posting on MyLungCancerTeam.
Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Tristan Jesby graduated from Quinnipiac University's five-year MAT program with a bachelor’s degree in mathematics and a master’s in secondary education. Learn more about him here.
