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Ascites is when excessive fluid accumulates inside the abdominal cavity. This can occur when the blood pressure within them increases or when the kidney begins accumulating sodium and water in the body. Another factor that can cause this process is the decreased amount of albumin, a special protein that helps keep fluids within the blood vessels. Regardless, all of those mechanisms result in the accumulation of variable amounts of fluid in the abdominal cavity, which causes abdominal swelling.

Patients with ascites due to liver disease have other manifestations of liver disease including:

• Jaundice, especially in acute liver inflammation
• Swelling of the legs
• Easy bruising and bleeding
• Loss of muscle mass
• Feeling of easy fatiguability
• Insomnia, increased sleeping hours or both

Other symptoms may be related to the ascites itself and they include:

• Abdominal discomfort, which occurs when the abdomen is hugely distended with the fluid, causing pressure on the abdominal wall muscles.
• Difficulty in breathing: Difficulty breathing can occur if ascites is huge and is an indication for immediate treatment.
• Fever: Although fever is not a manifestation of ascites, the fluid can commonly become infected, causing fever.
• Hernia: Persistent ascites causes weakness of abdominal wall muscles, predisposing the patient to umbilical hernia, which is the protrusion of a part of the intestines covered by skin outside the abdominal cavity.

Medical treatment may include any or all of the following:

• Restriction of salt intake, since most patients with ascites have increased level of sodium, which damages the kidney and worsens the condition. Most patients are advised not to eat any table salt.
• Diuretics: Diuretics are medications that act on the kidney, increasing the excretion of water and improving ascites. Furosemide (Lasix) is usually the first diuretic used. Since diuretics allow electrolytes to be excreted along with water, they can, in turn, cause electrolyte disturbances. Therefore, more advanced diuretics are used known as aquaretics, which allows water only to be excreted.
• Paracentesis: Paracentesis basically means the physical removal of ascitic fluid. It is done using a special catheter inserted into the abdominal cavity. It is a procedure that can be repeated and large volumes of fluid can be removed at once. If repeated drainage is necessary, a PleurX catheter may be an option.
• Albumin infusion: Albumin is normally formed by the liver and can be severely deficient in patients with ascites due to liver cirrhosis. In addition, its infusion following paracentesis has been shown to decrease the incidence of hepatorenal syndromeAntibiotics: Antibiotics for bacterial peritonitis is an essential part of management. It is a life-threatening condition that needs urgent treatment

A colostomy is a surgically created opening in your abdomen that allows waste or urine to leave your body. It takes time to become comfortable with an colostomy

Many questions may run through your mind as you plan your first ventures outside of your home. Can you go back to work after colostomy? Can you ride your bike if you have an ileostomy? Will everyone figure out you’ve had urostomy surgery just by looking at you?

You can do many of the same activities you enjoyed before your colostomy or other ostomy surgery.

If you have a urostomy, you might be concerned about urine odor. Certain foods can cause a stronger urine odor, but you can minimize that by drinking water or cranberry juice.

Constipation occurs when your bowel movements are less frequent than normal or become difficult to pass. This can happen for different reasons, including dehydration and problems with movement of stool through the bowels.

Drugs used to manage other chemotherapy or cancer-related symptoms (such as opioid pain medications) may cause secondary constipation. Additionally, being diagnosed with cancer or dealing with cancer treatment can change a person’s eating, drinking, and exercise habits. Changes in diet, being less active, and not drinking enough fluids may all cause constipation on their own — even without chemotherapy drugs.

Constipation may cause your stools to be small, hard, dry, and difficult to pass. You may also experience additional symptoms, including gas, bloating, stomach cramps, and nausea.

Managing Chemotherapy-Induced Constipation

As always, talk to your doctor if you experience new or worsened constipation. You should not start taking new medications — even over-the-counter drugs — without talking to your doctor. Aside from any doctor-recommended changes or additions to treatment, the following suggestions may help you manage constipation caused by chemotherapy drugs.

Stay Hydrated

Dehydration can cause or worsen constipation. Make absolutely sure that you are getting plenty of liquids every day. Do not eat or drink anything that will dehydrate you.  You might try prune juice or drinking warm liquids in the morning if you’re experiencing constipation.

Change Your Diet

Fiber can help prevent constipation. Gradually increase your fiber intake with whole fruits, vegetables, beans, legumes, and whole grains.

Your treatment team may recommend taking a fiber supplement, stool softener, or laxative to help relieve symptoms. You may also want to ask for a referral to a registered dietitian, who can create a dietary plan tailored to your needs.

Stay Active

Moving your body stimulates bowel motion, too. You don’t have to exercise hard, but intentionally moving your body can improve chemotherapy-related constipation.

Medication

Taking a stool softener might help relieve persistent constipation. Unfortunately, this can go too far and cause diarrhea. Finding a balance that involves the right levels of the right medications is important when it comes to battling constipation. With time and a dedicated medical team, it’s possible to find a combination that does both

If possible, avoid harsh laxatives, suppositories, or enemas — although these may become necessary if your constipation becomes particularly severe. Instead, try something that will be easier on your gastrointestinal system and your rectum. Your health care provider can make recommendations if you’re not sure where to start.

Everyone gets diarrhea now and then. If you have cancer, the things that commonly cause diarrhea can still affect you. But there are other causes in people with cancer, such as:

• Cancer treatment
• Infections
• Cancer itself

The duration and severity of your diarrhea depend on what’s causing it. Talk to your health care provider about what you can expect. Ask how long the diarrhea may last and what you can do to ease your symptoms.

When should you call your doctor?

Diarrhea may just be an uncomfortable problem, or it could be a sign of something more serious. It can also lead to other problems. If diarrhea causes severe dehydration, it could lead to weakness and fatigue.

Contact your health care provider right away if you have any of the following signs or symptoms:

• Six or more loose bowel movements a day for more than two days
• Blood in your stool or rectal area
• Weight loss due to diarrhea
• Fever of 100.5 degrees Fahrenheit (38 degrees Celsius) or higher
• Inability to control bowel movements
• Diarrhea or abdominal cramps that last more than a day
• Diarrhea accompanied by dizziness, especially when getting up from a sitting or lying position

If your diarrhea doesn’t seem severe but starts to interfere with your daily activities, talk to your provider. For example, if you’re nervous about leaving home or going somewhere without a toilet nearby, tell your provider.

Also call your provider if you’re taking chemotherapy in pill form and you experience diarrhea. Your provider can decide whether it’s safe for you to keep taking chemotherapy pills.

Diarrhea that happens during cancer treatment can be serious. Though it’s embarrassing to discuss, it’s important to bring it up with your health care provider. The sooner you tell your provider, the sooner your provider can act to help relieve your symptoms.

What can you do?

When you begin experiencing diarrhea, you might find some relief by making changes to what you eat and drink. For instance:

• Drink clear liquids.As soon as your diarrhea starts, switch to a diet of clear liquids. Examples include water, apple juice, clear broth and ice pops. Avoid milk products. When you have diarrhea, you may need to drink 8 to 12 cups (2 to 3 liters) of liquid a day.
• Eat low-fiber foods.As your diarrhea starts to improve, add foods low in fiber to your diet, such as bananas, rice, applesauce and toast.
• Eat 6 to 8 small meals a day.
• Avoid foods that can irritate your digestive tract.These include dairy products, spicy foods, alcohol, high-fat foods and beverages that contain caffeine, orange juice or prune juice.
• Try probiotics.Probiotics are helpful bacteria that may improve digestion. Probiotics are often found in yogurt and dietary supplements. Examples include lactobacillus and bifidobacterium. If you’ve had a bone marrow transplant, check with your provider before using probiotics.

As you start to feel better, you can slowly return to your usual diet.

Treatments and surgery can have a great impact on your self-esteem and body image and the way you feel and think about yourself.  They can cause considerable distress. You may be afraid to go out, afraid of rejection or feel angry or upset even if the effects of treatment may not show as much as you think. Some of the challenges associated with these changes can permanently change or disfigure.

Tips for managing the changes that you experience include:

• Mentally prepare yourself – when you wake up after surgery, you’re immediately facing a new life.
• Remind yourself that you can do it, but also why you’re doing it – to survive your cancer.
• Join a support group – people with similar experiences can understand the loss, fear, and challenges that you are facing.
• Connect with a counsellor – mental rehabilitation is just as important as physical rehabilitation, and it’s important to seek help when you need it.
• Have patience and perseverance – you may have to learn how to do many familiar tasks all over again, but it is important to persist and ask for help when needed.
• Find positivity in your situation – this can help people around you feel more comfortable while also making you feel better.
• Choose reconstruction or prosthetic options carefully so that you can make decisions best for your own situation.

Chemotherapy and radiation therapy in the head or neck area can reduce the flow of saliva and cause dry mouth.

When this happens, foods are harder to chew and swallow. Dry mouth also can change the way foods taste. Some of the ideas for sore mouth and throat may help. The suggestions below also may help you deal with dry mouth:      

• Have a sip of water every few minutes to help you swallow and talk more easily. Consider carrying a water bottle with you so you always have some handy.
• Suck on hard candy or popsicles or chew gum. These can help make more saliva.
• Eat soft and pureed foods, which may be easier to swallow.
• Keep your lips moist with lip salves.
• Moisten food with sauces, gravies, and salad dressings to make it easier to swallow.
• If your dry mouth problem is severe, ask your doctor or dentist about products that coat, protect, and moisten your mouth and throat. These are sometimes called “artificial saliva.”

Swelling, otherwise known as edema, is a buildup of fluid in the body. Swelling most often affects the dependent extremities (like the feet, ankles, and hands) but swelling can also affect other parts of the body, such as the abdomen. Causes of swelling include:

• Fluid retention, including salt and water related to medication, heart disease, liver disease, or kidney failure.
• Blockage of veins or lymph system.

Chemotherapy-related, or cancer swelling:

• Some chemotherapy drugs can cause fluid retention in the body. This form of cancer swelling is most noticeable in the feet, ankles, hands, and face.
• Swelling or angioedema may also occur with hives as part of an allergic reaction. It is a vascular reaction that causes an increased ability for fluid in the cells to “leak” into the layers of the skin, resulting in swelling. This happens much less often than hives alone. The fluid retention causes swelling generally in the tongue, lips, or eyelids. Swelling of the airways can result in difficulty breathing, closing off of the airway and death. If swelling is happening along with signs of breathing difficulty seek help immediately.

Symptoms of Swelling:

• Feet and lower legs get larger when you sit or walk.
• Take a look at your feet, ankles and hands. Are they swollen? When you press on the skin with your finger, is there an indentation that stays for a few seconds? If so, you may have “pitting edema.”
• Hands feel tight when you make a fist
• Rings are too tight
• Abdomen appears to be swelling or distended
• Shortness of breath (especially when lying down)

Tips To Manage Swelling:

• Elevate your feet as often as possible. (Either sitting in a chair with your feet on a stool with a pillow or in the bed or couch with feet up on two pillows)
• Do not stand for long periods of time.
• Avoid tight clothing (shoes, girdles, etc).
• Do not cross your legs.
• Reduce your salt intake if swelling is present. Avoid foods such as bouillon, potato chips, tomato juice, bacon, ham, canned soups, soy sauce, and table salt, for example.
• Try to eat a balanced diet (see eating well section).
• If your swelling is severe, consider wearing Jobst stockings or TED hose.
• Weigh yourself daily. Notify your doctor or health care provider if you have gained 5 pounds or more in a week.
• Take your medications exactly as prescribed.

Drugs/Recommendations That May Be Prescribed by Your Doctor:

• Depending upon the causes of your swelling, your doctor or health care provider may prescribe a diuretic. Diuretics – may be known as “water pills” as they work by making you urinate out extra fluid. Some examples of this medication may include furosemide (Lasix), and Hydrochlorothiazide. You may receive this medication alone or in combination with other medications.
• Your doctor or health care provider may recommend that you see a registered dietician to help plan a diet tailored to your condition.

When to Contact Your Doctor or Health Care Provider:

Call your doctor or health care provider immediately:

• If you are short of breath.

Call your doctor or health care provider within 24 hours:

• If you have gained 5 pounds or more in one week.
• If you develop sudden and severe fluid retention.
• Your feet or hands feel cold to the touch.
• If you are unable to eat for more than a day.
• If you have urinated only a little bit or not at all.
• If the swelling appears to move up your arms or legs.

Fatigue means that you are feeling tired and lacking energy and is a common symptom reported by cancer patients. The exact cause is not always known. It can be due to your disease, chemotherapy, radiation, surgery, low blood counts, lack of sleep, pain, stress, and poor appetite, along with many other factors.

Fatigue from chemotherapy feels different from fatigue of everyday life. Fatigue caused by chemotherapy can appear suddenly. Patients with cancer have described it as a total lack of energy and have used words such as worn out, drained, and wiped out to describe their fatigue. Rest does not always relieve it. Not everyone feels the same kind of fatigue. It can last days, weeks, or even months.

Here are some tips on coping with fatigue:

• Plan your day so that you have time to rest.
• Take short naps or breaks, rather than one long rest period.
• Save your energy for the most important things.
• Try easier or shorter versions of activities that you enjoy.
• Take short walks and do light exercise, if possible. Exercise may help to reduce fatigue.
• Talk to your doctor about ways to save your energy and treat your fatigue. Certain medications may be helpful in reducing your symptoms depending on the cause of your fatigue.
• Try activities like meditation, yoga, guided imagery, and visualization.
• Consider alternative therapies like acupuncture.
• Eat as well as you can and drink plenty of fluids. Eat small amounts at a time, if that is helpful. Your doctor may have you work with a dietitian to make sure that you are meeting your nutritional needs.
• Limit the amount of caffeine and alcohol you drink.
• Join a support group like FRIENDS for the Journey. Sharing your feelings with others can ease the burden of fatigue. You can learn how others deal with their fatigue. Your doctor can connect you with a support group in your area.
• Ask family and friends to help you with household chores and shopping.
• Keep a diary of how you feel each day. This will help you plan your daily activities.
• Report any changes in energy level to your doctor.

Hair loss can occur as early as the second or third week after the first cycle of chemotherapy, and the loss may begin only after the second cycle of chemotherapy. Even though you know that hair loss will occur, it still comes as a shock when it happens.

Some people gradually lose hair, while others immediately begin to lose hair in large quantities. In any case, applying at least some of the tricks we share below will work wonders.

• Buy a wig
• Cut or shave your hair before treatment starts
• Purchase some head coverings
• Look into a cold cap
• Stock up on sunscreen

Hiccups can be a very annoying and frustrating symptom or side effect when dealing with advanced cancer.  Sometimes, a simple change in your breathing or posture can relax your diaphragm.

• Practice measured breathing.Breathe in for a count of five and out for a count of five.
• Hold your breath.Inhale a large gulp of air and hold it for about 10 to 20 seconds, then breathe out slowly. Repeat as necessary.
• Breathe into a paper bag.Place a paper lunch bag over your mouth and nose. Slowly breathe in and out, deflating and inflating the bag. Never use a plastic bag.
• Hug your knees.Sit down in a comfortable place. Bring your knees to your chest and hold them there for two minutes.
• Compress your chest.Lean or bend forward to compress your chest, which puts pressure on your diaphragm.
• Use the Valsalva maneuver.To do this technique, try to exhale while pinching your nose and keeping your mouth closed.
• Pressure points are areas of your body that are particularly sensitive to pressure. Applying pressure to these points with your hands may help to relax your diaphragm or stimulate your vagus or phrenic nerves.
• Pull on your tongue.Pulling on your tongue stimulates the nerves and muscles in your throat. Grab the tip of your tongue and gently pull it forward once or twice.
• Press on your diaphragm. Your diaphragm separates your abdomen from your lungs. Use your hand to apply pressure to the area just below the end of your sternum.
• Squeeze your nose closed while swallowing water.
• Squeeze your palm. Use your thumb to apply pressure to the palm of your other hand.
• Massage your carotid artery.You have a carotid artery on both sides of your neck. It’s what you feel when you check your pulse by touching your neck. Lie down, turn your head to the left, and massage the artery on the right side in a circular motion for 5 to 10 seconds.
• Eating certain things or changing the way you drink may also help to stimulate your vagus or phrenic nerves.
• Drink ice water.Slowly sipping cold water may help stimulate the vagus nerve.
• Drink from the opposite side of the glass.Tip the glass up under your chin to drink from the far side.
• Slowly drink a glass of warm water without stopping to breathe.
• Drink water through a cloth or paper towel.Cover a glass of cold water with a cloth or paper towel and sip through it.
• Suck on an ice cube.Suck on the ice cube for a few minutes, then swallow it once it shrinks to a reasonable size.
• Gargle ice water.Gargle ice water for 30 seconds. Repeat as necessary.
• Eat a spoonful of honey or peanut butter. Allow it to dissolve in your mouth a bit before swallowing.
• Eat some sugar.Put a pinch of granulated sugar on your tongue and let it sit there for 5 to 10 seconds, then swallow.
• Suck on a lemon.Some people add a bit of salt to their lemon slice. Rinse out your mouth with water to protect your teeth from the citric acid.
• Put a drop of vinegar on your tongue.
• Tap or rub the back of your neck.Rubbing the skin at the back of your neck may stimulate your phrenic nerve.
• Distract yourself with something engaging.Hiccups often go away on their own when you stop focusing on them. Play a video game, fill out a crossword puzzle, or do some calculations in your head.

Jaundice is yellowing of the skin and white of the eye, also called hyperbilirubinemia (high bilirubin) because the blood contains too much bilirubin, the yellow pigment that causes the discoloration.

Treatment of jaundice is based on the cause of the elevated bilirubin level. If it is caused by viral hepatitis, the doctor may prescribe antiviral medications. In cases of blockage of the bile ducts, surgery may be performed to remove the gall bladder or the tumor causing the blockage. Using an ERCP procedure, a doctor may insert plastic or metal tubes called stents inside the bile ducts to prevent them from collapsing and ensure normal bile flow.

Cancer patients should monitor their muscle mass early in their healing process so the proper steps can be taken to prevent any damage to the body from cachexia. 

Even though it can be difficult, it is important to continue to move as much as   possible after diagnosis.

• Modify, but don’t stop, your exercise routine.
• Continue with hobbies that keep you active.
• Use your muscles so that they can constantly rebuild.
• Move more when possible.

Adequate nutrition is another important factor in maintaining muscle mass and can lead to malnutrition.

• Eat balanced meals as often as possible.
• Choose high-quality proteins for meals and snacks.
• Avoid skipping meals and snacks if possible.
• Eat small, frequent meals and snacks throughout the day.

Talk with your treatment team about any struggles that you are dealing with and seek help. Ask to consult with a nutritionist early in your diagnosis.

Nausea is a common side effect during chemotherapy treatment. Your doctor   may be able to prescribe medication to help with the symptoms. Even with medication, many people still find that they struggle to deal with the effects of nausea.

There are tips and tricks that you can do to help. Here are some tested ideas for reducing nausea during chemotherapy…

• Eat small, regular meals.
• Drink plenty of liquids.
• TIP  Suck on popsicles or ice chips

• Choose simple foods and avoid fatty, fried, spicy or very sweet foods.
• Avoid strong smells as these can worsen or precipitate nausea.
• Prepare and freeze some meals ahead of your treatment.
• Rest after eating to let your food settle.
• Try Queasy Pops, Ginger, or Peppermint hard candies.
• Use relaxation techniques.
• Keep yourself busy so that you don’t dwell on the nausea.
• Talk to a FRIEND for the Journey and learn tips that they used.

Neuropathy can cause pain, tingling, burning or numbness in the hands and feet. It is, says Suzanne Lindley, one of the hardest side effects she has had to deal with. Decreased muscle tone and loss of feeling in the feet can cause balance problems and trigger falls as well as causing great discomfort.

Neuropathy is caused by certain chemotherapies due to inflammation or damage to the nerves. Common medications that cause neuropathy include taxanes, vincristine, bortezomib and platinum-based chemotherapies such as oxalipllatin. However, not everyone receiving these drugs will develop neuropathy and the duration and severity of neuropathy is unpredictable.

• Acupuncture
• Biofeedback
• Keep moving
• Massage
• Warm baths
• Vitamin B Complex
• Alpha Lipoic Acid
• Prescription medications such as Neurontin, Cymbalta, or Lyrica

Your doctor will want to monitor symptoms during treatment. Tell your treatment team if they get worse. To avoid long-term damage, you may need:

• Smaller doses of chemotherapy
• Delayed treatment
• A break from certain drugs until your side effects get better

When cancer affects the lungs, fluid can sometimes collect between the sheets of tissue that cover the outside of the lung and the lining of the chest cavity. These sheets of tissue are called the pleura. 

Doctors call this fluid collection a pleural effusion.  Pleural effusion can lead to symptoms such as:

• Shortness of breath
• cough
• cough that’s worse in certain positions
• being unable to lie flat
• chest pressure
• chest pain

Your exact treatments will depend on other factors and when pleural effusion develops. Options generally include:

• Thoracentesis:Doctors use this procedure both to diagnose and treat pleural effusion.
• Tube thoracostomy:In a thoracostomy, doctors insert a tube into your chest for a day or more to drain fluid.
• Catheter:Doctors can place a catheter into your chest to drain fluid. They may use this option when fluid drainage needs to be ongoing.
• Shunt:A shunt is a surgically inserted tube doctors use to move fluid from one area of your body to another.
• Chemotherapy:In some cases, treating pleural effusion with chemotherapy is the best treatment.

Many people with advanced cancer experience skin rashes as side effects from different treatments such as radiation, chemotherapy, targeted therapy, immunotherapy, or stem cell transplantation. Different kinds of skin reactions can occur, depending on the specific treatment. Rashes may be managed at home but may sometimes need help in a clinical setting.

In addition to being uncomfortable, itchy, and frustrating skin rashes can also cause anxiety and depression around self-image.  It is important to speak with your treatment team and to have a FRIEND for the Journey when dealing with skin eruptions.  Here are some helpful hints:

• Clean skin with warm water, mild cleansers, and soft cloths.
• Rinse the affected area with care and gently pat it dry.
• Moisturize dry skin.
• Protect skin from cold and hot temperatures.
• Avoid the sun and use a recommended sunscreen.
• Dress the affected area in loose, soft clothing.
• Adhere to your treatment plan for any prescribed or recommended topical treatments.
• Seek urgent medical advice if your skin appears to be infected

Discuss treatment options for rashes with your treatment team, particularly if any skin is open or bleeding. Your doctor may prescribe oral or topical medications. You may be prescribed corticosteroids to help prevent rashes from some chemotherapy drugs.

Ask which soaps, moisturizers, and sunscreens are best for your rash.

It’s essential to maintain any recommended treatment plan to avoid more serious complications and to improve your quality of life.

Many people with advanced cancer experience skin rashes as side effects from different treatments such as radiation, chemotherapy, targeted therapy, immunotherapy, or stem cell transplantation. Different kinds of skin reactions can occur, depending on the specific treatment. Rashes may be managed at home but may sometimes need help in a clinical setting.

In addition to being uncomfortable, itchy, and frustrating skin rashes can also cause anxiety and depression around self-image.  It is important to speak with your treatment team and to have a FRIEND for the Journey when dealing with skin eruptions.  Here are some helpful hints:

• Clean skin with warm water, mild cleansers, and soft cloths.
• Rinse the affected area with care and gently pat it dry.
• Moisturize dry skin.
• Protect skin from cold and hot temperatures.
• Avoid the sun and use a recommended sunscreen.
• Dress the affected area in loose, soft clothing.
• Adhere to your treatment plan for any prescribed or recommended topical treatments.
• Seek urgent medical advice if your skin appears to be infected

Discuss treatment options for rashes with your treatment team, particularly if any skin is open or bleeding. Your doctor may prescribe oral or topical medications. You may be prescribed corticosteroids to help prevent rashes from some chemotherapy drugs.

Ask which soaps, moisturizers, and sunscreens are best for your rash.

It’s essential to maintain any recommended treatment plan to avoid more serious complications and to improve your quality of life.

Many people will experience taste changes with cancer and cancer treatment. These changes can vary with the type of treatment you are receiving and with each person. Taste changes can also vary from week to week. The following tips may make managing taste changes easier.

• If something smells good to you right now, eat it right now.
• Stay away from foods that have odors that bother you.
• Don’t eat for a few hours before and after treatment.
• Get protein from eating chicken, eggs, fish, nut butters, etc., instead of beef, which can cause a metallic taste.
• Eat prepared meals from stores, restaurants, family or friends.
• Drink more liquids.
• Keep your mouth clean and healthy. Brush your teeth before and after every meal.
• If your food tastes like metal, use plastic forks and spoons.
• Add healthy fats to your diet.
• Eat small meals 4-6 times a day instead of 2-3 large meals.
• Choose sugar-free mints or gum.
• Chew on ice.
• Marinate meats in sweet fruit juices, salad dressing, barbecue sauce or sweet-and-sour sauces.
• Flavor foods with herbs, spices, sugar, lemon and tasty sauces.
• Chilled or frozen foods may be more acceptable than warm or hot foods.

Losing too much weight can be a problem for many people with cancer.  Too much weight loss can slow down or delay your treatment and affects your quality of life. Side effects of treatment, including loss of appetite, can make it challenging to eat enough food to get the calories your body needs.

Protein is an essential nutrient for healing, tissue maintenance, and growth. Your body requires protein to maintain its muscle mass; people who keep their muscle mass generally have fewer side effects during cancer treatment and recover more quickly.

Tips to get more protein and calories:

• Switch from skim milk to whole milk if you are struggling with weight loss
• Melt cheese on sandwiches or stir it into scrambled eggs or grate on top of soups.
• Add cottage or ricotta cheese to fruits and vegetables, egg dishes, or desserts.
• Mix powdered milk into milkshakes and smoothies for an extra boost.
• Spread peanut butter and other nut-based spreads on sandwiches, toast and vegetables or swirl them into shakes, smoothies, yogurt, and soft ice cream.
• Sprinkle nuts over cereal, salads, vegetables, pancakes, or fruit as a crunchy topping.
• Add chopped meat to salads, omelets, and quiches.
• Mix lentils and beans into chicken or beef broth.
• Cook vegetables and meats in olive oil.
• Turn fruit into smoothies or sauces, such as apple sauce.
• Also consider drinking nutritional supplements, like Boost or Ensure.

Weight gain can be an unexpected side effect of cancer and treatment. While many oncologists prefer patients put on a few pounds, significant weight gain may lead to other health issues such as high blood pressure, diabetes, and heart disease.  There are several causes for weight gain during cancer treatments.  Cancer medications may slow your metabolism and lead to water retention and fat deposits.  Hormone treatments can cause weight gain as can steroids.  Cancer also makes establishing a consistent workout routine difficult.  Here are some tips for keeping weight gain in check:

• Diet and exercise.
• Monitor your nutritional needs.
• Work with a nutritionist.
• Eat in moderation.
• Choose fresh over packaged.
• Maintain key nutrition.
• Start your exercise program slowly.

As you deal with some or all of these issues never lose sight of the reason you are undergoing treatment – look at your friends, family, and loved ones – but most importantly never forget to look in the mirror!