We've all felt the shock (and fear) of seeing an extremely emaciated person at the cancer treatment centre. With ovarian cancer, there are many reasons for severe weight loss including complications from surgery, intestinal blockage, ascites, disease encroachment, chemotherapy side effects, pain and depression. Our tabs on Advanced Disease and Advanced Disease Dietary Help give an in depth description of the more notable causes.
Putting on weight during illness is as daunting as dieting and is equally frustrating for the patient and their families. A "healthy" appetite is viewed as just that - healthy. Oncologists have reported that some of the most stressful times in a patient's journey is when their spouse or loved ones interpret their lack of appetite as giving up - an unwillingness to live.
Whether you're being weaned off TPN or recovering from a bowel obstruction, knowing that you must put weight back on is challenging, a bit scary and requires diligent work. Not regaining weight weakens your immune system, puts you at added risk for osteoporosis, causes nutrient deficiencies and will ultimately lead to disease progression.
Theoretically, one needs to add 500 calories a day in order to gain one pound per week. 32 years ago, when my mother was originally diagnosed with breast cancer, she was told by her doctor to eat everything and anything she wanted. He told her to choose cream over milk, butter over margarine. Today, we think we're a little wiser (maybe not!)... remember being taught the difference between good and bad calories? Also be reminded that cancer thrives in an acidic environment so try to choose the majority of your foods accordingly. Here's a chart outlining foods which are alkaline and those which are acidic:
http://www.rense.com/1.mpicons/acidalka.htm
Normally, a patient's healthcare provider should guide them as to what form of food is appropriate - i.e. if you're post-bowel blockage or surgery, you would be encouraged to start with juicing and purees rather than raw foods.
Here are some basic suggestions for regaining weight:
- Plan and count your calories. Make every mouthful count. Livestrong has a neat calorie counter app for either wanting to gain or lose weight. It will calculate your ideal weight, let you search their library to see the caloric benefit of millions of individual foods and help you track your progress. http://www.livestrong.com/thedailyplate/ Check out the site before preparing your shopping list.
- Start slowly and eat/snack six times a day. Overwhelming yourself with large meals can be harmful and discouraging. Additionally, carefully planning scent and taste can make a significant difference in stimulating your appetite. I remember my own emancipation from the "feed bag" - having been nourished with a completely balanced liquid (TPN) for ten days following surgery - then with the flick of a switch returning to solid foods - was very confusing and more than a bit frightening.
- Add healthy fats such as nut butters, avocado, omega 3 oils.
- Make liquid calories count - choose 100% fruit drinks. Wine is a fruit drink and an appetite stimulant! Don't be afraid to revert to a food supplement drink in lieu of a snack. Freeze it in a popsicle container for variety.
- Be consistent - keep a journal - write down what you've consumed and add it up each day.
- Include exercise...it builds muscle, increases your appetite, helps with chemo fatigue and improves your mood.
- Go easy on yourself...leave a little room for a treat!
Educating caregivers is essential in supporting patients with weight loss "whiplashes". The speed of the decline can be alarming and the recovery can take time. In cases of very advanced disease, recovery is not always possible - this too, requires special understanding.
Barbara Ehrenreich wrote a brilliant essay called Welcome to Cancerland for Harper's Bazaar in 2001 http://www.barbaraehrenreich.com/cancerland.htm in which she says:
"Does anyone else have trouble with the term 'survivor'?' I ask, and, surprisingly, two or three speak up. It could be "unlucky," one tells me; it "tempts fate," says another, shuddering slightly. After all, the cancer can recur at any time, either in the breast or in some more strategic site. No one brings up my own objection to the term, though: that the mindless triumphalism of "survivorhood" denigrates the dead and the dying. Did we who live "fight" harder than those who've died?"
By definition, everyone is a survivor...one that survives...to remain alive, to continue to function. Society however, celebrates most cancer survivors - bestowing upon them a rarefied status as if we'd come through a great battle - blazing with glory. Some survivors would agree, others would take the stance that cancer is a man made disease, supported by the continuing abuses of man made products and then chemoed to near-death by man made pharmaceuticals. These are the "mad as hell" variety of survivor - the type that are more comfortable using the word victim.
Wikipedia makes this highly interesting comment on the definition of a cancer survivor:
"The ideal survivor, like a superwoman who simultaneously manages her home, family, and career, struggles valiantly to prevent cancer from affecting loved ones by appearing, behaving, and working as much as possible. Once the immediate crisis is past, the person may feel strongly pressured to donate time, money, and energy to cancer-related organisations. Above all, the ideal survivor does not die of cancer. People who publicly conform to this ideal are given social status and respect."
Good grief! "Social status and respect" - for conforming and not dying (publicly) from cancer! I'll certainly try not to!
I think if we were arguing the semantics of the word "survivor", we could come up with any number of alternatives but what is really at odds here is society's head-in-the-sand approach to the realities of cancer survivorship - ignoring the ongoing physical dramas, psychological scars, relationship struggles and financial worries.
On June 3rd, National Cancer Survivors Day http://www.ncsdf.org/ - a day for all survivors wherever they are on their journey - I will celebrate being alive - continuing to live. I welcome this opportunity to educate and increase awareness (with or without the promise of social status) - and hopefully earn society's respect by working hard for answers for those who have gone before us as well as for ourselves.
There is an excellent website called Survivorship A-Z http://www.survivorshipatoz.org/ which includes topics which are extremely practical without the sugar-coating.
As well, http://www.livestrong.org/ was formed for survivorship and the challenges which a survivor faces in the real world. They have a national network of Centers of Excellence in Survivorship which provides support of all types.
As the New Year rings in, we are reminded that January is Testicular Cancer Awareness month in Canada, affectionately known as Manuary. Many of us have heard about this disease as a result of the tremendous work done by Livestrong - the foundation created by Lance Armstrong - and as well by the many awareness campaigns led by Scott Hamilton. We're extremely proud to say that the Livestrong Foundation was one of the earliest "followers" of our website.
Few of us are aware of the similarities between testicular cancer and ovarian cancer - specifically, germ cell cancer - a very rare form of ovarian cancer. Ovarian germ cell tumours are malignant cells formed in the germ egg cells of the ovary. They account for about 5% of ovarian cancers according to the M.D. Anderson Cancer Center website.
There are several types of testicular cancer but the most common type is found in young men between the ages of 15-29. Similarly, germ cell tumours are typically found in teenage girls and young women. Both cancers are named gonadal and are treated almost identically. They are optimally debulked surgically followed by similar chemotherapy drugs and radiation.
In honour of our "brother" cancer, we have created a series of products aimed at Testicular Cancer Awareness and are launching them on our brand new major cause awareness website TheGiftMD.com . My sister, our webmaster and designer extraordinaire, has been busy creating unusual awareness products for the most notable causes - all worthy of our understanding and support.
Have a look at that little guy joyfully ringing the bell - just like us - when chemo's finished - life begins anew! Happy New Year to one and all!
