When it’s associated with cancer, weight loss worries patients and doctors. It’s important to know how to nourish your body adequately, without feeding the tumor in the process.

Cachexia, or rapid weight loss, affects almost half of cancer patients. It’s usually seen as a sign of progression of the disease. Doctors are often worried about cachexia, and they tend to make sweeping recommendations to cancer patients – suggestions such as, “It doesn’t matter what you eat, just make sure you don’t lose weight!” 

In fact, many doctors are disturbed by vegetarian or “anticancer” diets, and worried that they may be contributing to weight loss. Instead, they often recommend foods that are very rich in dairy products, sugar, white flour and saturated or omega-6 fats.

In reality, cachexia's weight loss does not result from a simple loss of appetite. It’s a much more complex phenomenon: a generalized inflammatory state, caused by the cancer itself, which is accompanied by fatigue, anorexia (loss of appetite) and the wasting-away of muscles’ proteins. This intense and rapid weight loss is often additionally associated with a steep fall in the immune system that further weakens patients.
Rather than accumulating empty calories from a diet rich in calories and poor in nutriments -- and which may actually further aggravate the inflammatory process -- it’s essential, first and foremost, to use good nutrition to fight the inflammation that the cancer has created.

Dr Keith Block is one of the pioneers of integrative oncology in the United States. His excellent 2009 book “Life Over Cancer” (1) on a comprehensive approach to cancer is enriched by his 30 years of experience in cancer treatment. In it, Dr. Block recommends a kind of meal replacement shake that I'm copying here for you in case you can put it together.

Meal Replacement Shake of the Block Medical Center

1.5 cups rice, soy, or oat beverage (a dairy replacement)
6 tbsp protein powder (cold-processed whey, egg white powder, or soy protein isolate)
2 g chlorella, or to taste (optional)
2 g free-form USP L-glutamine (optional; if omitted, take in capsule form)
2g L-leucine (optinal, if omitted take in capsule form)
6 g medium-chain triglyceride oil (if you use the shake for an extended period of time you can substitute almond or hazelnut oil)
8-12 g high-quality, high-potency fish oil (optional, this can be taken as fish oil capsules instead)
1 small banana
1 tbsp agave nectar/syrup

Combine all ingredients in a blender and blend well. Chill before serving.

This formula contains 3 servings of protein, 2 cups of grain, 2 servings of fruit, 1.5 cups of dairy alternative, and 1 tsp fat (for 580 calories).

Replacing each of two meals with this shake will provide up to half of the usual requirement in daily calories. (If allergic to one type of protein powder, substitute another).

A possible combination of supplements to help reduce the inflammatory process underlying cachexia (and nerve pain!) is below (amounts specified are for a daily dose):

- Pure EPA or high EPA fish oil (at least 50% EPA), 2 to 6 g daily
- 1,000 mg to 3,000 mg curcumin extract (active ingredient in turmeric)
- 1,000 mg to 1,500 mg Standardized Scutellaria extract
- 10-20 mg of rosemary extract
- 100-300 mg of ginger extract
- 1,500 mg of stinging nettle extract
- 1,000-1,500 mg of Vitamin C and 200-400 mg of Vitamin E

Drug interactions to discuss with your physicians that may come from these supplements include:
-      May increase the blood thining effects of anticoagulant medications (Coumadin and others)
-       May potentiate the sleepiness induced by CNS depressants (antidepressants, anti-anxiety medications, sleeping pills and others)
-       May lower blood pressure when combined with antihypertensive medications
-       May lower blood glucose when combined with insulin or oral hypoglycemic agents

Suggestion for increasing appetite include:

- Chewing very thoroughly small amounts at a time

- taking digestive enzymes such as bromelain and papain, or a small piece of pickled umeboshi plum
- Five or ten minutes of mild exercise, or walking 30 minutes before meals
- Treating depressed mood with adequate psychotherapy or natural methods (see my previous book “The Instinct to Heal, for natural depression treatments) but  conventional medication may be necessary and very helpful as well (Note that if opting for a herbal treatments such as St John's Wort, you need to be aware of possible interactions with some chemotherapy agents that may be eliminated too quickly by the liver when taking St John’s Wort which may result in a reduced effectiveness of chemotherapy)

- Traditional herbal teas that stimulate appetite are: ginger, catnip, fennel, peppermint, and ginseng
- Gentian extract, a constituent of "bitters", works for some patients
- A traditional Chinese medicine herbal formula to stimulate appetite recommended by Dr. Block is Bu Zhong Yi Qi Tang. 1,000-3,000 g of spray-dried extract. One tablet per day, on an empty stomach.
- Antiemetic medication may help if nausea is part of the problem
- Conventional medications such as Megace (400 to 800 mg per day), or Marinol and Oxandrin, may help to stimulate appetite as well

(1) This is taken from "Life Over Cancer", by Dr. Keith Block, 2009 Bantam Books edition, pages 131 and 510-513