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Medical Forum / Diseases and Disorders / Breast Cancer / September 2005Weight loss with advanced BC
My wife has been through partial breast removal, chemo and 5 years of Tamoxafin beginning in 1990. In 2003 she was diagnosed BC with mets to the brain, bone and a large tumor adjacent to the esophagus that severely limited breathing and swallowing. The tumor was zapped with radiation that seems to have done the job. Brain lesions were irradiated and seems to be no problem at this time. She has been on Zometa (to strengthen bone)and Femara (to limit estrogen production)for the past 20 months. The net results are that she has lost about 50 pounds from a starting weight of 165. She is continually nearly totally exhausted, but continues to do her best with chores around the house. I, of course, help out wherever needed. She has recently begun Procrit to enhance hemoglobin in hopes that she would regain some energy. Our question is: what mechanism explains the muscular weight loss and how far can we expect it to go. The loss seems to have slowed, but clearly it needs to STOP. Any information would be appreciated. Van > My wife has been through partial breast removal, chemo and 5 years of > Tamoxafin beginning in 1990. In 2003 she was diagnosed BC with mets to the [quoted text clipped - 14 lines] > > Van Well, it could be digestive problems, or respiratory/circulatory problems (which you say are being addressed) or it could be Cachexia. I don't think it would be a side effect of the drugs you mention, but pain meds might be contributing. NSAIDs (eg diclofenac/Volterol) are notorious for causing digestive problems. I imagine that having had radiation near the esophagus, that eating isn't much fun, and she might not be taking on as much as she needs. If this is so it might be worth trying some of the nutrition drink products that are designed for people who cannot handle solids. Possibly there might be some specific dietary shortage that could be rectified by supplements. Maybe blood tests would help show this up. Ask about it. If it is Cachexia, that is the bad news. This is the "wasting" condition which appears in the final stages of many cancers. I don't think the mechanism is fully understood, but it seems that the tumours release compounds that alter the body's tissue building program. It particularly attacks muscle rather than fat. It is generally irreversible, (unless you can remove the cancer) and not affected by nutrition etc., although it also seems to be associated with loss of appetite and lethargy. I don't know of any test or treatment for this, and the doctors' attitude seems to be to try treatments for other weight-loss conditions in the hope that either it isn't Cachexia, and to ensure as much as possible there aren't any other problems exacerbating it. They don't tend to talk about it much either. Tim Jackson Tim, Thanks for the input. However I doubt it's anything to do with digestion or nourishment. She eats fairly well, not a whole lot however, and doesn't seem to have any problem swallowing. She does take nutritional supplements. The esophagus rads were 18 months ago and were only a problem for a month or so. She hasn't had a need for pain meds following the healing. Leg aches around the knees are beginning to be a nuisance at night. This may be a result of bone cancer progressing. We don't know for sure. I hate to think of the other you mentioned, Cachexia. It doesn't sound pleasant. I'll listen to any input. Van >> My wife has been through partial breast removal, chemo and 5 years of >> Tamoxafin beginning in 1990. In 2003 she was diagnosed BC with mets to [quoted text clipped - 47 lines] > > Tim Jackson Sounds like what I have. I get hungary and eat, but fill up really fast and can't eat more, just lately I have had this problem and am starting to lose weight. I have been taking Slim fast and will finally try Ensure (as my MIL really turned me against it. and it doesn't sound appetizing to me) for added calories. Hope it works!!! I am stage IV and am on my 18 chemo treatment. I don't feel all that bad, tho...Pat from Apple Valley, CA > .... I get hungary and eat, but fill up really fast > and can't eat more, just lately I have had this problem and am starting > to lose weight. I have been taking Slim fast and will finally try Ensure > (as my MIL really turned me against it. and it doesn't sound appetizing > to me) for added calories. Hope it works!!! ----------- Pat, there is a product called Vital Cal which also comes in a can, but tastes a hell of a lot better than Ensure. I don't know where you would find it, though. I *think* maybe Walgreen's carries it. I could not drink Ensure or Boost, they taste absolutely horrible to me, but that Vital Cal stuff tasted like an old-fashioned milkshake. Eva > Pat, there is a product called Vital Cal which also comes in a can, but > tastes a hell of a lot better than Ensure. I don't know where you would > find it, though. I *think* maybe Walgreen's carries it. I could not drink > Ensure or Boost, they taste absolutely horrible to me, but that Vital Cal > stuff tasted like an old-fashioned milkshake. Is it sweet Eva? Some posters on alt.support.cancer don't like Ensure or Boost (too sweet). Thanks, J > > Pat, there is a product called Vital Cal which also comes in a can, but > > tastes a hell of a lot better than Ensure. I don't know where you would [quoted text clipped - 6 lines] > Thanks, > J ------------ Yes, it's sweet, but not *too* sweet. Not that artificially sweet taste. Here, they have a website. And I was right about Walgreens selling it. http://www.vitalcal.com/calories.htm Eva > "J" <pitstop@anon.inv> wrote in message > [ gentle snip...] [quoted text clipped - 8 lines] > > Eva Thank you very much for your reply, Eva. I'm sure the info will be helpful to one or another, reading the other cancer newsgroup. I'm so pleased to read that you're feeling well enough to do yoga. J >>.... I get hungary and eat, but fill up really fast >>and can't eat more, just lately I have had this problem and am starting [quoted text clipped - 10 lines] > > Eva Thanks I'll look for it. We used to buy Ensure for my MIL when she was failing. And she always said it was oily tasting. I have never tasted it. but that was enough to turn me against it. It doesn't take much. I was told that you need additives, not just calories when I told the Dr. that I could eat ice cream. I can also eat quite a bit of pasta, tho meat really turns me off. I was thinking a protein powder that I could add to the milk shakes...Pat | >>.... I get hungary and eat, but fill up really fast | >>and can't eat more, just lately I have had this problem and am starting [quoted text clipped - 18 lines] | meat really turns me off. I was thinking a protein powder that I could | add to the milk shakes...Pat I used to use the ensure with ice cream and make milk shakes for my DH. He reported they were quite good. He wouldn't drink the ensure on its own. Debbie > Sounds like what I have. I get hungary and eat, but fill up really > fast and can't eat more, just lately I have had this problem and am [quoted text clipped - 4 lines] > that bad, tho...Pat from Apple Valley, CA > That might well be a chemo side effect. When my wife was having GI problems (no, not the US soldiers, the gut) we used Enlive, the fruit-based version of Ensure, which she found more palatable. Tim I made it through six different chemo drugs before being diagnosed with acid reflux. That probably contributed to appetite problems on my current chemo. Anyway, I got put extra snacks, a milkshake (1 cup whole milk, 1 cup ice cream, 1/4 cup nonfat dry milk powder, 1 packet Carnation instant breakfast), and was given a prescription for Megace. I understand from a friend who has experience from another avenue that it is quite an effective appetite stimulant. The other stuff has worked and my weight is no longer in free fall, so I didnt try the Megace. It might be something to ask about though. I know that my energy was really low when I wasnt eating well. Chris > My wife has been through partial breast removal, chemo and 5 years of > Tamoxafin beginning in 1990. In 2003 she was diagnosed BC with mets to the [quoted text clipped - 14 lines] > > Van Thanks for all the tips, guys. My wife takes Ensure and Prosure but that doesn't seem to help much. Actually, she gets sick and tired of hearing of suggestions that I propose; doesn't want to hear anything more about cancer. Almost like she has resigned from any further cures. That's strange because she is a strong person with a will to keep going if for no other reason than to seen the new twin grandkids coming along in a month or so.. . Thanks again. Will try some of the recent suggestions. >I made it through six different chemo drugs before being diagnosed with > acid reflux. That probably contributed to appetite problems on my [quoted text clipped - 33 lines] >> >> Van > I made it through six different chemo drugs before being diagnosed with > acid reflux. That probably contributed to appetite problems on my [quoted text clipped - 6 lines] > be something to ask about though. I know that my energy was really low > when I wasnt eating well. Chris I am on my fourth type now. I really don't have digestive problems. No acid Reflux or anything. I have allways been one who could eat anything with no problems. Envied by many of my friends and relatives. I am on a lot of pain meds, so that might be a factor in my appetite. (I know I can hardly tell if I have to pee.) Pat Strangely enough, I don't think it was the chemo that caused the acid reflux. I was off chemo this winter, but I was taking a lot of Ibuprofen. Thought it was mild compared to chemo! Turns out just not on your stomach. Chris > > I made it through six different chemo drugs before being diagnosed with > > acid reflux. That probably contributed to appetite problems on my [quoted text clipped - 13 lines] > lot of pain meds, so that might be a factor in my appetite. (I know I > can hardly tell if I have to pee.) Pat > Strangely enough, I don't think it was the chemo that caused the acid > reflux. I was off chemo this winter, but I was taking a lot of > Ibuprofen. Thought it was mild compared to chemo! Turns out just not on > your stomach. > > Chris All NSAIDs are hard on your stomach. This is really the main limit on their use. If you are taking Ibuprofen / Volterol etc. regularly, long term, then the doctor should also prescribe an antacid, eg Cimetidine to combat this very common side effect. Tim Jackson |
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