Approach to the seriously ill or terminal cancer patient who has a poor appetite

Lack of appetite is a frequent complaint of patients with serious illness and is particularly bothersome to cancer patients and their families. As patients enter the terminal phase of their illness, poor appetite becomes an even more distressing problem that affects not only physical symptoms but also functional, social, and psychological aspects of a patient's quality of life. Family and friends frequently relate a patient's poor appetite as a specific contributor to their perception of lack of health. We have investigated a number of ways to approach the seriously ill or terminal cancer patient who has a poor appetite with education, dietary changes (including the use of smaller, more frequent meals but still providing the patient's favorite foods), and at times dietary supplements. Appetite stimulants such as Megace Oral Suspension (Bristol-Myers Squibb, Princeton, NJ) are used not so much for facilitating weight gain as for adding to the quality of life, including social and psychological well-being, by allowing patients to enjoy foods they like in a social family setting.