Is my wife's trouble eating related to her hormone therapy?

1 answer | Last updated: Sep 23, 2016
Sandart asked...

I am caring for my wife of almost 50 years who is being treated for the third time with a rucurrent breast cancer that has metastisized into the bone and liver. She is now at home undergoing hormone therapy (femara) after several months of chemo which was not being tolerated well. Our main problem is contentiouslness over eating /drinking. It's a battle at times to get her to take her boost and drink enough water. Problems compounded by fact that treatment interupted her dental program of replacement of several of her front and other chewing teeth. She has a well made temporary denture but her unusuallly sensitive gag reflex causes her to shun its use as putting it in and wearing it fro any extended time cause her to gag. She doesn't complain of nausea very much but says that what she is eating is giving her gas. I don't think it's the Boost or the food. Could this be attributed th the hormone therapy? how can I get her to eat more without an argument at every meal?

Expert Answers

Andrew Putnam, M.D. is a Palliative Care physician at Smilow Cancer Center at Yale New Haven Hospital and Yale University.

It is very challenging to encourage eating with anyone with advanced cancer. While it may be the hormone therapy, it is also possible that it is the advanced stage of the illness itself. With advanced cancer, it is normal for a patient to lose interest in food for many reasons. One reason could be a change in taste buds from treatment that can make food taste like dust or even bad. Another is that eating can cause nausea or pain. Problems with teeth or dentures such as your wife has are common. Occasionally there is a pure loss of appetite that can be treated with certain medicines that stimulate appetite.

Unfortunately, especially when the liver is involved, it is common that a person can lose her appetite as a symptom of the disease and there is nothing that can be done to change it. In that situation, trying to force the person to eat makes mealtimes uncomfortable for all. Also when nearing the end stage of the disease, the food does not seem to make the person stronger. At that point, eating should be considered for pleasure. Prepare whatever the person wishes so that she will want to eat as much as she can. Fighting about it is not worth it and can simply make everyone, especially the patient, dread mealtimes when they should be social occasions to share.