Sickness, loss of appetite & taste changes

Treatments for secondary breast cancer can have a wide range of effects on your appetite and ability to eat, drink and go about your day as normal.

In this section

Sickness

The treatment you are taking, or your cancer itself, may make you feel as though you are going to be sick (nausea) or cause you to be sick (vomiting). This can be very distressing and may make it difficult for you to go about your day. There are lots of things you can do to help prevent and ease these symptoms.

 ‘Anti-sickness’ medications

There are lots of different medications to prevent sickness which your doctor may prescribe for you. Some examples include Domperidone, Cyclizine and Metoclopramide. A steroid drug (e.g. Dexamethasone) may also be prescribed to help ease sickness. Often, it is easier to prevent nausea and vomiting rather than waiting to treat it once you are experiencing these symptoms. This means that it is important for these drugs to be taken regularly (though there is a maximum daily dose which you must not exceed).

Different drugs work better for different people so if you find that one isn’t helping, it is worth trying another. Sometimes, a combination of drugs can work best.

If you are struggling with nausea or vomiting and have not been prescribed any of these medications, please ask your doctor (or, if you have one, your breast cancer nurse) for further advice.

Eating

You may find it is a particular struggle to eat on days when you are being treated.

Don’t force yourself to eat if you are feeling or being sick. Also, (if possible) try not to be the one preparing meals as the smells and sights can cause you to feel sick. It can be useful to have a supply of meals or left overs in the freezer, which you can easily prepare when feeling sick. Cold foods, such as sandwiches, may be easier to manage since they are usually less strong smelling.  

Try eating little and often, or whenever you feel you can manage it, rather than trying to stick to three larger meals a day. It is good idea to avoid greasy, spicy, salty, strong-smelling or strongly flavoured foods, since these could worsen your symptoms. Bland foods such as dry toast or crackers can help to ease you back into eating.

Drinking

Even if you don’t feel like eating, it is important to try and drink plenty of fluids to stop you becoming dehydrated. Try having small sips of cold, clear fluids regularly throughout the day. Having a bottle of water with you during the day can help to remind you to drink little and often.

Drinking through a straw can help when you are feeling sick. Some people also find it better to drink between rather than with meals, since lots of fluids with food can make you feel more full and nauseous. 

It can be helpful to avoid drinks containing caffeine (e.g. tea, coffee, some fizzy drinks) and alcohol. Drinks containing citrus fruits, such as orange juice, can also be irritating to your stomach and make you feel sick.

Surroundings

Some people find it helpful to be in a quiet, clean and relaxing space. Keeping cool, sitting by a window or getting some fresh air can also help. You may also like to have a towel and empty bowl to hand just in case, so you are not worried about rushing to be sick should you need to.

Distracting yourself from the feeling of being sick, or the thought of treatment, is also a useful technique. This can be particularly helpful if you find yourself feeling or being sick in anticipation of treatment (‘anticipatory’ nausea and vomiting). Certain smells or sights associated with having treatment can become ‘cues’ for feeling or being sick. The following may help to overcome this:

  • Taking a friend or relative along to treatment with you.
  • Listening to music or podcasts.
  • Reading a book or magazine.
  • Having a strong flavoured sweet to mask unpleasant tastes.
  • Using perfume to disguise smells.
  • Varying your routine on treatment days.

Complementary therapies & other helpful tips

Some people find that peppermint tea or drinks containing ginger can help to ease nausea.

There is some evidence suggesting that acupuncture can help with nausea, though further research is needed [1].

Some people also find wearing a stretchy band, known as an acupressure band, at a particular point on their wrist (the acupressure point) can help to control nausea and sickness. These bands can be purchased from your local pharmacist and some health food shops.

Relaxation techniques may also help to distract you from these symptoms and for you to feel better able to cope with them.

See our section on Complementary therapies for further information.

Loss of appetite

Sickness can be one of many things that puts you off your food when undergoing treatment for secondary breast cancer. You may also find that treatment causes your taste to change. There are lots of small things you can do to help improve your appetite.

Treatment

If your loss of appetite is a result of you feeling or being sick, your doctor can prescribe some anti-sickness medications to help ease this. These need to be taken regularly to keep the sickness under control. It is much easier to prevent the sickness before it ‘kicks in’ than to treat it once you are feeling or being sick. See our section on sickness above for further information. If you are losing weight as a result of poor appetite, your doctor may also decide to prescribe a course of steroids. Speak to your doctor (or, if you have one, breast cancer nurse) for advice on these medications.

Supplements

If you continue to struggle with poor appetite, or are losing weight, your doctor or nurse may recommend that you use meal supplements. These are food products containing nutrients and calories needed to boost your regular diet or to replace you meals completely if you are struggling to eat. They come as hot or cold drinks, soups, yoghurts, soft desserts or as a powder for you to make up or add to your food. Some commonly prescribed supplements include Ensure, Fortisip or Fresubin.

Some supplements can be bought over the counter in chemists or supermarkets without a prescription (e.g. Complan) but these can be expensive and you may need to try a few before you find one that suits your tastes. It is important that your hospital medical team are aware if you are taking any supplements or vitamins and you should not take more than recommended by your doctor, nurse or dietitian. Some of these supplements contain vitamins which can be harmful if taken in too large a quantity.

Fluid intake

Even if you are struggling to eat, it is very important that you continue to drink plenty of fluids to prevent you from becoming dehydrated (when your body lacks the water it needs in order to function properly). Whilst other drinks such as tea, coffee and fruit juices do contribute to your recommended daily fluid intake (2-3 litres), try to make water the main fluid you drink throughout the day.

Alcohol and drinks with caffeine in (tea, coffee and fizzy drinks) cause you to become dehydrated (i.e. to lose water) so try to drink these in moderation.

Tips for coping with poor appetite

Get your calories when you can. If you have a poor appetite and are struggling to eat regularly, it is important to get as many nutrients and calories as you can when you feel able to eat. If you struggle to eat in the few days after a treatment, don’t give yourself a hard time. You can make up for the lost calories by eating really well when you feel able to.

Little and often. Try not to over face yourself with a large meal. Instead, attempt to eat a well-balanced diet of smaller meals and snacks little and often throughout the day.

Snack. Keep snacks to hand, such as fruit and nuts, for when you feel able to nibble something.

Avoid low calories options. It is important for you to get the calories you need to function. You can still maintain a balanced diet whilst opting for higher calorie options such as full fat milk and yoghurt.

Ask for help. If the sight and smell of food cooking spoils your appetite, ask family or friends for help with preparing meals.

Think ahead. Be prepared for when you might feel able to eat. Have meals prepared and stored in advance and have a stock of soups, snacks and other tinned goods in the cupboard.

Tempt yourself! Have your favourite food and snacks in as you may find these can tempt your appetite more.

Try ginger. Some people find that ginger, in various forms, can reduce feelings of sickness. You can try this as ginger tea, ginger biscuits or ginger beer.

Changes in taste

Around half of people treated with chemotherapy find that they experience changes in their sense of taste. This can mean food and drinks take on a different taste e.g. metallic, more salty or bitter.

This usually returns to normal when treatment finishes, but for women with secondary breast cancer who are on long-term treatment this can be an ongoing struggle.

Whilst there are no specific treatments for changes in taste, there are lots of things you can do to try and help.

Tips for coping with taste changes

Trial and error. Try to find and avoid the foods which now taste unpleasant to you. This is not to say you won’t be able to come back to them if your tastes change. Some people find hot foods are better than cold foods, whilst others find the opposite. See what tastes better for you.

Experiment. Explore different flavours by using herbs, spices, garlic and lemon juice in your cooking (though be careful with strong spices or citrus juice if your mouth is sore). Chutneys, pickles and relishes are also good for adding strong flavours to food. You can also try more strongly flavoured versions of your favourite foods, such as smoked home or a very mature cheese.

Prevent unpleasant tastes. Try chewing fresh pineapple, chewing gum or celery if you have an unpleasant taste in your mouth or sucking boiled sweets or ice lollies.

Avoid metal. If you are struggling with an unpleasant metallic taste in particular, try using wooden or plastic forks and spoons.

Disclaimer: on this website you will find self-management advice to help you to manage a range of mild symptoms and side effects of secondary breast cancer and its treatment. Please ONLY use this advice if you are currently participating in the LIBERATE study. Otherwise, please follow the advice of your own healthcare team.

References

  1. Ezzo J, Richardson MA, Vickers A, Allen C, Dibble S, Issell BF, Lao L, Pearl M, Ramirez G, Roscoe JA, Shen J. Acupuncture‐point stimulation for chemotherapy‐induced nausea or vomiting. Cochrane database of systematic reviews. 2006(2).

Sources

Page last updated: April 2020