THREE MAIN APPROACHES TO IMPROVING APPETITE

Q: My husband has just been diagnosed with lung cancer. His recommended
treatment is six weeks of radiation therapy. He initially went for help
because of loss of appetite and weight loss. Is there something he can do
to stimulate his appetite? The doctors we've seen don't seem to have any
answers.

- -- S.M., Ormond Beach, Fla.

A: There are many causes for loss of appetite (anorexia). Cancer is an
important cause and anorexia is often one of the first symptoms. And
anorexia can be very debilitating.

It's even more important to try to find ways to stimulate your husband's
appetite because the stress and anxiety related to dealing with the cancer
may make the situation worse. And his radiation therapy and chemotherapy
also can suppress the appetite.

There are three main approaches to improving the appetite: enhancing the
eating experience; using supplements, and using medications.

You can improve the eating experience by planning regular meals in a
comfortable and relaxed environment. Light exercise about an hour before
eating and relaxation exercises just before eating may help. Eating small
meals frequently and snacking also are helpful.

Getting adequate amounts of protein is especially important, and this can
be enhanced by fortifying food and drinks with nonfat dry milk powder. And
there are many nutritional supplements on the market that contain more
protein and extra vitamins. Because antioxidants are being shown to help
prevent cancer and treat some cancers, it may be beneficial to take
supplements of these as well.

Several different drugs are are useful in stimulating the appetite.
Drinking a small amount of wine or other alcoholic beverage just before
eating has been shown to help some people. And two hormones -- prednisone
and Megace - - may be used to increase the appetite.

Marinol, a synthetic and legal form of an active ingredient in marijuana,
is usually prescribed to prevent nausea, but a side effect is stimulation
of the appetite.

Although a recent government panel of experts did support the benefits of
marijuana as an appetite stimulant, they did not endorse this approach over
other medications. But remember that it is illegal almost everywhere, and
smoking marijuana can damage the lungs.

It's also important to consider any other medical problems that exist or
may develop. They can have a major impact on the types of foods and
supplements that your husband needs.

I strongly recommend that you ask for a referral to a dietitian who can
help you assess all your nutritional needs and concerns. But then it's up
to both of you to actually follow the plan you develop.

Probably no single approach will be effective. So you and your husband will
need to learn by trying many things to find out which ones work best.

This column is for informational and educational purposes only. It is not
intended to provide medical advice or take the place of consultation with a
doctor or other health-care provider.