Managing cachexia

Chemotherapy and cancer drugs

Q: How should a very thin (underweight) cancer patient manage their diet when having chemotherapy; do they need to gain weight and if so how would they do it without following the NHS advice to eat lots of dairy, cheeseburgers and feast on biscuits, cake and slabs of chocolate! They are particularly concerned about giving me chemotherapy and a risk of cachexia. Can I manage cachexia to minimize my risk? I’d be grateful if you could point me in the right direction.

A: There are two parts to this answer, and both come straight out of research:

a) Reducing the risk of cachexia 

Hospitals, particularly in the UK, are afraid of cancer patients dying of cachexia. What is this?  Cachexia is when the chemotherapy drug actually causes severe weight loss and this leads to death. And we can’t have people dying from the drug, can we? So dieticians (who are rushed off their feet in UK Hospitals) produce booklets encouraging patients to eat cheeseburgers, sugary and milky foods and ’feed themselves up’! This advice feeds the very cancer you are trying to kill off, it is the opposite of new recommendations in America (to eat nutritiously), it is the opposite of general UK ’Healthy eating’ guide lines, and it is totally opposed to the latest research on the benefits of, say, fasting which can stop a cancer progressing and Calorie Restriction with radiotherapy and chemotherapy.

Preventing cachexia - It has now been shown in research that consuming fish oils helps prevent cachexia in lung cancer patients (and I am pretty sure this could be widely extrapolated to include most, if not all, cancers).

Boston College biology Professor Dr Seyfried goes further. He has shown that attacked cancer cells produce the pre-cursor agent for cachexia because of their glucose-burning activity, and fish oils can stop this: ‘It is important to recognize that pro-cachexia molecules such as proteolysis-inducing factor are released from the tumor cells into the circulation and contribute to the cachexia phenotype. By targeting the glycolytically active tumor cells that produce pro-cachexia molecules, restricted diet therapies can potentially reduce tumor cachexia. These therapies could be supplemented with omega-3 fatty acids, which can also reduce the cachexia phenotype. Omega-3 fatty acids from fish oil also have the benefit of maintaining low glucose while elevating ketone levels. Once the tumor becomes managed, individuals can increase caloric consumption to achieve weight gain’.

b) Using a good diet and managing cachexia

The fact is that the normal hospital dietician recommendations to eat sugary and fatty foods are actually not just wrong, they are dangerous!

For example, common sugar actually feeds cancer cells - they are inflexible. They MUST have glucose, and that is why they have large numbers of insulin receptor sites on their membranes.

For example, saturated fat is linked to an increased risk of cancer, and when people have cancer and consume high levels of saturated fat they get more metastases and lowered survival. So much for the NHS ’Diet for chemotherapy’ recommendations designed to reduce cachexia risk!!! 

The basic principles of a good anti-cancer diet and managing cachexia are:

1. Eat nutritiously - avoiding all empty calories, glucose, high fructose corn syrup, salt, bought fruit juices, refined food and packaged, prepared food. 

Go to: 20 links between sugar and cancer 

2. Eat 6 small to medium meals a day, not one or two big ones. Graze

3. Eat colourful vegetables across the week, and supplement with quality bioactive supplements.

4. Eat plenty of good fats like extra virgin olive oil, flaxseed oil, nuts, fish oils and avocados.

5. If you have to eat carbs, eat low glycaemic carbs - whole grains, whole oats, whole root vegetables. Please do not juice fruits and use during the day.

6. Eat quality fresh meat (for example, organic chicken) and fish, never preserved, or dried meats..

7. Avoid all ’bad’ fats, saturated fats, trans fats and cows’ dairy. They can make your cancer worse. Go to: Saturated fat consumption and cancer, metastases and survival 

8. Nourish your healthy body, not the cancer - Treat your body to the good things in life.

So, for example, if you want carbs, eat whole oat porridge with blueberries and flaxseed on it for breakfast. Snack on nuts and seeds. Lunch of grilled fish and salads. Dine on grilled meats and greens. Use good fats to provide your calories.

Go to: The Rainbow Diet - and how it can help you beat cancer 

The key is to be nutritious and nourishing. Less is more.

See our other relevant articles:

A Diet for Chemotherapy

The Ketogenic Diet

Fasting and cancer

The Rainbow Diet


At last - the definitive, research-based book on how to build a diet to help beat cancer. Click here to read about it.

Chemotherapy and cancer drugs
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