Nutrition/Gaining Weight
Hello to a wonderful group! My dad was just diagnosed with esophageal cancer. He is undergoing all of the diagnostic exams right now, so we don't have information about staging, but his team is tentatively planning a radiation/chemotherapy series of treatments and then surgery after that. I have spent a lot of time online - sometimes a very big mistake - but the one thing that keeps coming up is keeping weight and strength up (before, during, and after treatment/surgery). Right now, my dad can swallow - slowly - on his own, but I'd like to know if anyone has some suggestions about how to increase the caloric levels of the nutritional formulas that he's now reliant on. He's already relatively thin and very active/athletic, at the age of 76, and I'd love to know how to increase his weight. Many thanks to everyone; I've spent a lot of time on this forum and am so appreciative, even in the midst of all of the anxiety and fear, of your presence here and your willingness to be so open and helpful.
Comments
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High Calorie Ideas
I am sorry to read that your Dad has been diagnosed with esophageal cancer. But with treatment and surgery there can be a productive life after diagnosis. When I was going through chemotherapy I lost a considerable amount of weight. I found that drinking high calorie supplements was helpful in reducing the amount of weight I lost. I found that making a variety of smoothies that were fortified with protein powder and chia seeds provided extra calories. I also found that Nestles has a number of high protein supplements that are available online or at WalMart. Here is a link to their web site http://www.nestlenutritionstore.com/departments/supplemental-nutrition/protein/protein
When I had my esophagectomy they installed a “j-tube” (jejunostomy tube) that provided nutritional support while I learned to eat with my new digestive system. http://cancer.dukemedicine.org/cancer/health_library/care_guides/treatment_instructions/jejunostomy
One thing that is often missed during chemotherapy counseling is the need to provide adequate hydration support. Chemotherapy seems to rob the body of liquid and it is very difficult to drink enough (particularly when nauseated) to maintain adequate hydration levels. Many patients will require IV hydration periodically during treatment.
I hope your Dad gets good news from his testing and staging.
Best Regards,
Paul Adams
McCormick, South Carolina
DX 10/2009 T2N1M0 Stage IIB - Ivor Lewis Surgery 12/3/2009 - Post Surgery Chemotherapy 2/2009 – 6/2009
Cisplatin, Epirubicin, 5 FU - Four Year Survivor
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Food
Food was one of the biggest problems we had during cancer treatment. My husband had a J-tube for six months. We've since learned this is somewhat unusual. My husband said that food became his enemy. But, he engaged the enemy 6-7 times a day, eating small amounts, but more or less eating constantly throughout the day. It was a chore. We found that whole milk, ice cream, gnocchi, and mashed potatoes loaded with every imaginable high calorie ingredient helped. We also made high calorie purees and he sipped them both hot and cold. At one point, everything he ate had to melt in his mouth. He would put peanut butter in his mouth and let it melt while he watched TV. He said he use to do this as a kid. He had a smoothie every day, loaded with anti-angiogenesis foods, including tofu. We used coconut juice as the fluid. These smoothies were surprisingly good and I drink them now, too. We also started juicing. We add spinach, kale, cherries, squeezed fresh limes and lemons into the mix, pineapple and mango. I also added flax seeds. He still yoyo-ed back and forth in weight, before finally stabilizing at 20 pounds less than when he was diagnosed. Only in the past 30 days has he started gaining weight, again, six months after surgery.
Hope this helps.
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Thank you!paul61 said:High Calorie Ideas
I am sorry to read that your Dad has been diagnosed with esophageal cancer. But with treatment and surgery there can be a productive life after diagnosis. When I was going through chemotherapy I lost a considerable amount of weight. I found that drinking high calorie supplements was helpful in reducing the amount of weight I lost. I found that making a variety of smoothies that were fortified with protein powder and chia seeds provided extra calories. I also found that Nestles has a number of high protein supplements that are available online or at WalMart. Here is a link to their web site http://www.nestlenutritionstore.com/departments/supplemental-nutrition/protein/protein
When I had my esophagectomy they installed a “j-tube” (jejunostomy tube) that provided nutritional support while I learned to eat with my new digestive system. http://cancer.dukemedicine.org/cancer/health_library/care_guides/treatment_instructions/jejunostomy
One thing that is often missed during chemotherapy counseling is the need to provide adequate hydration support. Chemotherapy seems to rob the body of liquid and it is very difficult to drink enough (particularly when nauseated) to maintain adequate hydration levels. Many patients will require IV hydration periodically during treatment.
I hope your Dad gets good news from his testing and staging.
Best Regards,
Paul Adams
McCormick, South Carolina
DX 10/2009 T2N1M0 Stage IIB - Ivor Lewis Surgery 12/3/2009 - Post Surgery Chemotherapy 2/2009 – 6/2009
Cisplatin, Epirubicin, 5 FU - Four Year Survivor
I really appreciate your thoughts and will relay all of this to my parents. This has been a devastating time, so I'm trying to do a lot of the planning ahead/brainstorming so that they can just get through the day-to-day. I have a feeling that I'll be on this forum a lot in the coming weeks and months. Thank you so much (and I'm so happy to hear that things have gone so well for you)!
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This helps immensely! ThankJKGulliver said:Food
Food was one of the biggest problems we had during cancer treatment. My husband had a J-tube for six months. We've since learned this is somewhat unusual. My husband said that food became his enemy. But, he engaged the enemy 6-7 times a day, eating small amounts, but more or less eating constantly throughout the day. It was a chore. We found that whole milk, ice cream, gnocchi, and mashed potatoes loaded with every imaginable high calorie ingredient helped. We also made high calorie purees and he sipped them both hot and cold. At one point, everything he ate had to melt in his mouth. He would put peanut butter in his mouth and let it melt while he watched TV. He said he use to do this as a kid. He had a smoothie every day, loaded with anti-angiogenesis foods, including tofu. We used coconut juice as the fluid. These smoothies were surprisingly good and I drink them now, too. We also started juicing. We add spinach, kale, cherries, squeezed fresh limes and lemons into the mix, pineapple and mango. I also added flax seeds. He still yoyo-ed back and forth in weight, before finally stabilizing at 20 pounds less than when he was diagnosed. Only in the past 30 days has he started gaining weight, again, six months after surgery.
Hope this helps.
This helps immensely! Thank you so much. I'm going to print out all of your suggestions and start a "food ideas" journal to keep on hand! I'll be thinking of you and your husband and sending good thoughts.
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Nutritional Supplements
I have a minor problem of keeping the weight on. I was told to use Ensure Plus, 13 grams of protein. I use the drug store variety. So far i have used Rite Aid, Walgreen and CVS's versions of the E+. Look for sales, they become real cheap. I can't tell which brand I prefer, they all go down easy and I am drinking them warm, not chilled as recommended on the can.
Sounds like he is doing the right thing ....eating constantly, with small amounts. It is hard to eat just 2 oz of prime rib.
Dennis
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Its good that you are getting
Its good that you are getting informed now, it can be difficult but for so many it can be managed. My dad says that the ensures taste the best, but will drink boost. They have several brands that are relitively higher with calories and lots of protein. For instance, Ensure high protien shakes. They are a little bigger but boast a whoping 26g of protein. there are also some protein suppliments that the doctor can order if needed like prostat. Its not medical and can be purchased online at sites like amazon. With prostat I think its something like 15g protein per 1 oz. Keep in mind he needs alot of protein, but the body can only absorb so much at any one time. Calories you can get with milkshakes- add icecream to the ensures and blend up, or add your supplement powders etc...
What we found my dad liked was home made beef and (store bought) noodles pureed up it had lots of protien and carbs, paird with an ensure shake. His tastes in foods and drinks went back and fourth and have remained forever changed. Once an avid tea drinker now he preferes water at all times. Keep up on the fluids as others have mentioned, with drinking much of their food its sometimes hard to think about drinking water too. If you dad starts getting really tired, or just blah ask your doctors or nurses about the possible need to get IV fluids on board. They do them in the same setting and time as the Chemo etc, and it can work wonders.
My dad too ended up with a J tube and he was not pleased with this but it did allow him to focus more on fluid in take and not so much of the protein/calorie counting.
talk to your nutritionist through the hospital, often they have coupons for the shakes and sometimes even some protein powder samples.
Best wishes!
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Nutritional Formulas
I wish your dad and your family the best. There is some great organic products that your father may find very beneficial to sustain energy and provide valuable nutrients. It can be added to other drinks like juices and proteins. I find it a lot easier to drink my nutrients at times, and when i dont have the time to prepare my food I have a scoop of my vitamins. I have tried many of them but (this one) by far has given me the best results, as far as energy and just feeling well overall, and it doesn't taste too bad. You can also try, (All one powder vitamins), and (perfect food raw), all great products. I Hope this helps. Best Wishes.
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nutritionglowy44 said:Thank you!
I really appreciate your thoughts and will relay all of this to my parents. This has been a devastating time, so I'm trying to do a lot of the planning ahead/brainstorming so that they can just get through the day-to-day. I have a feeling that I'll be on this forum a lot in the coming weeks and months. Thank you so much (and I'm so happy to hear that things have gone so well for you)!
Hello, my husband was able to gain weight back before the operation but he could not stand the taste of any supplement. there was a pre treatment visit with a nurse before chemo and she suggested using a lot of heavy cream in everything . so he had lots of pasta sauces with cream, lots of whipped cream on ice cream or sherbert, etc .
Also very important he exercised a lot as he uses the bicycle as his mode of transportation .
If your Dad gets cisplatin as part of the treatment hydration is very important even in addition to the hydration they do when giving the cisplatin.
There is a supplement he did force himself to take , that's one given specifically before the operation . I think he had to take it a least a week before the operation. you can ask your surgeon about this , and if you want I can look up an article about this that I probably still have.
Wish you all , all the best,
danièle
ps
you can look at the forum "smart patients" and look up a conversation i started under the title " a list of must questions
if you have trouble finding it i'll send you the link
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