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Lack of appetite with weight loss

Posts: 2
Joined: Jun 2009

My father had esophagectomy with gastric pull-up in 2006. He still has no desire to eat and continues to lose weight. We've tried supplements such as Boost and things like Megase. Any ideas from anyone?

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Posts: 2
Joined: Jun 2009

Dear "William66",

Thank you so much for taking the time to write this answer. It was very helpful to me and I will pass this information on to my parents. A new gastroenterologist is a good suggestion, as well as the chocolate bars to put on weight.

He never did regain his appetite after the surgery in 2006 and has continued to lose weight since then. He does regularly see his internist and also has an oncologist (he has had three negative PET scans since the surgery ordered by the oncologist). He made a special appointment to address his eating difficulties with the surgeon, but left with the impression that the surgeon didn't have much to offer in the aftermath. He even tried a psychologist and antidepressants without change. I was getting the impression from the doctors that this total lack of appetite and weight loss was inevitable after gastric pull-up and was just part of the price to pay for the cancer treatment. I thought the vagus nerve was always severed with this type of surgery and would cause delayed emptying of the stomach.

So I was very interested to read that you love to eat! This is an important piece of information to me. Thank you for your input that there has to be a reason that he is losing weight and doesn't have an appetite. If others regain appetite following esophagectomy, it is not just a side effect from the surgery.

I found that a drug Domperidone is used to stimulate gastric motility. One study said that botulinum toxin injection eliminated post-op gastroparesis in 11 of 12 patients after esophagectomy. I found that gastric electrical stimulation is used to treat medically refractory gastroparesis, but can't imagine my father undergoing surgery to implant it. I wanted him to try Juven, which is said to preserve muscle mass in cancer patients, but his internist was not in favor of it and he never used it. I'm wondering if you or any of the others have experience with any of these things.

I've seen your name thoughout the posts since I found this site. I'm sure your story brings hope to many people who are living with fear. It was also helpful for me to read about how you cope with the uncertainty. This comes with my best wishes to you and your wife and my gratitude to you. Cindy Newton (aka "seeking_answers")

Posts: 5
Joined: Jun 2009

I am new to this sight, but have been reading numerous postings and see of us are in the same boat!
My Dad, age 77 was diagnosed with stage 3 adenocarcinoma of the GE junction in Nov 08. Had been a very physically active guy with no health problems besided hypertension.
Had complained of mid back pain after eating for about a year. He was concerned that it was pancreatic cancer, as this is what his Mom died from. CT scans showed pancreas was ok. Then he developed hiccoughs and had an episode of difficulty swallowing an apple. I am a nurse and encouraged him to get in for a scope. Never did I think they would find esophageal cancer! He went through the cycles of chemo and daily radiation for 5 weeks. All in all did pretty well with that. Was able to keep up his exercise and activities as usual. He rested up for a few months and then had the Ivor Lewis procedure beginning of May. Did INCREDIBALLY well after that. No lymph node envolvement and PETS are negative. He is down form 191 preop to 174 and is having a time gaining any weight. He eats pretty darn well, even though he is not really very hungry, but he knows it is important. Walks about 1/2 mile daily and does PT to improve his upper body strength. He for the most part has a positive attitude, though is "cranky" more than he used to be. I think he is entitled! My Mom gets weepy often, but spends her time trying to fatten him up.
We go to the Oncologist in a few days to discuss starting chemo again as a precaution as they think they may be able to "cure"him. I have mixed feelings on chemo as I know he has already been through so much....
Anyway, that is the story! Forgot to mention that he still has pain over the thoracotomy site. Had to remove 5 inches of rib. He still has to take pain meds 3 times daily. Unsure how long that goes on. Anybody with an answer?

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MichelleP's picture
Posts: 254
Joined: May 2009

I've been giving my husband smoothies made from whey protein power, soy milk, peanut butter blended with ice. It's actually full of protein and calories and he loves it. He had lost 30 lbs while in the hospital for a month and he's been home 3 weeks and gained 9 pounds back.

PS Sometimes I have a bit of banana for a change too.

Posts: 1
Joined: Jan 2010

have you hear about banna diet?

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