Weight gain during and after adjuvant chemotherapy, is becoming an ever-increasing significant concern. Women with breast cancer, for example, report a 45% incidence of significant weight gain often at a time in their lives when loosing it becomes difficult.

There are several reasons why patients, more often women, gain weight:

• Chemotherapy tends to cause some mild nausea, which many report gets worse on an empty stomach resulting in regular snacking; with modern anti-sickness medications, unlike the past, nausea is seldom enough, apart from the first few days to stop people eating. Many oncology units and information materials, however, still encourage patients to eat more as a throw back to days where vomiting and weight loss was normal. 

• Steroids are usually given with chemotherapy drugs which encourage a strong appetite and increased fat deposition. 

• With the fatigue and disruption of their daily routine regular exercise is reduced putting further pressure on the pounds!

• Hormone therapies such as tamoxifen aromatase inhibitors and zoladex can also cause weight gain and unlike chemotherapy are usually given for many years after initial surgery.

• Finally but of equal importance is the attitude of patients to food during treatments. Many people have had to be careful with their calories before they even get their diagnosis. Unfortunately, this tends to go out the window after their diagnosis – “dammed if I’m going to diet now I’ve got cancer!”

The trick is not to put on weight in the first place, but of course this is easier said than done, if we were all perfect we would not be human. Nevertheless despite the daunting task ahead, whatever the reasons and whenever you’re hoping to slim down it is never too late. The lifestyle section provides further advice on diet after cancer but the following table highlights some salient tips.

Tips for eating fewer calories:

•      Avoid faddy diets

•      Distract yourself from thinking about food

•      Avoid processed food

•      Eat less fatty foods e.g. deep fried

•      Avoid pastries, pies

•      Cut fat off meat 

•      Eat less meat more fish

•      Eat a large salad with every meal

•      Reduce alcohol intake

•      Try not to eat 3 hours before bed

•      Try not to snack between meals

•      Avoid food from lunch to evening meal

Burning up the calories with regular daily exercise not only helps to loose weight but published interventional studies have demonstrated significant improvement in body fat and lean mass indices. Likewise, exercise improves bone mineral density, muscle strength and walking distance, all potential risk factors post chemotherapy. Tips on how to exercise after cancer are described in detail in a separate advice sheet within the lifestyle section.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.