It's been mentioned a time or two that weight loss from radiation treatment is usually lean muscle loss, not fat loss. I'm having a hard time getting my head around this based on what I know about metabolism.

I used to run marathons. We all knew what hitting the wall (usually at mile 20) meant. Your stores of glycogen are gone and your fuel needs are in excess of what the slower metabolism of fat can provide, so you start to eat some of your own muscles.

I can understand that in the higher energy world of marathon running. But in cancer treatment I'm not running a marathon. I'm at a much lower energy requirement mode. I sit around a lot, I read, I sleep, I eat, I walk some (but certainly no running).

Doesn't the body use the fuel source that easiest to burn, glycogen first, fat second (unless you're running a marathon), muscle last.

I know the radiation is causing higher energy needs, but is there something else going on that causes fat metabolism to be bypassed in favor of muscle metabolism?

If I'm not asking the right question, please educate me. I'm an engineer, we need to know the WHY of things, not just do it because I say to do it.

thanks, Tony

When going thru treatments, your body is NOT using less energy. It is consuming more, alot more. It is burning calories at an incredible rate. Its trying to fight off the invading cancer cells and at the same time trying to repair the damage the cancer has done and the radiation treatments are doing. Thats why you need more calories while going thru treatment and recovery.

I noticed a few posts back you mentioned losing 3 pounds. That might not seem like much but its something to keep a close eye on. If you continue to lose weight then your intake is too low. Even 2500 calories daily can be too low to sustain a patient during rads and recovery.

I would drink the giant chocolate milk shakes 2 or 3 times per day almost every day of the week. So my intake was normally well over 4000 calories daily with some days taking in 7000+. I still lost weight. It seemed like no matter what I did my intake could never keep up with the cancer and radiation treatments. Overall I lost 65 pounds in less than 3 months. Its no wonder I wound up hospitalized for malnutrition and dehydration a couple times. This is why I stress the importance of your intake. To save others from going thru what I did. Its NOT fun getting stuck in the hospital and feeling like you are going to die. Having to explain it to every person that walked into the room was exhausting and burned more calories.

When a patient skimps thinking they can make it up the next day it turns into a viscous cycle of playing catch up. The next day never comes and the patient soon is malnourished and dehydrated after only a couple days. The first signs of this are weight loss. No matter if a patient is lean or has a good 50 extra pounds, optimal nutrition will have the patient not lose even a pound. When the losing weight starts it can quickly get out of hand.

I actually was planning on copying another member's relative on here and planned on carrying rocks in my pockets to my weigh ins. Those darn nurses had their eye on me and I hated it. They would make me do feedings while I was there to force me to take more in. How I despised every single one of those sweet ladies! They never let me get away with anything, always watching and calling to check up on me. They knew I didnt have a caregiver so they tried to help as much as they could.

I dont know all the medical details of losing fat vs muscle but I know what happened to me. I am now a weakling! Friends were visiting me a couple years ago and their adorable little girl wanted me to pick her up. She was built like a tank of solid muscle at about 25 pounds. I tried and tried and couldnt lift her. Finally the mother picked her up and placed her on my lap. I have since learned that only about 12 pounds is the heaviest I can lift. When I dropped all that weight, it also took my muscle. By not losing weight during treatment and/or recovery the patient will not lose their muscle mass either.

Hope this has helped you to understand why we stress the minimum 2500 calories and 48 oz of water so much. Most people think we are exaggerating but those numbers are the bare minimum. OC patients really should be shooting for 3500+ calories and 80 oz of water daily. That should ensure their intake is enough to avoid losing weight during treatment.
Intake is about the only thing a patient has control over. Too often they feel helpless like everything is out of their control so they will skimp thinking its ok here and there. By changing that way of thinking to realizing their intake is the most important thing they can work on and push themselves daily, the whole treatment and recovery process will be much easier on them. This is especially difficult for independent people. For those patients its really hard to be told what to do and for them to follow thru and do it. Maybe stubbornness comes into play a little bit too???

Eat up, Tony! No more weight loss for you, my friend.

Tony, listen to her! If you are losing pounds during massive healing, your body has already burned through fat and water stores. If you are up to it study the ATP cycle and metabolism. There are so many systems throughout the body using energy to fight off the toxicity of treatment and then residual radiation kicks the immune system into a cyclical overdrive. As an athletic or active person your metabolism is already running at a high but efficient level. Inactivity even for a few days drops the autosynaptic process of the lower motor neurons maintaining some tone. As the swelling, scar tissue, radiation damage and/or surgery to the neck start putting any constriction on the nerves, the motor neuron signal can be weaker and accelerate weakness and atrophy. Inefficiencies from the body fighting so many different things can also contribute to faster atrophy. Add to that constriction in blood flow from edema, etc. and muscles deteriorate much faster than just sitting around.

If you break the metabolic cycle too soon, the immune system may not have destroyed all the cells in the area treated.

Thanks to both of you. Uptown that's the kind of answer I was looking for, but I'll have to do some research to understand it.

I'll redouble my efforts to eat, though loss of all taste has really put a damper on the desire to eat. Even scrambled eggs and sausage this morning tasted like cardboard. If memory serves two nights ago even cake and ice cream had little if any taste. Fortunately I still have saliva (both sides) right now.

I just had an Ensure, and I actually tasted it, so maybe it's not all gone.

Oh well, time to suck it up and eat for survival.

thanks again, Tony

Tony - don't know if this might help, but what my son and others here have discovered is that they could still smell the food even though they couldn't taste it. I noticed this when my son would lean close to his chicken broth and just breathe in through his nose, saying that it was almost like tasting it and it did make it easier for him to eat. When he first started doing this I thought he was casting aspersions on my cooking!

Tony, pardon me but I giggled when you mentioned cardboard. There seems to be groupings of people that tasted specific tastes during treatment. I was cardboard, too. Unfortunately you may need to take concepts like taste and appetite out of the vocabulary. It's all,about adequate nutrition for the body. Good calories. Lots of them. Regular feedings like every 3-4 hours.

A real key is stretching so veins and musculature maintain flexibility.

Tony,

You just have to eat as much as you can, plain and simple. I lost about half my taste and no off taste for me but the lack of appetite was my main struggle. Just had no desire to eat or hunger pains to prod me to eat. Having off-taste, no-taste, and lack of appetite makes eating a big chore. You are tough, just force it down for as long as you can. The goal may be to maintain weight but nearly all fail, the game is to just minimize the loss and tough it out to the end. Don

Don
You hit the nail on the head. What you wrote is exactly my situation; no desire to eat, just forcing it down as best I can.

Thanks, it helps to have another confirm it.

Tony

Uptown pretty much summed it up, and it's very a complex and multifactoral situation when it comes to weight loss, muscle loss from cancer treatment, cachexia, anorexia, and other side effects, especially in head and neck cancer patients who may already be nutritional deficient due to tobacco, alcohol dependency, and the tumor itself causing dysphagia, and other metabolic changes in the body. Other treatment related toxicities from chemotherapy, radiation can cause nausea, vomiting, diarrhea, mucocitis, aspiration, increased transit time, skeletal muscle loss, inflammatory responses, and a host of other problems, not to mention other medications that can cause muscle wasting like antibiotics, and a fetynal patch.

Thanks guys, I'll just try to choke it down.

I'm off to the kitchen to do scrambled eggs, a bottle of Ensure and lightly toasted bread with butter and jelly.

A dance partner brought me a whole cheesecake last night, homemade, it looks great, just wish I could taste it.

Oh well, life goes on. At least I still have saliva and not having to take pain meds ... yet. I was able to enjoy dancing last night. Actually I have a lot to still be happy about.

T