In the past, weight loss was one of the most devastating side-effects that people having chemotherapy treatments had. The weight loss usually came as a result of uncontrolled vomiting and diarrhea. However, medicines to prevent vomiting and diarrhea have improved so much, that weight loss is usually less of a problem than weight gain during treatment.
Unintended weight loss is a common symptom of lymphoma, but during and after treatment, many patients report distress at changes in their weight including unintended weight gain and loss.
This page will give an overview of weight changes related to treatment and the time after treatment. For information on weight loss as a symptom of lymphoma, please see the link below.
Weight loss
Weight loss can happen during and after treatment for lymphoma for several reasons. These can include:
- Nausea and vomiting leading to you eating less,
- Diarrhea,
- Dehydration due to not drinking enough water, excessive sweating or diarrhea,
- Malnutrition – not getting the right nutrients and calories for your body’s needs
- Loss of muscle mass.
Management
If you have nausea, vomiting or diarrhea, please see the links below for more information on how to manage these and stop losing more weight. The below pages will also provide information on eating a healthy diet and drinking enough fluids to keep you hydrated.
If you're sweating a lot, feeling hot or getting chills take your temperature. If it is 38º(degrees) or more, go to the emergency department at your nearest hospital. Tell them you are having treatment for lymphoma and have a temperature. Please also see the link below on Neutropenia - Infection risk.
Dehydration may be caused by vomiting or diarrhea. Please see the links above if you have either of these. To recognise symptoms of dehydration and learn how to prevent dehydration, read on.
Signs of dehydration
- weight loss
- dry skin, lips and mouth
- delayed healing if you hurt yourself
- dizziness, changes to your vision or headaches
- low blood pressure and fast heartbeat
- changes to your blood tests
- fainting or weakness.
Tips to prevent dehydration
- Wearing loose fitting clothes made from natural material such as cotton, linen or bamboo.
- Drinking cool or cold water, cordial or juice (avoid this if you are having a chemotherapy called oxaliplatin).
- Put a cool wet flannel or face washer at the back of your neck and on your head (this can also help when you feel nauseous).
- If you have a leather or synthetic lounge, use a cotton, linen or bamboo towel or sheet to sit on over the lounge.
- Use a fan or air-conditioning if you have one.
- Drink at least 2 or 3 litres of water each day. If you can’t drink that much water you can also drink cordial, fruit juice, watery soup or jelly. Avoid drinks with caffeine or alcohol as these can dehydrate you even more.
How to rehydrate
The only way to rehydrate is to replace the fluids that you have lost. If you can tolerate eating and drinking, try some of the below foods and drinks to rehydrate. It may be easier if you have small snacks or sips through the day rather than large drinks or meals. You need 2-3 litres of fluid every day to maintain healthy levels.
If you cannot tolerate food and drinks, you need to go the emergency department at your nearest hospital. Thay may need to give you fluids through cannula or central line straight into your blood stream.
Foods and drinks to rehydrate
Fruits and vegetable | Drinks | Other foods |
Cucumber Watermelon Celery Strawberries Cantaloupe or rock melon Peaches Oranges Lettuce Zucchini Tomato Capsicum Cabbage Cauliflower Apples Watercress | Water (can be flavoured with cordial, juice, lemon, lime, cucumber or fresh herbs if you prefer) Fruit juice Decaffeinated tea or coffee Sports drinks Lucozade Coconut water  | Ice cream Jelly Watery Soup and broth Plain yoghurt |
Malnutrition happens when your body is using more energy than you are getting from your diet. It can be a result of eating less due to loss of appetite, nausea and/or vomiting and diarrhea.
It can also happen if your lymphoma is actively growing and using up your body’s energy stores. It is really important for you to get all the nutrients and calories you need while having treatment as your body needs the energy to repair your good cells affected by treatment and help you heal.
Look at the above links for tips on managing nausea, vomiting and diarrhea. If these tips don’t work to get your weight back to what it was before starting treatment and keeping it steady, ask to see a dietician.
Dietician
Most major hospitals have a dietician team that are experienced in helping people with cancer. However, your GP can also organise a referral for you to see a dietician in your community.
Dieticians can assess you and look at what nutrients you may be low in, and how many calories your body needs to function properly, give you energy, repair or replace damaged cells and keep you as healthy possible during treatment. They can help you make a diet plan that you will enjoy and can afford. They can also help advise you on any supplements you may need to take.
If you are losing weight, ask your GP or haematologist to refer you to a dietician.
Muscle is heavier than fat. And, when you are not as active as normal you can lose muscle mass.Â
Many people have long periods of time travelling, sitting at appointments or while having treatment. Many also have more bed rest due to fatigue, illness or hospital stays.
All this extra inactivity can result in muscle deterioration…and sadly, it can happen very quickly.
It is important to keep as active as possible even during treatment.
A gentle walk, stretching or other gentle exercise can help stop muscles wasting away. Further down the page we have a link to a video by an exercise physiologist with tips on how to stay active when tired or going through treatment.
Stress can cause changes to our hormones, which in turn can affect the way we carry our weight. It can also cause changes in our behaviours, eating, sleeping and exercise habits. For some, stress can cause weight gain, while for others it can cause weight loss.
Speak with your local doctor (GP) about having a mental health care plan done. This can help look at the extra stressors you have in your life due to lymphoma and its treatments and make a plan for how to manage your stress, mental health and emotions.
Everyone with any type of cancer should do this, and even your loved ones can have a plan done too.Â
Management
Managing stress when you have lymphoma will need more than one fix. Research shows that trying to do some form of physical activity every day can help reduce stress.
You may also need to consider the quality of your sleep, and if you are not getting enough good quality sleep you may need to improve this.Â
In some cases, you may find counselling or medicine helps to improve your stress and develop new ways of responding to stressful events and removing unnecessary stressors from your life.
Further down this page is a link to our side-effects page. Click on this and then scroll down the page and click on the side-effects you are interested in. We recommend you look at:
- Fatigue
- Sleep issues
- Mental health and emotions
Some herbs and nutritional supplements can interfere with your treatments for lymphoma. Some interactions can make the treatment less effective, while others may make your side-effects from treatment worse.
Always speak to your haematologist or pharmacist before taking anything new, and ask if it is safe to take during treatment.
Weight gain
Weight gain can be a distressing side-effect of treatments. Even if you have always been very active, have a good metabolism and continue to exercise during treatment, you may notice you put on weight easily, and have more difficulty losing it.
There are several reasons you may gain weight during treatment. Click on the headings below to learn more about possible causes of your weight gain.
Some cancer treatments can cause you to retain fluid. This fluid can sometimes leak out of your lymphatic system and into other parts of your body. This fluid retention is called oedema (sounds like eh-deem-ah).
Oedema can make you look puffy or swollen and can affect any part of your body. It is common to get oedema in your legs. When you have oedema in your legs, you may find that if you press on your leg with your finger, that when you remove your finger, and indentation of your finger remains where you pressed.
Oedema can also affect your heart and lungs. If this happens you may:
- have difficulty breathing or feel out of breath for no reason
- get chest pain or changes to your heart beat
- fell very unwell.
Management
Your doctor will likely do blood tests to check your liver and kidney function and also check a protein in your blood called albumin. You may need to:
- check your weight at the same time every day.
- have an infusion of albumin if this is low. Albumin helps to pull the fluid back into your lymphatic and blood vessels.
- take tablets to help remove the fluids such as frusemide (also called Lasix) which will make you wee (urinate) more. You may even be given this intravenously straight into your blood through a cannula or central line.
Many treatments for lymphoma include medicines called corticosteroids. Corticosteroids are similar to a hormone we naturally produce called cortisol and includes medicines called dexamethasone, prednisone, prednisolone or methylprednisone.
Corticosteroids can cause weight gain by:
- changing the way, and where your body stores fat
- affecting the electrolytes (salts and sugars) in your blood that can result in fluid retention
- increase your appetite so you may eat more than usual while taking them.
Talk to your doctor
Never stop taking your medicines without talking to your haematologist or oncologist first.Â
Stress can cause changes to our hormones, which in turn can affect the way we carry our weight. It can also cause changes in our behaviours, eating, sleeping and exercise habits. For some, stress can cause weight gain, while for others it can cause weight loss.
Speak with your local doctor (GP) about having a mental health care plan done. This can help look at the extra stressors you have in your life due to lymphoma and its treatments and make a plan for how to manage your stress, mental health and emotions.
Everyone with any type of cancer should do this, and even your loved ones can have a plan done too.Â
Management
Managing stress when you have lymphoma will need more than one fix. Research shows that trying to do some form of physical activity every day can help reduce stress.
You may also need to consider the quality of your sleep, and if you are not getting enough good quality sleep you may need to improve this.Â
In some cases, you may find counselling or medicine helps to improve your stress and develop new ways of responding to stressful events and removing unnecessary stressors from your life.
Further down this page is a link to our side-effects page. Click on this and then scroll down the page and click on the side-effects you are interested in. We recommend you look at:
- Fatigue
- Sleep issues
- Mental health and emotions
Some treatments can change the way your thyroid or adrenal glands work. Our thyroid and adrenal glands are organs that regulate many hormones in our body. For females, some treatments can also cause early menopause which also affects your hormones.
Hormonal changes can change the way our body burns energy and how it stores fat.
Talk to your GP (local doctor) or haematologist about having your hormones checked if you are having changes to your weight without obvious reasons.
For information on early menopause or ovarian insufficiency, click here.
Treatment related
When you’re having treatment for lymphoma there is a lot of time where you may be sitting and not being very active. Sitting in the waiting room for your appointments, sitting or laying down while having treatment, travelling to different appointments can all decrease your usual activity.
Side-effects
You may also feel very tired or have other side-effects from treatment that mean you need to rest more. While your body is likely using up a bit more energy than usual to help you heal from treatments, it may not be enough to make up for your decreased activity.Â
Diet versus activity
When your activity levels drop and you are still eating the same amount as before treatment, you may gain weight. This is because the calories you are getting from your diet are more than the calories you are burning up. The extra calories are stored in your body as fat.
Management
The first step to improving your activity levels is to make sure your symptoms and side-effects are properly managed. Click on the link further down this page to get more information on managing side-effects.
When you are feeling a bit low, many people turn to some of their favourite treats to comfort eat. Also, if you are feeling nauseous you may find snacking throughout the day is better for managing nausea than having larger meals less frequently. Depending on your comfort foods or snacks, these may be adding extra calories to your diet.
You may need to add more activity to your day to help burn more calories, or look at how you can cut down calories in your diet. Walking, even for 10-30 minutes every day can help slow down weight gain and also has been proven to improve symptoms of fatigue, depression and improve energy levels.
Managing side-effects
Knowing the cause of your weight changes is the first step to normalising your weight. If your weight changes are a result of other side-effects, you need to manage those. See the link below for tips on how to manage different side-effects at home and when you should get medical advice.
If you have finished treatment, you may like to visit our finishing treatment page to learn more about what to expect.
Support available
If you are concerned about the changes to your weight, speak with your doctor or nurse and ask what can be done to help you.Â
Depending on the cause of your weight changes your GP or haematologist may be able to refer you to a:
- dietician
- exercise physiologist
- physiotherapist
- occupational therapist
- psychologist.
Lymphoma Australia Nurses
Our nurses are here to support you. You can call our patient support line on 1800 953 081 Monday-Friday 9am to 4:30pm QLD time for nursing support and advice. You can also email our nurses at nurse@lymphoma.org.au
Summary
- Weight changes are common for people with lymphoma. It can be a symptom of lymphoma, side-effect of treatments or result due to changes in your activity levels or diet.
- Understanding the cause of your weight changes is important to prevent more problems and help to regulate your weight.
- There is support available. Talk to your nurse or doctor about what is available near you.
- Managing side-effects that are affecting your diet and activity levels can help to stop more changes in your weight.
- Talk to your doctor, nurse or call our Lymphoma Australia nurses if you are concerned about your weight.
