Fighting over food: patient and family understanding of cancer cachexia

Oncol Nurs Forum. 2009 Jul;36(4):439-45. doi: 10.1188/09.ONF.439-445.


Purpose/objectives: To investigate tensions over food that exist between patients with advanced cancer with cachexia and their families.

Research approach: Heideggerian phenomenologic inquiry using unstructured interviews.

Setting: A regional cancer center in the United Kingdom.

Participants: 8 patients with advanced cancer living with cachexia and 8 family members.

Methodologic approach: Singular unstructured interviews were recorded digitally, transcribed verbatim, and analyzed using thematic and interpretative phenomenologic analysis.

Main research variables: Cachexia and advanced cancer.

Findings: A fine line existed between offering food to a patient and forcing a patient to eat; often, conflict arose as a result. Contributors to that conflict focused on reduced dietary intake by the patient and the reaction to food refusal by the family, which frequently led to patients eating to please.

Conclusions: This study highlights the anxiety that surrounds eating and the distress it causes to patients and their families. This strain can escalate into arguments over food, causing negative repercussions for patients and their family members.

Interpretation: This is the first study to uncover tensions about eating as experienced by patients with advanced cancer and cachexia and their families. Nurses must consider this issue when designing and delivering effective care for this patient population.

MeSH terms

  • Cachexia / diet therapy
  • Cachexia / nursing*
  • Eating
  • Family Health
  • Family Nursing / methods*
  • Female
  • Humans
  • Male
  • Neoplasms / diet therapy
  • Neoplasms / nursing*
  • Neoplasms / psychology
  • Nursing Methodology Research
  • Oncology Nursing / methods*
  • Stress, Psychological / nursing*
  • Stress, Psychological / psychology