Eating During Cancer Treatment

WHAT YOU SHOULD KNOW:

• Cancer treatment may include chemotherapy (kee-moh-THER-ah-pee), radiation therapy, surgery, hormone therapy and immunotherapy (im-u-noh-THER-ah-pee). Cancer treatment can cause several side effects (changes to your body) including changes to your appetite and problems eating. Side effects can be different for different people. The side effects a person may have depends on the part of the body being treated, the type and length of treatment, and the dose (amount) of treatment.
  
  
• Your diet during cancer treatment should have enough calories and protein to repair and build new body tissues. The kind of foods that are best for you will depend on the side effects that you have and the part of your body affected by cancer. During cancer treatment, you may need to try foods and drinks that are not part of your usual diet. You may also need to make certain diet changes if you have other health problems like diabetes, high blood cholesterol or high blood pressure.

AFTER YOU LEAVE:

What can I eat and drink during cancer treatment? The amount of calories and protein you need depends on your weight. Your caregivers may want to check your weight often, and have you eat more if you are losing weight. Nutrition supplements may help you get the nutrition you need without having to eat a large amount of food. Nutrition supplements provide extra calories, protein, vitamins and minerals. If you cannot eat enough food to keep from losing weight, your caregivers may want you to get nutrition through a feeding tube. Getting the right nutrition may help your body fight the cancer, and help you recover faster after cancer treatments. Ask your caregiver, a dietitian, or a nutritionist any questions you may have about eating during cancer treatment. A dietitian or nutritionist works with you to find the right foods for you.

How should I eat if I have a decreased appetite, and I have lost weight?

• Eat small meals and snacks every few hours, rather than eating large meals. Plan to eat as much as you can during the time of day when your appetite is best. Keep favorite foods on hand to help you eat more.
  
  
• Add extra calories to your foods. Do this by adding butter, margarine, milk, cheese, sour cream, salad dressings, eggs, and mayonnaise to main dishes, sandwiches, and salads. Add whipped cream, honey, jam, sugar, granola, and dried fruits to desserts. To add extra protein, add dairy products such as cheese, milk, nonfat instant dry milk, ice cream, and yogurt to foods. You can also add instant breakfast powder, eggs, nuts, peanut butter, meat or beans to foods for extra protein.
  
  
• Limit the amount of foods you eat that do not have very many calories, such as plain coffee or tea, and clear soups. Avoid high-fiber foods (such as foods made with bran, raw fruits and vegetables, and beans) as they can make you feel full. Drink only small amounts of liquids with meals, or drink liquids between meals because liquids can make you feel full.

How should I eat if I feel full quickly after eating? Eat small meals throughout the day instead of large meals. Eat healthy snacks between meals. Drink liquids thirty minutes before or after meals, rather than drinking fluids with meals. Chew foods for a long time and eat slowly. Avoid eating gas-producing and high-fiber foods because they will make you feel full too quickly. Some examples of gas-producing foods are cabbage, broccoli, cooked dried beans, cauliflower, onions, and garlic. Some examples of high-fiber foods are whole-grain foods, fresh fruits and vegetables, and beans.

How should I eat if I have nausea or vomiting?

• Eat small meals every few hours instead of eating large meals. Foods that may be easier for you to eat include toast, crackers, pretzels, yogurt, cream of wheat, boiled potatoes, rice or noodles. Sip liquids often throughout the day, but avoid drinking liquids during meals. Foods that are cold or at room temperature may be easier to eat than foods that are hot.
  
  
• Fatty, greasy, spicy, high-fiber, and gas-producing foods may make nausea worse. High-fiber foods include fresh fruits and vegetables, whole-grain cereals and breads, and beans. Gas-producing foods include cabbage, broccoli, and dried cooked beans. Avoid foods that have strong odors. Drinks that contain alcohol may also cause nausea.
  
  
• Do not skip meals. Let someone else prepare meals, and avoid being around the smell of food until it is time to eat. Avoid eating your favorite foods around the time of your treatment because you are more likely to have nausea during this time. You may lose interest in your favorite foods if you try eating them while you have nausea.
  
  
• Wear loose clothing. Avoid lying down right after eating. If you need to lie down, use several pillows to keep your head high. Your caregiver may be able to order medicines to decrease or prevent nausea.

• Drink plenty of liquids to replace fluids lost during vomiting. Drink sips of clear liquids such as apple juice or clear soda. When you are feeling better, you may start to eat soft foods such as cream of wheat, pudding, frozen yogurt or gelatin. When you are ready to start eating solid foods, try eating dry starchy foods such as cooked plain macaroni, rice, potatoes, or plain bread. Slowly increase the amount of food, and add other foods to your diet. You may want to avoid eating in the hours right before and after cancer treatment. You are more likely to vomit during this timeframe.
  
  

How should I eat if I have diarrhea or constipation?

• Work with your caregiver to find out what is causing your diarrhea. Some medicines may help to decrease the amount of bowel movements you have. Be sure to drink plenty of liquids to prevent dehydration. Dehydration is a condition that results after not drinking enough, or losing too much body water. Good liquids to drink are water, diluted juices, broth and caffeine-free tea or coffee. Eat five or six small meals each day instead of large meals. Include foods that are low in fiber such as mashed potatoes, yogurt, noodles, applesauce, toast, cottage cheese, rice, eggs, and cream of wheat.
  
  
• Avoid caffeine, alcohol and prune juice because they may increase the number of bowel movements you have. Lactose (a type of sugar) in milk products can cause some people to have more bowel movements. If you have problems with lactose, try drinking milk that has the lactase enzyme added to it. The lactase enzyme helps your body digest the lactose found in milk products. You may also choose to switch to lactose-free milk for a period of time.

• Increase the amount of liquids you drink each day to at least eight cups or more. Drink a hot liquid about one-half hour before the usual time that you have a bowel movement. Eat foods that naturally cause more bowel movements such as prunes, prune juice, rhubarb, and papaya.
  
  
• Ask your caregiver if you may increase the amount of fiber in your diet. Extra fiber may help you to have more bowel movements. Some high-fiber foods include bran cereal, raw fruits and vegetables, cooked dried beans, and whole grain breads. Talk with your caregiver about using a fiber supplement or laxative. If you are able to, increase the amount of physical activity that you do every day. Walking, swimming, and biking are exercises that may decrease problems with constipation.

How should I eat if I have thick saliva?

• Eat soft, moist foods. Foods and drinks that are tart such as lemon-lime soda, tea with lemon, citrus fruit, hard sour candies, and fruit ice may help to thin saliva. Milk products may increase the thickness of saliva. Try low-fat milk products like skim milk, or foods with added milk such as custard, instead of avoiding milk products. Try soymilk because it is less likely to cause thick saliva. Drink clear liquids after eating or drinking soy or milk products.
  
  
• Avoid foods that are hard or dry, such as tough meats, crackers, chips, and granola bars. Avoid thick liquids and foods. Limit caffeine, alcohol, and spicy foods in your diet. Rinse your mouth with club soda or baking soda mixed with water throughout the day.

How should I eat if I have trouble swallowing? You may need a swallowing test to find out what kinds of foods and liquids are best for you. Eat small meals that are high in calories and protein every few hours. Drink liquids between meals instead of with meals to avoid getting full too quickly. Eat moist foods, or make dry foods moist with gravies, sauces and dressings. When foods get stuck in your throat, wash them down with liquids. Swallowing may be easier if you use a straw.

How should I eat if I have a sore mouth, tongue or throat?

• Eat small meals that are high in calories and protein every few hours rather than eating three large meals. Eat foods that are soft, moist and blenderized (foods thinned in a blender) because they are easy to chew and swallow. Use liquids to make dry foods moist, such as gravy on bread, and milk on dry cereal. Drink plenty of liquids. Brush your teeth and rinse your mouth often to decrease pain and help your appetite. Your caregiver may suggest medicine to help decrease the pain.
  
  
• Avoid foods and drinks that can increase mouth and throat pain. This may include foods and drinks that are spicy, salty, tart, very hot, or very cold. Avoid foods that are crisp or rough. Drinks with alcohol, and chewing tobacco or smoking can also make your mouth hurt more. If you take a vitamin and mineral supplement, crush it and add it to a food.

How should I eat if my mouth is dry?

• Drink caffeine-free cold liquids every few minutes to decrease mouth dryness. Eat soft, moist foods. Make dry foods moist with sauces, gravies and salad dressings. These foods can also help to lubricate your mouth and make it easier to chew and swallow foods. Take a sip of liquid with every mouthful of food to help you chew and swallow the food.
  
  
• Try eating sweet or tart foods and liquids because they may help your mouth make more saliva. Some examples of sweet or tart foods are lemonade, orange-flavored soft drinks, frozen juice bars, and sherbets. Sucking on hard candy, popsicles or chewing sugar-free gum may also help to make more saliva. Keep your lips moist with lip moisturizers. Avoid salty foods, drinks that contain alcohol, and mouthwash because they can dry your mouth.

How should I eat if my sense of taste or smell changes?

• Eat small meals that are high in calories and protein every few hours. Try different flavors like tart, salty, or sweet to find foods that you like. Try adding seasonings and flavorings to make foods taste better. If meats taste like metal or are bitter, try serving them cold or at room temperature. Add meat to casseroles or marinate meats in pineapple juice, wine, or other liquids before cooking to improve the taste. If you cannot eat meat, choose other foods that have protein in them. Some ideas are cheese, milk, pudding, yogurt, shakes, eggs, nuts, and tofu. Eat with plastic utensils to decrease the taste of metal in your mouth.
  
  
• Drink plenty of liquids. Drink liquids with meals to decrease the bad taste in your mouth. Foods that are cold or at room temperature may taste better than hot foods. Make foods less salty or less sweet if these flavors taste bad. Eat more of your favorite foods and comfort foods. Brush your teeth and rinse your mouth often between meals to help decrease the bad taste in your mouth. Rinse your mouth with baking soda mixed in water.

How should I eat if I often feel tired?

• Cooking food takes effort and can use up your energy. Buy foods that need little or no work to prepare. Keep many kinds of food on hand, and try new things often. Packaged puddings, gelatin desserts, cheese sticks, peanut butter and cracker packs, boxed juices, frozen entrees and high-calorie nutrition supplements are some examples.
  
  
• Ask family and friends to help you shop for food and keep a good supply of things you like at home. Ask others to help you make batches of food and freeze extra for later. Be sure to drink plenty of liquids. Most adults should drink at least eight (8-ounce) cups of water each day. If you do not drink enough liquids, you may feel more tired. Try to do light exercise. Exercise can help you have more energy.

How should I eat if I gain weight? Choose healthy foods such as vegetables, fruits, whole grains and beans. These foods are naturally low in calories and are high in nutrients and fiber. Eat only when you are hungry. Try not to eat because you are feeling stressed, afraid or sad. Decrease the amounts of the foods you eat. Try measuring the serving size listed on the food labels of the foods that you eat regularly. This can help you to keep track of how much you are eating.

What are some other diet suggestions?

• People who are going through cancer treatment may have a hard time fighting infections. It is important to try to avoid infections and food poisoning. To avoid food poisoning, wash all raw fruits and vegetables very well. Scrub the surface of melons before cutting them. Wash your hands before and after preparing foods, especially after handling raw meat. Wash all surfaces where food was prepared, such as the countertop and cutting boards. Thaw meat in the refrigerator instead of on the counter. Cook meats and eggs very well. Avoid eating raw shellfish, and drink only pasteurized juices, milk and cheese.
  
  
• Some vitamins, minerals, herbs, and medicines may interact (not work well with) your cancer treatment. Tell your caregiver about all other medicines, vitamins, and other products that you use. Always talk with your caregiver before taking any new vitamin, mineral, herb, or medicine during your cancer treatment.

Risks: Cancer treatment can cause problems with eating and drinking. You may have weight changes, and problems such as malnutrition, dehydration, and vitamin or mineral deficiencies. You may also feel too tired to do your usual activities, and you may feel very sad. Getting the right nutrition may help you feel better, and prevent weight changes and other medical problems. Talk with your caregiver if you are unable to eat as much as you should, or are having other problems with eating, drinking and weight changes.

CONTACT A CAREGIVER IF:

• You throw up for more than three days in a row.
  
  
• You lose your ability to swallow.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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