The side effects of cancer and cancer treatment that can affect eating include:
- Anorexia (loss of appitite).
- Mouth sores.
- Dry mouth.
- Trouble swallowing.
Cancer and cancer treatments may affect taste, smell, appetite, and the ability to eat enough food or absorb the nutrients from food. This can cause malnutrition (a condition caused by a lack of key nutrients). Malnutrition can cause the patient to be weak, tired, and unable to fight infections or get through cancer treatment. Malnutrition may be made worse if the cancer grows or spreads. Eating too little protein and calories is a very common problem for cancer patients. Having enough protein and calories is important for healing, fighting infection, and having enough energy.
It is important to treat weight loss caused by cancer and its treatment.
It is important that cancer symptoms and side effects that affect eating and cause weight loss are treated early. Both nutrition therapy and medicine can help the patient stay at a healthy weight. Medicine may be used for the following:
- To help increase appetite.
- To help digest food.
- To help the muscles of the stomach and intestines contract (to keep food moving along).
- To prevent or treat nausea and vomiting.
- To prevent or treat diarrhea.
- To prevent or treat constipation.
- To prevent and treat mouth problems (such as dry mouth, infection, pain, and sores).
- To prevent and treat pain.
Surgery and Nutrition
Surgery increases the body’s need for nutrients and energy.
The body needs extra energy and nutrients to heal wounds, fight infection, and recover from surgery. If the patient is malnourished before surgery, it may cause problems during recovery, such as poor healing or infection. For these patients, nutrition care may begin before surgery.
It is common for patients to have pain, tiredness, and/or loss of appetite after surgery. For a short time, some patients may not be able to eat what they usually do because of these symptoms. Following certain tips about food may help. These include:
- Increase calories by frying foods and using gravies, mayonnaise, and salad dressings. Supplements high in calories and protein can also be used.
- Choose high-protein and high-calorie foods to increase energy and help wounds heal. Good choices include:
- Whole milk.
- Ice cream.
- Peanut butter.
- If constipation is a problem, increase fiber by small amounts and drink lots of water. Good sources of fiber include:
- Whole-grain cereals (such as oatmeal and bran).
- Whole-grain breads.
Stay away from carbonated drinks (such as sodas) and foods that cause gas, such as:
- Brussels sprouts.
- Green peppers.
Nutrition therapy is very important for patients who have a stem cell transplant.
Transplant patients have a very high risk of infection. High doses of chemotherapy or radiation therapy decrease the number of white blood cells, which fight infection. It is especially important that transplant patients avoid getting infections.
Patients who have a transplant need plenty of protein and calories to get through and recover from the treatment, prevent weight loss, fight infection, and maintain general health. It is also important to avoid infection from bacteria in food. Nutrition therapy during transplant treatment may include the following:
- A diet of cooked and processed foods only, because raw vegetables and fresh fruit may carry harmful bacteria.
- Guidelines on safe food handling.
- A specific diet based on the type of transplant and the part of the body affected by cancer.
- Parenteral nutrition (feeding through the bloodstream) during the first few weeks after the transplant, to give the patient the calories, protein, vitamins, minerals, and fluids they need to recover.
Anorexia (the loss of appetite or desire to eat) is one of the most common problems for cancer patients. Eating in a calm, comfortable place and getting regular exercise may improve appetite. The following may help cancer patients who have a loss of appetite:
- Eat small high-protein and high-calorie meals every 1-2 hours instead of three large meals. The following are high-calorie, high-protein food choices:
Cheese and crackers.
Powdered milk added to foods such as pudding, milkshakes, or any recipe using milk.
Finger foods (handy for snacking) such as deviled eggs, deviled ham on crackers, or cream cheese or peanut butter on crackers or celery.
- Add extra calories and protein to food by using butter, skim milk powder, honey, or brown sugar.
- Drink liquid supplements (special drinks that have nutrients), soups, milk, juices, shakes, and smoothies, if eating solid food is a problem.
- Eat breakfasts that have one third of the calories and protein needed for the day.
- Eat snacks that have plenty of calories and protein.
- Eat foods that smell good. Strong odors can be avoided in the following ways:
- Use boiling bags or microwave steaming bags.
- Cook outdoors on the grill.
- Use a kitchen fan when cooking.
- Serve cold food instead of hot (since odors are in the rising steam).
- Take off any food covers to release the odors before going into a patient’s room.
- Use a small fan to blow food odors away from patients.
- Order take-out food.
- Try new foods and new recipes, flavorings, spices, and foods with a different texture or thickness. Food likes and dislikes may change from day to day.
- Plan menus ahead of time and get help preparing meals.
- Make and store small amounts of favorite foods so they are ready to eat when hungry.
Changes in how foods taste may be caused by radiation treatment, dental problems, mouth sores and infections, or some medicines. Many cancer patients who receive chemotherapy notice a bitter taste or other changes in their sense of taste. A sudden dislike for certain foods may occur. This can cause a loss of appetite, weight loss, and a decreased quality of life. Some or all of a normal sense of taste may return, but it may take up to a year after treatment ends. The following may help cancer patients who have taste changes:
- Eat small meals and healthy snacks several times a day.
- Eat meals when hungry rather than at set mealtimes.
- Eat favorite foods and try new foods when feeling best.
- Eat poultry, fish, eggs, and cheese instead of red meat.
- Eat citrus fruits (oranges, tangerines, lemons, grapefruit) unless mouth sores are present.
- Add spices and sauces to foods.
- Eat meat with something sweet, such as cranberry sauce, jelly, or applesauce.
- Find non meat, high-protein recipes in a vegetarian or Chinese cookbook.
- Use sugar-free lemon drops, gum, or mints if there is a metallic or bitter taste in the mouth.
- Rinse mouth with water before eating.
- Eat with family and friends.
- Have others prepare the meal.
- Use plastic utensils if foods have a metal taste.
The main treatment for dry mouth is drinking plenty of liquids. Other ways to help relieve dry mouth include the following:
- Keep water handy at all times to moisten the mouth.
- Eat moist foods with extra sauces, gravies, butter, or margarine.
- Eat foods and drinks that are very sweet or tart (to increase saliva).
- Eat ice chips or frozen desserts (such as frozen grapes and ice pops).
- Drink fruit nectar instead of juice.
- Suck on hard candy or chew gum.
- Use a straw to drink liquids.
- Clean teeth (including dentures) and rinse mouth at least four times a day (after eating and at bedtime). Don’t use mouth rinses that contain alcohol.
Mouth Sores and Infections
- Eat soft foods that are easy to chew and swallow, such as the following:
- Soft fruits, including bananas, applesauce, and watermelon.
- Peach, pear, and apricot nectars.
- Cottage cheese.
- Mashed potatoes.
- Macaroni and cheese.
- Custards and puddings.
- Scrambled eggs.
- Oatmeal or other cooked cereals.
- Stay away from the following:
- Citrus fruits and juices, (such as oranges, tangerines, lemons, and grapefruit).
- Spicy or salty foods.
- Rough, coarse, or dry foods, including raw vegetables, granola, toast, and crackers.
- Use a blender to make vegetables (such as potatoes, peas, and carrots) and meats smooth.
- Add gravy, broth, or sauces to food.
- Drink high-calorie, high-protein drinks in addition to meals.
- Cook foods until soft and tender.
- Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth.
- Cut foods into small pieces.
- Use a straw to drink liquids.
- Numb the mouth with ice chips or flavored ice pops before eating.
- Clean teeth (including dentures) and rinse mouth at least four times a day (after eating and at bedtime).
Nausea caused by cancer treatment can affect the amount and kinds of food eaten. The following may help cancer patients control nausea:
- Eat before cancer treatments.
- Rinse out the mouth before and after eating.
- Eat foods that are bland, soft, and easy-to-digest, rather than heavy meals. Eat small meals several times a day.
- Eat dry foods such as crackers, bread sticks, or toast throughout the day.
- Slowly sip fluids throughout the day.
- Suck on hard candies such as peppermints or lemon drops if the mouth has a bad taste.
- Stay away from foods that are likely to cause nausea. For some patients, this includes spicy foods, greasy foods, and foods that have strong odors.
- Sit up or lie with the upper body raised for one hour after eating.
- Don’t eat in a room that has cooking odors or that is very warm. Keep the living space at a comfortable temperature with plenty of fresh air.
- Eat broth, soups, bananas, and canned fruits to help replace salt and potassium lost by diarrhea. Sports drinks can also help.
- Drink plenty of fluids during the day. Liquids at room temperature may cause fewer problems than hot or cold liquids.
- Drink at least one cup of liquid after each loose bowel movement.
- Stay away from the following:
- Greasy foods, hot or cold liquids, or caffeine
- High-fiber foods—especially dried beans and cruciferous vegetables(such as broccoli, cauliflower, and cabbage).
- Milk and milk products, until the cause of the diarrhea is known.
- Foods and beverages that cause gas (such as peas, lentils, cruciferous vegetables, chewing gum, and soda).
- Sugar-free candies or gum made with sorbitol (sugar alcohol).
Low White Blood Cell Counts and Infections
The following may help cancer patients prevent infections when white blood cell counts are low:
Stay away from:
- Raw eggs or raw fish.
- Old, moldy, or damaged fruits and vegetables.
- Food sold in open bins or containers.
- Salad bars and buffets when eating out.
- Wash hands often to prevent the spread of bacteria.
- Thaw foods in the refrigerator or microwave. Never thaw foods at room temperature. Cook foods immediately after thawing.
- Keep hot foods hot and cold foods cold.
- Cook all meat, poultry, and fish until well done.
- Refrigerate all leftovers within 2 hours of cooking and eat them within 24 hours.
- Buy foods packed as single servings, to avoid leftovers.
- Do not buy or eat food that is out of date.
- Do not buy or eat food in cans that are swollen, dented, or damaged.
Dehydration (Lack of Fluid)
- Drink 8 to 12 cups of liquids a day. This can be water, juice, milk, or foods that have a lot of liquid in them, such as ice pops, flavored ices, and gelatins.
- Stay away from drinks that have caffeine in them, such as sodas, coffee, and tea (both hot and cold).
- Take a water bottle whenever leaving home. It is important to drink even if not thirsty.
- Drink most liquids between meals.
- Use medicines that help prevent and treat nausea and vomiting.
To prevent constipation:
- Eat more fiber-containing foods. Twenty-five to 35 gms of fiber a day is best. Food labels show the amount of fiber in a serving. (Some sources of fiber are listed below.) Add a little more fiber each day and drink plenty of fluids at the same time to keep the fiber moving through the intestines.
- Drink 8 to 12 cups of fluid each day. Water, prune juice, warm juices, lemonade, and teas without caffeine can be very helpful.
- Take walks and exercise regularly. Wear shoes made for exercise.
To treat constipation:
- Continue to eat high-fiber foods and drink plenty of fluids. Try adding wheat bran to the diet; begin with 2 heaping tablespoons each day for 3 days, then increase by 1 tablespoon each day until constipation is relieved. Do not take more than 6 tablespoons a day.
- Stay physically active.
- Use over-the-counter constipation treatments, if needed. These include:
- Bulk-forming products (such as Citrucel, Metamucil, Fiberall, and Fiber-Lax).
- Stimulants (such as Dulcolax and Senokot).
- Stool softeners (such as Colace and Surfak).
- Osmotics (such as milk of magnesia).
- Cottonseed and aerosol enemas can also help. Do not use lubricants such as mineral oil because they may keep the body from using important nutrients the way it should.
Good food sources of fiber include the following:
- Legumes (beans and lentils).
- Cold cereals (whole grain or bran).
- Hot cereals.
- Whole-grain breads.
Nutrition in Cancer Prevention
Following certain dietary guidelines may help prevent cancer.
The American Cancer Society and the American Institute for Cancer Research both have dietary guidelines that may help prevent cancer. Their guidelines are a lot alike and include the following:
- Eat a plant-based diet with a large variety of fruits and vegetables.
- Eat foods low in fat.
- Eat foods low in salt.
- Get to and stay at a healthy weight.
- Be active for 30 minutes on most days of the week.
- Drink few alcoholic drinks or don’t drink at all.
- Prepare and store food safely.
- Do not use tobacco in any form.