Nutrition During Cancer Treatment

During cancer treatment, eating can turn from an everyday task into a challenge. Nausea, changes in taste, mouth sores, and tiredness can all take away your desire to eat. At the same time, your body needs energy and protein to heal and to get through treatment. This article offers a few simple ways to cope. Every patient’s needs are different, so it’s best to build your eating plan with your doctor and a dietitian.

What is the goal?

The goal is not a “perfect diet.” The goal is to eat enough, as much as you can. Most patients need more protein and calories during treatment than a typical healthy person. Avoiding unwanted weight loss and keeping up your strength are the most important goals.

General principles

• Small, frequent meals. Instead of three big meals, eat five or six small ones.
• Put protein first. Include meat, chicken, fish, eggs, yogurt and cheese, beans and lentils, and nuts in your plan.
• Use your hungry hours. Eat your biggest meal when your appetite is best.
• Keep ready-to-eat food on hand. Before treatment starts, put some home-cooked meals in the freezer, and accept offers of help from people around you.
• Nourishing drinks. Smoothies, milk, soup, and juice are good substitutes for solid food on days when you have no appetite.
• Drink fluids between meals. Drinking a lot with a meal can fill you up quickly. Small sips with food are fine.

When you have no appetite

Low appetite is common and does not mean you are failing. A few ideas:

• Keep small, nourishing snacks within reach and eat every few hours, even if you aren’t hungry.
• Make food appealing: color, aroma, and your favorite dishes.
• Eat with friends or family.
• Light activity, such as a short walk, may help some people; talk with your doctor.

Nausea

Anti-nausea medicines are often most effective if taken before symptoms start. Talk with your doctor about them and take them as directed. Dry, plain food, served cold or lukewarm, is usually easier to tolerate, and the smell of hot food may make nausea worse.

Changes in taste and smell

• If food tastes too salty, use spices, fresh herbs, or fruit instead of salt.
• If food tastes too sweet, add a little lemon juice or vinegar, or a pinch of salt.
• If food tastes metallic or bitter, use plastic or wooden utensils, avoid metal containers, and eat chicken, dairy, or beans and lentils instead of red meat.
• If food smells bother you, eat food cold, sit away from the kitchen, and pick foods that don’t need much cooking.

Mouth sores and dry mouth

• Eat soft, moist, finely chopped food.
• Eat food cold or at room temperature. Ice chips can numb the mouth a little.
• Avoid sour, spicy, salty, hard, and hot foods.
• Give up smoking and alcohol.
• Keep your mouth clean with a soft toothbrush and gentle mouth rinsing, as your care team directs.
• See a dentist before starting chemotherapy, immunotherapy, or radiotherapy to the head and neck.

Food safety

Some treatments weaken the body’s defenses, so food poisoning is more dangerous. Wash your hands and utensils, cook meat, chicken, fish, and eggs thoroughly, wash raw fruit and vegetables well, keep raw meat apart from other foods, and refrigerate leftovers quickly. Don’t eat food that is spoiled or that you aren’t sure about. If your doctor has given you specific advice about certain foods (such as unpasteurized dairy or raw food), follow it.

Supplements and nutrition claims

Ready-made nutrition supplements (powders or drinks) can help when your appetite is low, but it’s best to check with your care team. Vitamins and herbal products may also interfere with treatment. No food, diet, or supplement cures cancer on its own. If someone promises you a “cure with this or that food,” talk with your doctor about it.

When to get help

Contact the care team if:

• You have lost a lot of weight in a short time
• You haven’t been able to eat food or drink fluids for several days
• You have severe vomiting or diarrhea
• You have signs of dehydration: dry mouth, little dark urine, dizziness
• You have a fever of 38 degrees Celsius or higher

Every patient’s treatment plan is different; ask your doctor about your own situation.