Diet and Cancer Treatment - Tips for Healthy Eating Fact Sheet No. 9.332 Food and Nutrition Series|Health

by L. Bellows and R. Moore* Quick Facts Cancer and Nutrition: The Eat a variety of foods — A low fat • Weight loss is a common Importance of Healthy diet with fruits, vegetables, whole- problem for individuals Weight Maintenance grains, nonfat dairy, and lean protein, undergoing cancer treatment. Weight fluctuations are a common is important for a nutritionally complete diet. • Cancer patients who retain problem for patients undergoing weight and maintain a good cancer therapy. Weight loss is the Limit caffeine, sugar, sodium (salt), nutritional state have fewer most frequent problem; however and alcohol — Exceptions for this complications from treatment. some cancer treatments may result guideline include those experiencing in weight gain. Those undergoing weight loss, as sugar and fat are good • Side effects of cancer or its treatment for cancer should try sources of calories that will aid in treatment, which may result in to maintain a healthy weight and weight gain. weight loss include: reduced avoid any losses or gains in weight. appetite, food taste changes, Hydration — Drink as many fluids Research shows that cancer patients diarrhea, constipation, and as possible throughout the day, as who retain weight and maintain a swallowing difficulty. dehydration may be a problem with good nutritional state have fewer nausea or diarrhea. If weight loss • Dietary changes can complications, regardless of the is a problem, try high calorie fruit overcome or reduce many of form of treatment (chemotherapy, smoothies or natural juices. these side effects. radiationtherapy or surgery). Fewer Refer to a medical professional complications result in shorter • Always consult a medical for advice on specific dietary hospital stays, reduced illness, fewer professional when seeking recommendations. infections, full benefit of treatment, alternative treatment for the and better maintenance of strength side effects of cancer therapy. and sense of well-being. A healthy Coping with Cancer’s Effect Some herbal, vitamin, and weight is important for increased on the Diet mineral supplements can energy levels, strength, and coping Cancer’s effect on the diet falls into interfere with recovery and with the side-effects of cancer two categories: cause unwanted side effects. treatment. 1. Dietary side effects of the • During treatment, immune disease itself system function may be Dietary Tips for Healthy Weight 2. Dietary side effects of cancer compromised. Always Maintenance treatment practice safe food handling The following tips are useful for all techniques. cancer patients. However, for those 1. Diet and Cancer — Side experiencing weight loss, maintaining Effects of the Disease a healthy weight by consuming Loss of Appetite and Unexplained protein and calorie rich foods should Weight Loss — Early signs and be a primary goal. symptoms of cancer include a © Colorado State University decreased ability to eat, digest, or Extension. 3/02. Revised 11/12. absorb food and nutrients. Cancer *L. Bellows, Colorado State University Extension food and www.ext.colostate.edu nutrition specialist and assistant professor; and R. Moore, cells may use the body’s energy graduate student. 11/2012 reserves, or release chemicals that alter the way that the body makes diarrhea or constipation, all of Unfortunately, mouth blindness energy from food. With a cancer which may adversely affect dietary may continue for up to a year after diagnosis, a lack of appetite may intake. These effects will end within radiation therapy is discontinued. also be a result of emotional distress a few days after the chemotherapy or depression. treatment ends. Cancer and Nutrition: Change in bowel habits or bladder Radiation Therapy —The dietary Guidance Before, During, function — Constipation, diarrhea, side effects of radiation therapy and After Treatment or pain when urinating may depend on the location of the result from colon, bladder and tumor. Therapy for a head or Before Cancer Treatment prostate cancer. This may interfere neck tumor often causes nausea, with proper nutrient absorption, fatigue, loss of appetite, swallowing • Make sure your body is well and result in loss of fluids and pain, dry mouth and altered taste. nourished before treatment electrolytes. Therapy for abdomen and pelvis begins. often cause nausea, diarrhea, • Plan ahead and stock your Trouble swallowing — Cancer kitchen with foods you can patients with difficulty in chewing increased urination, fatigue, and loss of appetite. easily prepare. or swallowing may result from head • Stock nutritious snacks in and neck cancer, or esophageal Changes in Food’s Flavor and case you do not feel like cancer. These symptoms may cause Odor preparing a meal. vomiting, early satiety, and fluid and • Have a support group to help electrolyte imbalances. Cancer often affects the taste with preparing meals and buds. Most commonly, it reduces grocery shopping. the ability to taste sweetness. • Look into a grocery delivery This changes the flavor of sweets, service for your home. desserts, fruits and vegetables. Some individuals may experience During Cancer Treatment an unusual dislike for certain foods, flavors or odors. This side effect may • Eat before treatment, but develop when unpleasant symptoms greater than 1-2 hours prior. are tied to a food recently eaten. A • Between treatments, nourish third potential taste change is an your body well when an increased liking for tart flavors, such appetite is present. as grapefruit and cranberry juice. • Be patient when coping with Alteration of taste, also called side effect such as changes in 2. Diet and Cancer — Side taste preference, loss of taste Effects of Treatment “mouth blindness,” seems to have a greater effect on diet than other side and smell. For chemotherapy, Surgery — The effects of surgery effects, specifically from head and these side effects usually last on the diet vary greatly depending neck radiation therapy. Spicy foods, throughout the treatment. on the location of the tumor and strongly flavored foods, or coarsely For radiation therapy, these the surgical procedure used. If textured fruits and vegetables symptoms may be present up surgery is scheduled, talk to the are most likely to be acceptable to 3 weeks post treatment. doctor about what side effects might to people with mouth blindness. develop. When a side effect does After Cancer Treatment develop, the doctor or registered • Cancer survivors are at an dietitian can assist with the diet. increased risk for developing Chemotherapy — Chemotherapy other cancers; therefore it works by destroying rapidly dividing is important to minimize cells such as cancer cells. It also ones risk through a nutrient destroys normal body cells that dense diet, healthy weight divide rapidly, such as those in bone maintenance, and living a marrow and those that line the small physically active lifestyle. For intestine. Side effects can include more information, see fact taste alterations, nausea, vomiting, sheet 9.313 Diet and Cancer Prevention. Table 1. Diet and Cancer — Strategies to Cope with Side Effects Troubled with: Try: Weight Loss Eat smaller, more frequent meals throughout the day. Use protein and calorie containing supplements (whey, soy powder). Keep nutrient dense foods in the home, and snack frequently.

Nausea or vomiting Eat five or six smaller meals instead of three larger meals. Drink beverages one-half to one hour before meals instead of with meals. Eat dry or salty foods: toast, crackers, corn chips or pretzels. Avoid high fat, greasy, spicy, or highly sweetened foods. Avoid foods with strong odors. Eat bland and soft foods on treatment days.

Constipation Drink plenty of fluids (8 cups per day), especially hot beverages and fruit juices. Incorporate more light physical activity into your day. Include foods high in fiber or bulk: raw fruits and vegetables, whole grains, bran.

Diarrhea Drink plenty of clear liquids. Eat applesauce, bananas, yogurt, canned peaches, rice or pasta, which are easy to digest. Avoid foods high in bulk or fiber: raw vegetables, whole grains, bran. Avoid foods that cause gas or cramping: beans, cabbage, broccoli, spicy foods, and carbonated beverages.

Sore Throat or Sore Mouth Eat foods that are soft and moist, and avoid dry, rough foods. Avoid alcohol and highly acidic foods (citrus, vinegar). Consume food at a soothing temperature.

Fatigue Snack frequently; keep nutrient dense foods on hand. Drink fluids throughout the day. Increase physical activity.

Dry mouth Eat sauces and gravies with food. Suck on hard, sugarless candies or chew gum. Dunk foods in beverages, such as coffee, tea or milk. Take a swallow of beverage with each bite of food. Use artificial saliva.

“Mouth blindness” Try highly spiced foods: pizza, spaghetti, chili. Eat strongly flavored foods: sauerkraut, cabbage, Limburger cheese. Emphasize texture in meals: crisp lettuce and fruits, creamy mashed potatoes, soft bread, crunchy toast.

Taste changes Add a teaspoon of sugar to vegetable cooking water.

Reduced ability to taste Glaze vegetables such as carrots with brown sugar. sweetness Increase the sugar in desserts and try new recipes.

Unusual dislike for meat Replace beef or pork with poultry, fish, eggs, milk products, legumes. Marinate meats. Cook meats in sauces or with tomatoes. Eat meats cold or at room temperature.

Increased likeness for tart Add lemon juice to foods. flavors Drink tart beverages: lemonade, grapefruit, cranberry juice.

Appetite loss Eat during best times. Use foods easy to prepare and eat. Eat smaller meals. Use liquid meals. Don’t drink with meals. Eat foods that are nutrient dense. Be physically active, which may serve as an appetite stimulant.

Swallowing or chewing Use softer foods. Drink with a straw. • Following the USDA Dietary nutrition care process. St. Louis, Guidelines is recommended Mo: Elsevier/Saunders. for proper nourishment, U.S. Department of Agriculture which can help rebuild and U.S. Department of Health strength after treatment. and Human Services. Dietary Guidelines for Americans, 2010. Additional Resources 7th Edition, Washington, DC: U.S. Government Printing Office, Keep the doctor informed of diet December 2010. problems, treatment difficulties, and changes in condition. Hospital Image Sources registered dietitians and those http://www.fsis.usda.gov/Be_ in private practice can help with FoodSafe/BFS_Photo_Gallery/ dietary problems. They help patients index.asp better understand the effects cancer Myfooddiary.com fruit smoothie and its treatment may have on diet. The American Cancer Society can provide names of support groups or other services, such as Meals on Wheels, available to cancer patients in the community. Contact the American Cancer Society at: 1-800-227-2345, or visit their website at: www.cancer.org. The National Cancer Institute offers a helpful booklet called Eating Hints for Cancer Patients: Before, During, and After Treatment. This document can be accessed online at: www.cancer.gov/cancertopics/ coping/eatinghints. Free copies can be obtained by calling 1-800-638- 6694. For additional help and information, call the Cancer Hotline at 1-800-4-Cancer.

References Duyff, ADA . American Dietetic Association: Complete Food and Nutrition Guide. Hoboken: John Wiley & Sons, Inc., 2006. Kushi LH, Doyle C, McCullough M, Rock CL, et al. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity. CA Cancer J CLin. 2012;62:30- 67. Colorado State University, U.S. Department of Mahan, L. K., Escott-Stump, S., Agriculture and Colorado counties cooperating. Raymond, J. L., & Krause, M. CSU Extension programs are available to all without discrimination. No endorsement of products mentioned V. (2012). Krause’s food & the is intended nor is criticism implied of products not mentioned.