Side effects of cancer therapy may affect your eating habits and nutritional status.

The following pages

contain suggestions for managing common eating difficulties during and after treatment.
Loss of appetite is common in people with
cancer and can lead to weight loss and
undernutrition (malnutrition).
Poor nutrition can slow the body’s ability to
heal. Severe malnutrition can interfere with
proper functioning of the heart, liver, kidneys,
and immune system.
Try these ideas for improving your appetite and maintaining calorie and protein intake during cancer
treatment:
ü Eat five or six smaller meals per day.
ü Eat the largest meal when you are hungriest.
ü Start with high-protein foods while your appetite is strongest.
ü Keep favorite high-calorie foods and beverages within easy reach.
ü Try to be as physically active as you are able to be to help stimulate your appetite.
ü Enlist the help of your loved ones and caregivers to help with purchasing and preparing food.
ü Ask to talk with a registered dietitian for personalized help.
ü In certain situations, your doctor may prescribe a medication to help improve your appetite.
Nausea and vomiting can be caused
by chemotherapy or from radiation
therapy to the stomach, abdomen, or
brain. Being nauseated or vomiting
because of cancer treatment can make
it difficult for a person to eat and
drink.
Try these ideas for managing nausea and vomiting:
ü Eat small amounts of food more often.
ü Small portions of meals and snacks are often more easy to tolerate than large.
ü Eating foods and sipping on clear liquids at room temperature or cooler may be easier to tolerate.
ü Avoid high-fat, greasy, spicy, or overly sweet foods.
ü Avoid foods with strong odors.
ü Sip on beverages between meals rather than with meals.
ü Eat sitting up and keep head raised for about an hour after eating.
ü For vomiting, avoid eating or drinking until vomiting is controlled—then try sipping on small amounts of clear liquids such
as cranberry juice or broth. Nibbling on plain foods such as pretzels or crackers may also help.
ü Take anti-nausea medicine as prescribed. If it is not controlling symptoms, contact the healthcare professional that
prescribed the antinausea medicine, and let him or her know what is happening.
Evaluate if you are feeling indigestion or reflux versus nausea. Discuss your symptoms with your healthcare professional as
treatment options for each condition vary.
Fatigue is the most common side
effect for those diagnosed with
cancer. It can be related to the
cancer itself or can be one of the
effects of cancer treatment. Eating
regularly and being as physically
active as you are able may help to
relieve your fatigue and enhance
your mood.
Try these ideas for managing fatigue:
ü Temporarily rely on ready-to-eat foods like frozen dinners, fruits, and vegetables.
ü Prepare food when you feel your best and freeze leftovers in meal-size portions.
ü Try to drink plenty of fluids. Being dehydrated can make fatigue worse. Aim for at least 8 cups of
hydrating fluid each day unless advised to restrict fluids for another medical condition. Hydrating
fluids include water, clear juices, sports drinks, broth, or weak tea.
ü Accept help with meals from friends and family members.
Diarrhea and Constipation
Diarrhea can be caused by the
cancer itself, certain chemotherapy
agents and medicines, or because of
radiation therapy to the abdomen
and pelvis. Diarrhea is having
frequent and loose watery stools.
Try these ideas for managing diarrhea:
ü Drink plenty of liquids such as water, clear juices, sports drinks, broth, weak tea, or oral
rehydration solutions (available over-thecounter at most pharmacies).
ü Eat small amounts of soft, bland foods. Consider a diet that consists of water soluble
fibercontaining foods such as bananas, white rice, applesauce, and white toast.
ü Decrease intake of high fiber foods during this time. These include foods containing nuts and
seeds, raw vegetables and fruits, and whole grain breads and cereals.
ü Eat small amounts of food throughout the day rather than fewer large meals.
ü Take anti-diarrhea medicine as prescribed. If the medicine is not controlling the diarrhea, call the
healthcare professional that prescribed the medicine.
Constipation can be a symptom of the cancer itself or it can be caused by medicines used to treat cancer or
manage pain. Constipation is when bowels do not move regularly and when stools become hard and
difficult to pass.
Try these ideas for managing constipation:
ü Drink more healthy beverages to help keep your digestive system moving, especially water, prune
juice, warm juices, decaffeinated teas, and hot lemonade.
ü Increase intake of high fiber foods such as whole grains, fresh and cooked vegetables, fresh and
dried fruits, and foods containing peels, nuts, and seeds.
ü Work with your healthcare team to set up an individualized bowel regimen. This program may
include stool softeners and gentle, nonhabit forming laxatives.
ü Increase your physical activity as you are able, such as taking a walk or doing limited exercise
every day. Ask your healthcare team how much exercise is right for you
Changes in taste and reactions to smells are common problems that can happen while undergoing and
recovering from cancer treatment. These changes can affect your desire to eat.
Try these ideas for managing taste and smell changes:
• Choose foods that appeal to you. Often, moist and naturally sweet foods such as frozen melon balls,
grapes, or oranges work well. Some find tart foods and beverages appealing.
• Try eating cooler temperature foods, rather than hotter temperature foods, as they have less aroma
and taste.
• Try marinades and spices to mask strange tastes.
• Red meat often becomes less appealing, so try poultry, fish, beans, nut butters, or eggs.
• If foods taste bitter or salty, try adding small amounts of sugar.
• Brush your teeth and tongue and rinse your mouth regularly, especially before eating.
• Rinse your mouth several times a day with 1 to 2 ounces of a homemade salt and baking soda
solution (one quart of water combined with one teaspoon of salt and one teaspoon of baking soda)
or an alcohol-free mouth rinse.
A common side effect of certain chemotherapy agents or radiation therapy to the mouth and throat is an
inflammation of the mucus membranes that line the mouth and throat. This condition is called
mucositis and it can make it difficult to eat and swallow.
Try these ideas for managing a sore mouth or throat:
ü Eat soft, moist foods with extra sauces, dressings, or gravies.
ü Avoid dry, coarse or rough foods.
ü Avoid alcohol, citrus, caffeine, vinegar, spicy foods, and
acidic foods (like tomatoes).
ü Experiment with temperatures of foods (warm, cool, or icy)
to find which temperature is the most soothing.
ü Drink plenty of fluids. Focus on warm or cool milk-based
beverages, non-acidic fruit drinks (diluted if necessary), “flat”
carbonated beverages, and cream or broth-based soups.
ü Rinse your mouth several times a day with 1 to 2 ounces of
a homemade salt and baking soda solution (one quart of
water combined with one teaspoon of salt and one teaspoon
of baking soda). Sip, swish, and then spit the solution to rinse
and clean your mouth. Do not swallow.
ü Speak with your healthcare professional about medications
that can numb or soothe your mouth or throat
Weight gain can occur during or after treatment for hormone-sensitive cancers such as breast or prostate cancers.
Inactivity can also cause weight gain. In addition, medicines such as steroids used as a part of some cancer
treatments can contribute to increased weight.
Try these ideas for managing unwanted weight
gain:
• Try to focus on foods naturally low in calories
and high in fiber to help you feel full, such as
vegetables, fruits, whole grains, and beans.
Include small amounts of higher calorie foods
that you enjoy most, and be sure to savor them
for the most satisfaction.
• Pay attention to portion sizes and fill most of
your plate with lower calorie plant foods.
• Eat only when you are physically hungry. Try
to get regular physical activity to help you
reduce fatigue, control weight gain, and
improve mood.
Cancer and cancer treatment can weaken the
immune system and increase the risk of
infection. White blood cells are an essential
part of the body’s defense against infection
because they attack and destroy germs after
they enter the body.
The risk of infection increases as the number
of white blood cells decreases as the result of
some cancer treatments. This condition is
called neutropenia. If you develop neutropenia
it is very important to protect yourself against
infection. Contact your healthcare team right
away if you think an infection is developing.
The following may be signs of infection:
ü A temperature greater than 100.5º F.
ü Fever
ü Shaking, chills
ü Swelling
ü Redness of any part of the body.
ü If you experience a period of time when
your white blood cell counts are low, eat a
“safe food” diet to avoid harmful bacteria
and food-borne illness
Sara, a 45-year-old woman undergoing chemotherapy for breast cancer, is experiencing severe
nausea and a sore mouth. She has lost 4 kg over the last month and complains of fatigue, which
makes it hard to prepare meals. Sara says, "I can't stand strong smells, and everything tastes
metallic."

ü What practical strategies can Sara use to manage her nausea and improve her appetite?
ü How can Sara adjust her meals to accommodate her sore mouth?
ü Suggest 2-3 quick, easy-to-prepare snack ideas for Sara to help her maintain her calorie intake.