• Eating Well While Receiving Chemotherapy

    HCA image for chemo and food A diagnosis of cancer can be one of the worst things that can happen in your life. But chemotherapy , the very thing that is used to treat cancer, can be frightening too. Chemotherapy brings with it several side effects, one of the most common is difficulty eating. Here are some strategies to help you eat healthy while receiving chemotherapy.

    How Chemotherapy Affects Eating

    Chemotherapy acts by targeting and killing rapidly dividing cells, such as cancer cells. But, other cells in your body divide quickly as well, including the cells that line the gastrointestinal tract. Because of this, chemotherapy can have a profound impact on your ability to eat. Some chemotherapy side effects that affect your eating include:
    • Loss of appetite
    • Changes in taste and smell
    • Mouth tenderness, inflammation, and sores
    • Nausea and vomiting
    • Diarrhea
    • Constipation
    Eating well, however, is crucial to your recovery. According to the American Cancer Society (ACS), getting enough calories and nutrients while receiving chemotherapy can help you to:
    • Improve how you feel
    • Maintain strength, energy, and weight
    • Tolerate side effects from chemotherapy
    • Decrease the risk of infection
    • Be able to recover faster

    Tips for Eating

    At times, it may seem almost impossible to eat when you are receiving chemotherapy. The following suggestions may help you to get the much-needed nutrients and calories, while minimizing other side effects like nausea and vomiting.
    “The best advice for patients receiving chemotherapy is to eat smaller, more frequent meals of easily tolerated foods,” says Claire Saxton, who worked as an oncology dietitian with the Dana Farber Cancer Institute in Boston, MA. “Fatty, greasy foods and spicy foods,” Saxton notes, “might not be well-tolerated, so I steer clients away from these choices.”
    It is important to note that nutrition suggestions for a person receiving chemotherapy can be very different from what is recommended for daily healthy eating. Saxton explains, “Some patients need a reminder that this is a very different time for their bodies—they can and should throw some of the healthy eating rules out the window. I recommend not choosing reduced calorie, reduced fat, or light foods, but instead opting for the full-fat options when buying cheese, milk, and other foods.”

    Dealing With Loss of Appetite

    Most chemotherapy medicines cause some degree of appetite loss, which can range from mild to severe and can even lead to malnutrition. Usually, the change in appetite is temporary. Your appetite should return once you have completed chemotherapy. Until this happens, try some of the following tips:
    • Eat small meals every 1-2 hours, instead of the traditional three larger meals a day.
    • Eat high-protein, high-calorie foods.
    • Add extra calories and protein to meals by using ingredients like:
      • Milk powder
      • Protein powder
      • Peanut butter
      • Butter
      • Honey, jam, and sugar
      • Cheese and cream cheese
    • Use liquid supplements that are specially prepared with extra nutrients (found in most health food stores)
    • Drink shakes, smoothies, milk, and soup if chewing and eating solid food is a problem.
    • Eat soft foods that are easy to chew and swallow, such as:
      • Soft fruits (bananas, applesauce, watermelon, peaches, and pears)
      • Cottage cheese
      • Mashed potatoes
      • Macaroni and cheese
      • Custards and puddings
      • Scrambled eggs
      • Oatmeal or other cooked cereals
      Supplement meals with snacks that are rich in protein and calories, like:
      • Nuts
      • Cheese (soft, hard, and cottage)
      • Avocado spread on toast or crackers
      • Hard boiled eggs
      • Full-fat yogurt
    • Try to get a lot of calories at breakfast, as this may be the most tolerable meal of the day.
    • Avoid drinking fluids with meals to prevent feeling full from the fluid. Continue to drinks fluids throughout the rest of the day.
    • Eat in a pleasant environment with other people.

    Managing Nausea and Vomiting

    Nausea and vomiting are very common side effects of chemotherapy. If you are experiencing either, talk with your doctor. There are several drugs that prevent or alleviate nausea and vomiting. These medicines can be used before your symptoms appear.
    Some things you can do to help manage nausea and vomiting include:
    • Eat prior to chemotherapy treatment.
    • Avoid foods that are likely to cause nausea, such as spicy foods, greasy foods, or foods with strong odors.
    • Eat small meals.
    • Slowly sip fluids throughout the day.
    • Eat dry, bland foods like crackers, toast, or breadsticks throughout the day.
    • Sit up or lie down with the upper body raised for one hour after eating.
    • Avoid eating in the room where food was prepared. The odor may be too strong.
    • Avoid eating in a room that is too warm.
    • Rinse out your mouth both before and after eating.
    • Suck on hard candies, like peppermints or lemon drops, if there is a bad taste in your mouth.
    In addition, social support is critical to your recovery. Take advantage of the kindness of others. Let your family and friends help you. Ask for assistance with grocery shopping, meal preparation, and clean up. If you have no one to help you, investigate resources in your area, like a community assistance center, support groups, local churches, social service centers, or senior centers.
    If you are having problems eating, Saxton suggests asking your oncologist for a referral to a registered dietitian (RD). An RD can help you develop eating plans that may be better tolerated, while providing calories and nutrients.

    One Final—But Important—Note

    When you undergo cancer treatment, you can develop a weakened immune system. Avoiding foodborne illnesses is essential. Take the following steps to prevent this:
    • Wash all fruits and vegetables thoroughly, even if you plan on peeling the fruit or vegetable.
    • Wash your hands and food preparation surfaces before and after preparing food, especially after handing raw meat.
    • Thaw meat in the refrigerator, not on the kitchen counter.
    • Be sure to cook meat and eggs thoroughly.
    • Avoid raw shellfish and sushi.
    • Use only pasteurized or processed ciders and juices and pasteurized milk and cheese.
    And remember, your doctors may have some helpful hints of their own. There are also some medicines that can stimulate your appetite, reduce nausea, and generally boost your mood.

    RESOURCES

    American Cancer Society http://www.cancer.org/

    National Cancer Institute http://www.cancer.gov/

    CANADIAN RESOURCES

    BC Cancer Agency http://www.bccancer.bc.ca/

    Canadian Cancer Society http://www.cancer.ca/

    References

    Appetite changes. American Cancer Society website. Available at: http://www.cancer.org/Treatment/SurvivorshipDuringandAfterTreatment/NutritionforPeoplewithCancer/NutritionforthePersonwithCancer/nutrition-during-treatment-poor-appetite . Updated October 6, 2011. Accessed April 18, 2012.

    Chemotherapy. American Cancer Society website. Available at: http://www.cancer.org/docroot/MBC/content/MBC%5F6%5F2X%5FWhen%5FYou%5FHave%5FChemotherapy.asp?sitearea=MBC . Updated February 2008. Accessed March 11, 2010.

    Effect on cancer treatment on nutrition. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient/page3#Section%5F159 . Updated April 2009. Accessed March 11, 2010.

    Nutrition for the person with cancer during treatment. American Cancer Society website. Available at: http://www.cancer.org/Treatment/SurvivorshipDuringandAfterTreatment/NutritionforPeoplewithCancer/NutritionforthePersonwithCancer/nutrition-during-treatment-benefits . Updated October 6, 2011. Accessed April 18, 2012.

    Once treatment starts. American Cancer Society website. Available at: http://www.cancer.org/Treatment/SurvivorshipDuringandAfterTreatment/NutritionforPeoplewithCancer/NutritionforthePersonwithCancer/nutrition-during-treatment-once-treatment-starts . Updated October 6, 2011. Accessed April 18, 2012.

    Otto SE. Oncology Nursing . 4th ed. St. Louis, MO: Mosby, Inc; 2001.

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