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Understanding Cancer

Nutrition Guide

If you’ve been diagnosed with cancer, nutrition will likely become an important component of your treatment plan. You will find that there are certain foods that will help build your immune system, give you energy in the face of fatigue, keep nausea at bay, help you gain weight or lose weight, and more.

When you have cancer, though, you need to eat to keep up your strength to deal with the side effects of treatment. When you are healthy, eating enough food is often not a problem. But when you are dealing with cancer and treatment, this can be a real challenge.

When you have cancer, you may need extra protein and calories. At times, your diet may need to include extra milk, cheese, and eggs. If you have trouble chewing and swallowing, you may need to add sauces and gravies. Sometimes, you may need to eat low-fiber foods instead of those with high fiber. Your dietitian can help you with any diet changes you may need to make.

Staying healthy

Eat a variety of foods.  Each of the different food groups provides your body with essential and varied vitamins, minerals and nutrients. The following are recommended daily servings:

  • Vegetables:  3-5 servings
  • Fruit:   2-4 servings
  • Grains:  6-11 servings
  • Dairy:  2-3 servings
  • Meat:  2-3 servings

It’s especially important to choose a diet high in fiber and nutrients and low in fat, saturated fat and cholesterol. Also, limit your intake of sugar, sodium (salt) and alcohol, which have little nutritional value. Instead, eat plenty of whole grain breads, pastas, cereals and rice for their high fiber content, and choose dark green and deep yellow vegetables, citrus fruits, tomatoes, carrots and other vegetables for vitamin A, vitamin C, beta carotene and antioxidants. Avoid cured or smoked meats because of the high sodium content, and choose lean protein like fish, skinless chicken and turkey.  You can also get protein from eggs, low-fat dairy, beans and nuts.

Balance a healthy diet with regular exercise.  Talk with your doctor or dietician to determine your healthy weight and discuss exercise options. Exercise and a low fat diet will help you maintain a healthy weight. Choose activities you enjoy to motivate you to exercise.

Nutrition before treatment

Below are a few tips that you can use to prepare yourself and your cupboards for treatment:

  • Fill the refrigerator, cupboard, and freezer with healthy foods. Make sure to include items you can eat even when you feel sick.
  • Stock up on foods that need little or no cooking, such as frozen dinners and ready-to-eat cooked foods.
  • Cook some foods ahead of time and freeze in meal-sized portions.
  • Ask friends or family to help you shop and cook during treatment. Maybe a friend can set up a schedule of the tasks that need to be done and the people who will do them.
  • Talk with your doctor, nurse, or dietitian about what to expect. See the lists of foods and drinks that can help with many types of eating problems.

Nutrition during treatment

During treatment, you will likely have good days and bad days when it comes to food and eating. Here are some tips on how to manage your nutrition when you are in treatment:

  • Eat plenty of protein and calories when you feel up to it. This will help you keep up your strength and rebuild tissues that may be harmed by cancer treatment.
  • Eat when you have the biggest appetite. For most people, this is in the morning. You might want to eat a bigger meal early in the day and drink liquid meal replacements later on to supplement when you are not feeling well.
  • Eat those foods that you can, even if it is only one or two items. Stick with these foods until you are able to eat more. You might also drink liquid meal replacements for extra calories and protein.
  • Do not worry if you cannot eat at all some days. Spend this time finding other ways to feel better, and start eating when you can. Tell your doctor if you cannot eat for more than two days.
  • Drink plenty of liquids. It is even more important to get plenty to drink on days when you cannot eat. Drinking a lot helps your body get the liquid it needs. Most adults should drink 8 to 12 cups of liquid a day. You may find this easier to do if you keep a water bottle nearby.

Nutrition for Side Effects

Managing Nausea
There are many ways to combat nausea and still eat the healthy foods your body needs. Write down times you feel nauseous and try to determine what triggered it so you can avoid it in the future. Certain foods and smells may make you nauseous, especially overly sweet foods, fried, fatty and greasy foods, and any food with a strong odor. If food odors provoke nausea, stay away from the kitchen when foods are cooking.

Try to eat more when you’re feeling better. You can also eat six smaller meals throughout the day instead of three larger ones. Cold foods may be better than hot foods. Opt for soft, bland foods that are easy to digest and not too strong to the taste, such as rice, custard and poached eggs. Chew everything completely and eat slowly.

In the morning, eat dry toast or crackers to fight nausea. Throughout the day, drink fluids between meals instead of during, and try cool, clear beverages like cranberry juice, flat soda or Kool-Aid. If vomiting occurs, prevent dehydration with broths, ginger ale and fruit juices. Rinsing your mouth or sucking peppermint candy can eliminate bad tastes in your mouth, and holding a lemon wedge or fresh mint to your nose can calm nausea.

If you experience nausea during radiation or chemotherapy, avoid eating one to two hours before treatment.

Difficulty Eating
There may be times when you just don’t feel like eating. But it is crucial that your body receives the proper nutrients and fuel to help you recover and stay healthy. To get the most out of the foods you can eat, choose high protein foods when your appetite is at its peak and keep your favorite high-calorie snacks and supplements on hand for when you do feel hungry. If you are having difficulty eating due to a sore throat, mouth sores or dry mouth, you can make adjustments to the types and preparations of foods you eat.

Swallowing difficulty, mouth sores
Try to eat soft, non-irritating foods, and blend food with extra gravy, sauce, milk or non-citrus fruit juices to make it easier to swallow. You can also soak drier foods in liquid before eating them. Avoid dry, crisp or rough textured foods like raw vegetables or chips, and stay away from anything too spicy or acidic, like chili or salsa, citrus fruits and fruit juices. Also avoid very hot or very cold foods, and stay away from tobacco, caffeine and alcohol, as they may worsen the problem.

To lessen the pain of mouth sores, use a soft bristle toothbrush; if toothpaste irritates your mouth, use a mixture of ½ teaspoon of salt with four cups of cold water. You can also try gargling. Use a solution made up of: 1 quart of water, ½ teaspoon table salt and ½ teaspoon of baking soda.

Dry mouth
If you experience dry mouth, try eating moist foods and drinking lots of liquids. Take small sips of liquids between bites of food, and dunk foods like breads, donuts, cakes, crackers and cookies in milk or other high calorie beverages to moisten them. Use cream or cheese sauces, gravy, extra butter/margarine or broth to make dry meats and vegetables easier to swallow. Other foods that can be used to add moisture are syrups, mayonnaise, salad dressings, soups, dips, yogurt, sour cream and heavy cream.

Throughout the day, suck on lemon drops or tart candies, or chew gum to stimulate saliva. Sip on beverages throughout the day to keep the mouth from drying out. Try to breath through the nose instead of the mouth and use a humidifier in your home.  If the problem persists, discuss with your doctor.

If your appetite is weak or you feel nauseous in addition to eating difficulties, drink nutritional supplements like Ensure™ or Boost™. They are easy on your mouth and throat, and contain some protein and nutrients.

Loss of taste
If you experience a loss of taste, you may try brushing your teeth before eating anything. Tart or spicy foods may help spark taste buds. Or, simply select foods you’ve never eaten before so that you won’t have any taste expectations. Use marinades, lemon juice, flavoring extracts, gravies and various sauces (hot, sweet-n-sour, cream, BBQ) to find the best taste combination. Keep eating a wide variety of foods to find those that taste best and rely on those food items. Use these only if you do not have mouth sores. (See above)

If red meats are bitter or metallic tasting, try lean meats like chicken, turkey or seafood. If meat tastes funny, disguise the flavor by adding it to casseroles or soup dishes. Marinate meats in wines, soy sauce and fruit juices and experiment with herbs and spices.

To overcome a metallic taste, eat tart fruits or fruit flavored sour balls, which may help spark taste buds. If sweet foods are too sweet, sprinkle salt of them or cut the amount of sugar in recipes.  You can also substitute fruit nectars or juices for sugar. If salty foods taste too salty, add sugar or mix with other sweet foods. Eating sweet and salty foods in the same meal will counteract the intense flavors.

Diarrhea or Constipation
If you experience diarrhea, it’s important to replace lost fluids and salts. Drink beverages such as Gatorade™ or Pedialyte™. Take medicine, but only if you need it. Start with the BRAT diet: bananas, rice, applesauce and toast, plus drink plenty of clear liquids. Eventually, you can add pasta without sauce, white-meat chicken without the skin, scrambled eggs and other easily digested foods, as tolerated.

To ease constipation, eat plenty of dietary fiber: grains, beans and vegetables such as cauliflower or broccoli. Drink plenty of fluids, and make light exercise a part of your everyday schedule.

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