Rahma Cancer Patient Care Society

DURING TREATMENT

Nutrition for the Person with Cancer during Treatment

Nutrition is an important part of cancer treatment. Eating the right kinds of foods before, during, and after treatment can help you feel better and stay stronger.

Benefits of Good Nutrition during Cancer Treatment

Good nutrition is especially important if you have cancer because both the illness and its treatments can change the way you eat. Cancer and cancer treatments can also affect the way your body tolerates certain foods and uses nutrients.

The nutrient needs of people with cancer vary from person to person. Your cancer care team can help you identify your nutrition goals and plan ways to help you meet them. Eating well while you’re being treated for cancer might help you:

  • Feel better.
  • Keep up your strength and energy.
  • Maintain your weight and your body’s store of nutrients.
  • Better tolerate treatment-related side effects.
  • Lower your risk of infection.
  • Heal and recover faster.

Eating well means eating a variety of foods to get the nutrients your body needs to fight cancer. These nutrients include protein, carbohydrates, fat, water, vitamins, and minerals.

Cancer and Cancer Treatment Affect Nutrition

When you’re healthy, eating enough food to get the nutrients and calories you need is not usually a problem. Most nutrition guidelines stress eating lots of vegetables, fruits, and whole-grain products; limiting the amount of red meat you eat, especially those that are processed or high in fat; cutting back on fat, sugar, alcohol, and salt; and staying at a healthy weight. But when you’re being treated for cancer, these things can be hard to do, especially if you have side effects or just don’t feel well.

During cancer treatment you might need to change your diet to help build up your strength and withstand the effects of the cancer and its treatment. This may mean eating things that aren’t normally recommended when you are in good health. For instance, you may need high-fat, high-calorie foods to keep up your weight, or thick, cool foods like ice cream or milk shakes because sores in your mouth and throat are making it hard to eat anything. The type of cancer, your treatment, and any side affects you have must be considered when trying to figure out the best ways to get the nutrition your body needs.

When your cancer was first diagnosed, your doctor talked with you about a treatment plan. This may have meant surgery, radiation therapy, chemotherapy, hormone therapy, biologic therapy (immunotherapy), or some combination of treatments. All of these treatments kill cancer cells. But in the process, healthy cells are damaged, too. This damage is what causes cancer treatment side effects. Some of the more common side effects that can affect eating are:

  • Loss of appetite (anorexia)
  • Sore mouth or throat
  • Dry mouth
  • Dental and gum problems
  • Changes in taste or smell
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Feeling very tired all the time (fatigue)
  • Depression

You might – or might not – have any of these side effects. Many factors determine whether you’ll have side effects and how bad they’ll be. These factors include the type of cancer you have, the part of the body affected, the type and length of treatment, and the dose of treatment.

Many side effects can be controlled, and most go away over time after treatment ends. Talk with your cancer care team about your chances of having side effects and what can be done to help control them. After your treatment starts, tell your cancer care team about any side effects that aren’t controlled. Let them know if the medicines they’ve given you to help with side effects do not work, so that others can be used.

BEFORE TREATMENT BEGINS

Until you start treatment, you won’t know what, if any, side affects you may have or how you will feel. One way to prepare is to look at your treatment as a time to focus on yourself and on getting well. Here are some other ways to get ready:

Make plans now

You can reduce your anxiety about treatment and side effects by taking action now. Talk to your cancer care team about the things that worry you. Learn as much as you can about the cancer, your treatment plan, and how you might feel during treatment. Planning how you’ll cope with possible side effects can make you feel more in control and ready for the changes that may come.

Here are some tips to help you get ready for treatment:

  • Stock your pantry and freezer with your favorite foods so you won’t need to shop as often. Include foods you know you can eat even when you’re sick.
  • Cook in advance, and freeze foods in meal-sized portions.
  • Talk to your friends or family members about ways they can help with shopping and cooking, or ask a friend or family member to take over those jobs for you. Be sure to tell them if there are certain foods or spices you have trouble eating.
  • Talk to your cancer care team about any concerns you have about eating. They can help you make diet changes to help manage side effects like constipation, weight loss, or nausea.

For those whose cancer treatment will include radiation to the head or neck, you may be advised to have a feeding tube placed in your stomach before starting treatment. This allows feeding when it gets hard to swallow, and can prevent problems with nutrition and dehydration during treatment.

ONCE TREATMENT STARTS

Eat well

Your body needs a healthy diet to function at its best. This is even more important if you have cancer. With a healthy diet, you’ll go into treatment with reserves to help keep up your strength, prevent body tissue from breaking down, rebuild tissue, and maintain your defenses against infection. People who eat well are better able to cope with side effects of treatment. And you may even be able to handle higher doses of certain drugs. In fact, some cancer treatments work better in people who are well-nourished and are getting enough calories and protein. Try these tips:

  • Don’t be afraid to try new foods. Some things you may never have liked before may taste good during treatment.
  • Choose different plant-based foods. Try eating beans and peas instead of meat at a few meals each week.
  • Try to eat at least 2½ cups of fruits and vegetables a day, including citrus fruits and dark-green and deep-yellow vegetables. Colorful vegetables and fruits and plant-based foods contain many natural health-promoting substances.
  • Limit high-fat foods, especially those from animal sources. Choose lower-fat milk and dairy products. Reduce the amount of fat in your meals by choosing a lower-fat cooking method like baking or broiling.
  • Try to stay at a healthy weight, and stay physically active. Small weight changes during treatment are normal.
  • Limit the amount of salt-cured, smoked, and pickled foods you eat.

If you can’t do any of the above during this time, don’t worry about it. Help is available if or when you need it. Sometimes diet changes are needed to get the extra fluids, protein, and calories you need. Tell your cancer care team about any problems you have.

Snack as needed

During cancer treatment your body often needs extra calories and protein to help you maintain your weight and heal as quickly as possible. If you’re losing weight, snacks can help you meet those needs, keep up your strength and energy level, and help you feel better. During treatment you may have to rely on snacks that are less healthy sources of calories to meet your needs. Keep in mind that this is just for a short while – once side effects go away you can return to a healthier diet. Try these tips to make it easier to add snacks to your daily routine:

  • Eat small snacks throughout the day.
  • Keep a variety of protein-rich snacks on hand that are easy to prepare and eat. These include yogurt, cereal and milk, half a sandwich, a bowl of hearty soup, and cheese and crackers.
  • Avoid snacks that may make any treatment-related side effects worse. If you have diarrhea, for example, avoid popcorn and raw fruits and vegetables. If you have a sore throat, do not eat dry, coarse snacks or acidic foods.

If you’re able to eat normally and maintain your weight without snacks, then don’t include them.

Tips to get more calories and protein

  • Eat several small snacks throughout the day, rather than 3 large meals.
  • Eat your favorite foods at any time of the day. For instance, eat breakfast foods for dinner if they appeal to you.
  • Eat every few hours. Don’t wait until you feel hungry.
  • Eat your biggest meal when you feel hungriest. For example, if you are most hungry in the morning, make breakfast your biggest meal.
  • Try to eat high-calorie, high-protein foods at each meal and snack.
  • Exercise lightly or take a walk before meals to increase your appetite.
  • Drink high-calorie, high-protein beverages like milk shakes and canned liquid supplements.
  • Drink most of your fluids between meals instead of with meals. Drinking fluid with meals can make you feel too full.
  • Try homemade or commercially prepared nutrition bars and puddings.

Don’t forget about physical activity

Physical activity has many benefits. It helps you maintain muscle mass, strength, stamina, and bone strength. It can help reduce depression, stress, fatigue, nausea, and constipation. It can also improve your appetite. So, if you don’t already exercise, talk to your doctor about aiming for at least 150 minutes of moderate activity, like walking, each week. If your doctor approves, start small (maybe 5 to 10 minutes each day) and as you are able, work up to the goal of 150 minutes a week. Listen to your body, and rest when you need to. Now is not the time to push yourself to exercise. Do what you can when you’re up to it.

MANAGING EATING PROBLEMS CAUSED BY SURGERY, RADIATION, AND CHEMOTHERAPY

Different cancer treatments can cause different kinds of problems that may make it hard to eat or drink. Here are some tips on how to manage nutrition problems depending on the type of treatment you receive:

Surgery

After surgery, the body needs extra calories and protein for wound healing and recovery. This is when many people have pain and feel tired. They also may be unable to eat a normal diet because of surgery-related side effects. The body’s ability to use nutrients may also be changed by surgery that involves any part of the digestive tract (like the mouth, esophagus, stomach, small intestine, pancreas, colon, or rectum).

Radiation therapy

The type of side effects radiation causes depends on the area of the body being treated, the size of the area being treated, the type and total dose of radiation, and the number of treatments.

Side effects usually start around the second or third week of treatment and peak about two-thirds of the way through treatment. After radiation ends, most side effects last 3 or 4 weeks, but some may last much longer.

Chemotherapy

Chemotherapy (chemo) side effects depend on what kind of chemo drugs you take and how you take them.

Most people get chemo at an outpatient center. It may take anywhere from a few minutes to many hours. Make sure you eat something beforehand. Most people find that a light meal or snack an hour or so before chemo works best. If you’ll be there several hours, plan ahead and bring a small meal or snack in an insulated bag or cooler. Find out if there’s a refrigerator or microwave you can use.

Some side effects of chemo go away within hours of getting treatment. If side effects last longer, tell your cancer care team. There are things that can be done to lessen eating-related side effects. And prompt attention to eating-related side effects can help keep up your weight and energy level and help you feel better.

Source: The American Cancer Society

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