Nutrition During Cancer Treatment

Managing nausea and vomiting

Nausea can occur with or without vomiting. Be sure to tell you cancer care team if you have nausea or vomiting because there are medications that can help. Here are some nutrition tips:

• Eat 5-8 small meals/snacks a day instead of 3 large meals
• Rest with head elevated for 30-60 minutes after eating
• Consume drinks between meals rather than with meals. Things like tea or ginger ale may be soothing.
• Eat a few crackers or a piece of toast upon waking in the morning. This may help your stomach settle and prevent morning nausea.
• Avoid overly sweet or hot and spicy foods
• Avoid greasy or high fat foods
• Limit exposure to food smells
• Suck on hard candy such as ginger, peppermint, or lemon
• And if you are taking pain medications, take them with crackers or a light meal

Combating Diarrhea

Cancer treatments and medicines can cause your bowels to move much more often and become very loose. Three or more loose or watery stools a day is considered diarrhea. Uncontrolled, persistent diarrhea can lead to fluid loss also known as dehydration, weight loss, poor appetite, and weakness. Be sure to tell you cancer care team if you have diarrhea that lasts for more than 24 hours so they can help identify the cause and provide medications that can help.

Here are some tips for combating diarrhea:

• Drink plenty of mild, clear, non-carbonated liquids during the day.
• Drink liquids at room temperature instead of very hot or cold drinks.
• Limit caffeine
• Eat small, frequent meals and snacks throughout the day
• Focus on bland food with soluble fiber like bananas, oatmeal, white rice, white toast or applesauce.
• Avoid greasy, fried, spicy, or very sweet foods
• Limit milk or milk products to 2 cups a day. Yogurt and buttermilk are ok.
• Avoid drinks and foods that cause gas, such as carbonated drinks, gas-forming veggies, and chewing gum.
• Other examples of foods that may cause gas include apples, apple juice, broccoli, cauliflower, cabbage, corn, brussels sprouts, lentils, nuts, beans, peas, asparagus, spinach, sweet potatoes, onions, avocado, and beer.
• Drink and eat high-sodium (salt) foods like broths, soups, sports drinks, crackers, or pretzels.
• And drink and eat high-potassium foods like sports drinks, potatoes, and bananas.

Controlling Constipation

Certain medicines, changes in your eating habits, or being less active can cause your bowels to move less often and stools to become harder to pass.

If you’re constipated:

• Try eating high-fiber foods
  • Examples include bran cereals, popcorn, brown rice, whole-wheat breads and pastas, beans, nuts, fruits, and vegetables
• Drink extra fluids during the day
  • Drink 8-10 cups of liquid each day, such as water, juices, teas, or lemonade
  • A hot beverage may help to stimulate a bowel movement
• Eat at regular times each day
• And if possible, increase your physical activity

Difficulty Swallowing

Trouble swallowing solids or liquids can occur from cancer or cancer treatments, particularly for cancers of the head or neck.

If you are experiencing difficulties swallowing, contact your cancer care team right away. Your doctor may refer you to a speech language pathologist. This is a health professional who can teach you how to swallow better and how to decrease coughing and choking when you eat or drink.

You can also try:

• Eating soft foods or liquids.
• Eating 5-6 small meals or snacks throughout the day instead of 3 large meals
• Cut foods into small pieces and choose foods that are easy to chew and swallow
• Moisten foods with gravies and sauces
• If you’re unable to meet your nutritional needs with solid foods, try oral nutrition supplement shakes or other high-calorie protein liquids

Tips for Sore Mouth

Certain chemo drugs or radiation to the head and neck can cause mouth sores.

Here are some diet related tips and recommendations to help:

• Eat soft, bland foods like creamed soup, cooked cereal, macaroni and cheese, yogurt, or pudding
• Cut foods into small pieces
• Choose lukewarm or cool foods which can be soothing
• Avoid coarse, crunchy, dry, or rough foods
• Avoid tart, salty, hot, spicy, or acidic foods (particularly fruits and juices)
• Avoid alcohol, carbonated beverages, and tobacco
• Suck on ice chips
• If able, drink through a straw to bypass sores
• Rinse your mouth regularly with a salt, baking soda, and water solution
  • This helps prevent infections and helps your mouth feel better.
  • Gargle the mixture to relieve a sore throat, but don’t swallow it
• Your doctor may prescribe a “swish and swallow” mouthwash with a numbing agent if needed.

Taste and Smell Changes

Cancer and its treatment can change your senses of taste and smell. These changes can affect your appetite and are often described as a bitter or metallic taste. If you’re having these problems, try foods, marinades, spices, drinks, and ways of preparing foods that are different from those that you usually use. Also, keep your mouth clean by rinsing and brushing, which may help foods taste better.

Other suggestions include:

• Using plastic flatware and glass cups and plates
• Keep foods covered
• Try sugar-free lemon drops, gum, or mints
• Try fresh or frozen fruits and vegetables instead of canned
• Season foods with tart flavors like lemon wedges, lemonade, citrus fruits, vinegar, and pickled foods (but do not do this if you have a sore mouth/throat)
• Rinse your mouth with a baking soda, salt, and water mouthwash before eating to help foods taste better.
• If red meats taste strange, try other protein-rich foods like chicken, fish, eggs, or cheese
• Blend fresh fruits into shakes, ice cream, or yogurt
• To reduce smells, cover beverages and drink them through a straw.
• Choose foods that don’t need to be cooked.
• Avoid eating in rooms that are stuffy or too warm.