Nutrition Plans for Cancer Patients Undergoing Treatment

Here are some suggested foods to help with nausea:

• Cream of wheat, oatmeal and cold cereal
• Soups
• Cold sandwiches
• Cottage cheese
• Hard boiled eggs
• Plain pasta, rice, noodles and mashed potatoes
• Toast, dry Saltine-style crackers, natural potato chips or pretzels
• Canned fruit, applesauce and Jell-O
• Custard and pudding
• Sherbet, popsicles and frozen fruit bars
• Soda, juice and herbal tea
• Low-fat protein sources such as skinned chicken or tofu that is baked or broiled, not fried
• Peaches or other soft, mild-tasting fruits and vegetables
• Clear liquids such as apple and cranberry juice, low-salt broth and carbonated drinks without caffeine
• Teas such as ginger and peppermint, served lukewarm or cold

Vomiting

Vomiting may follow nausea and be brought on by treatment or food odors. If vomiting is severe or lasts for more than a day or two, contact your doctor. Visualization and relaxation exercises may help.

Here are some tips to help with vomiting:

• Do not eat or drink anything until you have the vomiting under control.
• Try tiny amounts of clear liquids such as water or bouillon, apple or cranberry juice, fruit ices without fruit pieces, ginger ale or 7-Up, plain gelatin desserts, popsicles, sports drinks such as Gatorade, vegetable broth and teas.
• Begin with 1 teaspoon every 10 minutes, gradually increasing the amount to 1 tablespoon every 20 minutes. Then, try 2 tablespoons every 30 minutes or as tolerated.
• Once you're tolerating these liquids, try a softer diet with bland foods such as mashed potatoes, rice, pureed fruits, smoothies, fruit nectars, yogurts, and cereals with milk (or soy if you have problems digesting milk).
• Drink and eat more potassium- and magnesium-rich foods when you're feeling better. Potassium-rich products include bananas, potatoes, orange juice, tomatoes and apricots. Good sources of magnesium include spinach, legumes, nuts, seeds and whole grains.

Constipation

Chemotherapy, certain medications or a lack of exercise may cause constipation. Adding more fiber to your diet may help.

Here are some easy ways to add fiber to your diet and to ease constipation:

• Include high-fiber foods – such as kidney beans, chickpeas, lentils, fresh fruit and vegetables and dried fruit – in your diet. Aim to include some fiber in each meal.
• Start your day eating bran cereals or shredded wheat, or foods made with whole grains such as bulgur or wheat berries. Aim for a cereal with at least 5 grams of fiber per serving.
• Add unprocessed wheat bran to hot cereals and yogurt.
• If you're not used to eating a lot of fiber, slowly increase your intake, as you may initially have increased flatulence (gas) until your body gets used to more fiber.
• To reduce flatulence that can come from eating beans, soak the beans in water before cooking them and discard the water.
• Drink plenty of liquids – eight to 10 glasses each day. A high-fiber diet requires plenty of fluids to work effectively.
• Reduce your caffeine intake. Caffeine may promote constipation by causing you to lose fluids.
• Drink a hot, non-caffeinated beverage such as lemon water in the morning when you wake up.
• Add exercise to your daily routine. Check with your doctor first.

Here are some suggested foods to help with constipation:

• Whole grain breads and pastas, bran cereals
• Cooked beans, peas and lentils
• Raw fruits and vegetables
• Dried fruit
• Prune juice and hot lemon water

Diarrhea

Diarrhea can have many causes, including chemotherapy, radiation therapy to the lower abdomen, malabsorption (problems absorbing nutrients from food), or use of antibiotics. It can also develop because of intolerance to milk or difficulty with absorbing fats.

If you have diarrhea:

• Drink plenty of room-temperature liquids to help prevent dehydration. These might include water, teas, Gatorade, ginger ale, peach or apricot nectar or fruit juices. Limit caffeinated beverages.
• Allow carbonated beverages to lose their fizz or stir them before you drink them.
• Consume more potassium-rich foods such as orange juice, tomato juice, bananas and potatoes.
• Try the BRAT diet, which consists of bananas, rice, applesauce, and toast.
• Try frequent, small meals.
• Avoid fried, greasy foods. Have spicy or highly seasoned foods only as tolerated.
• Cut down on high-fiber foods such as whole grains, bran cereals and vegetables.
• Try breads made from oat flour or refined flour without seeds or nuts.
• Avoid raw vegetables and the skins, seeds, and stringy fibers of unpeeled fruits.
• If you are lactose intolerant, use dairy products sparingly. Instead of regular milk, try Lactaid yogurt or milk, or soy milk.
• Avoid milk, ice cream and puddings for now since they can upset your stomach. Yogurt, sherbet, cheese and custard may be tolerated since these foods contain smaller amounts of lactose.
• Try taking probiotics, l-glutamine, and/or digestive enzymes to see if they improve your symptoms. Discuss the use of these supplements with a dietitian first to determine if these products are appropriate and which brands you may wish to try.
• Don't resume your consumption of higher fiber foods, fruits and vegetables until the diarrhea stops (and check with your dietitian and doctor first).

If you experience weight loss from diarrhea, it may be due to dehydration, which means that your body does not have enough water. Speak with your health professional to try to determine the cause of the weight loss and obtain the proper treatment.

Here are some suggested foods to help with diarrhea:

• Cream of wheat, oatmeal, plain rice and corn cereals
• Canned fruits, nectars and applesauce
• White rice, pasta and potatoes without skin
• Sandwiches on white bread
• Soups without cream
• Cheese and crackers
• Graham crackers and peanut butter
• Eggs
• Jell-O and popsicles
• Soda and herbal tea
• Nutritional drinks like Ensure, Resource, Sustacal, PediaSure and Boost

Loss of appetite

Problems such as pain, nausea, vomiting, diarrhea or a sore or dry mouth may make eating difficult and lead you to lose interest in eating. Depression, stress and anxiety may also cause a loss of appetite.

If you don't feel motivated to eat, here are some suggestions to help ensure you are getting the nutrition that you need:

• Eat three small meals and three snacks per day. Eat by the clock rather than by your hunger cues – for example, have meals at 9 a.m., noon and 6 p.m.
• Choose high-calorie foods, such as avocados, nuts, seeds, puddings, cooked cereals, dried fruits and vegetables dipped in hummus or prepared with olive oil. Use additional olive oil in salads.
• Snack between meals. Choose fruit smoothies, high-calorie puddings, shakes, high-calorie and protein drink supplements, sandwiches, avocados and nuts. Also, keep snacks by your bedside.
• Plan for special circumstances. If you must miss or delay a meal for a test or therapy, bring a snack of nuts, dried fruit or cheese and crackers. Ask your dietitian if these foods fit into your medical diet.
• Plan your daily menu in advance. Make a shopping list of your favorite foods and beverages and have the food available. You may want to portion out snacks and keep them in the refrigerator in Ziploc bags so that they are readily available.
• Request help in preparing your meals. Friends and relatives are often happy to help with meal preparation. You are important – ask for help when you need it, and ideally before you anticipate that you will need it.
• Fix several portions of your favorite foods and freeze them. This can make it easier to decide what to eat when your appetite is poor or you do not feel like cooking.
• Make food visually appealing. Eye appeal is often the first step in eating. Attractive colors and garnishes such as parsley, lemon wedges, olives and cherry tomatoes help enliven the appetite.
• Appeal to your sense of smell. Tap into the sense of well-being that smells can stimulate, such as the smell of fresh bread baking. If, however, you find that you are overwhelmed by smells at this time, stay away from the kitchen, and have someone else prepare your food.
• Make your mealtimes pleasant. Your mealtime atmosphere is important to encourage eating. Set the table, perhaps with candles. Whenever possible, eat with family or friends.
• Try milkshakes or supplements, such as Ensure or Carnation Instant Breakfast, when you do not feel like eating.

If you find it difficult to cook due to radiation therapy or chemotherapy side effects, consider calling organizations such as Project Open Hand or Meals on Wheels. These organizations provide nutritious foods for cancer patients, delivering meals directly to your house.

Mouth sores, chewing or swallowing difficulties

Soreness and tenderness in the mouth and throat are common with cancer treatment. If your swallowing difficulties are severe, you may need to work with a dietitian or swallowing therapist or consider alternative methods of feeding. If they are minor, the following suggestions may help:

• Eat frequent small meals and snacks to ensure that you are getting enough calories. Choose cool, smooth and bland foods. Soft solids and liquids work best.
• Cut foods into bite-sized pieces or grind them so that less chewing is required.
• Choose soft foods or foods that can be cooked until tender such as mashed potatoes, sweet potatoes, winter squashes (butternut and acorn), carrots, applesauce, ground beef or turkey and tofu.
• Consume liquid supplements such as ProSure, Ensure Plus, Boost Plus or shakes that can be made in your blender.
• Consider using a blender to puree the foods your family is eating. When adding liquid to process the foods, remember to add high-calorie liquids – such as gravy, milk, soy milk or broth – instead of water.
• Drink generous amounts of nutritious liquids with meals.
• Be adventurous. Try new sauces, gravies, or different oils on foods to make swallowing easier.
• Try apple, cranberry or grape juices or fruit nectars if you are sensitive to citrus juices.
• Keep some baby food on hand for something quick and tasty.
• Try drinking liquids through a straw or as recommended by your swallowing therapist.
• Avoid spicy, salty and acidic foods and beverages.

Here are some suggested foods to help with mouth sores, chewing or swallowing difficulties:

• Nectars and apple juice
• Canned fruit and applesauce
• Cream of wheat
• Potato soup, chicken noodle soup and rice porridge
• Custard, puddings, yogurt and Jell-O
• Popsicles, ice cream and sherbet
• Milkshakes and Carnation Instant Breakfast
• Nutritional drinks like Ensure, Resource, Sustacal, PediaSure and Boost

Taste and smell changes

• Avoid red meats if they taste metallic. Eat more chicken, turkey, dairy products and casseroles.
• If foods have less taste, try tart foods such as yogurt, lemon or orange Jell-O, or lemonade.
• If food tastes or smells funny, try cold or room temperature foods.
• Try marinated or spicy foods such as enchiladas, herbed chicken or spaghetti if you do not have nausea, vomiting or mouth sores.
• Use hard candies to take away a bad taste between meals.
• Maintain good oral hygiene.

For more information, visit our Nutrition and Coping With Cancer Symptoms page.