Dealing With Side Effects

Tips for Handling Nutrition-Related Problems During Treatment

The side effects of cancer therapy can affect your eating habits. Below are some tips that may help. These suggestions are not meant to replace talking to your doctor; please discuss any problems or changes in your eating patterns with your doctor or dietitian.

If you are experiencing:

Loss of Weight and Appetite

Weight loss is common in cancer patients. Severe weight loss and undernutrition can interfere with your body’s ability to heal and fight off infections.

If you have lost weight, suggestions include:

  • Eat several small meals a day instead of three large meals.
  • When eating a meal, eat high-protein foods first, when your appetite is strongest. Some examples of high-protein foods are beans, tofu, chicken, fish, meat, eggs, cheese and nuts.
  • Eat the most when you feel hungriest. If you are very hungry at breakfast, for example, make it your largest meal of the day, even if you would typically eat a smaller meal at that time.
  • If the odors of food bother you try eating your food cold or at room temperature.
  • Drink beverages between meals instead of with meals: Drinking a beverage while you eat can make you feel full faster.
  • Add protein and calories to favorite foods. For example, add powdered milk to oatmeal or other cooked cereals and soups.
  • Sip on high-calorie beverages during the day, such as juice, nectar, milk or a fruit and yogurt smoothie.

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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Weight Gain

Weight gain during treatment can result from many causes, including medications, a change in eating behavior, decreased activity level or response to stress.

The following suggestions for weight loss also apply to patients overweight before they started treatment:

  • Select healthy foods, including a variety of vegetables, fruits, whole grains and beans. These foods are low in calories and loaded with nutrients and fiber, which can help you feel full.
  • Measure out the serving size listed on the label of the foods you eat most often. Remember what this portion looks like on a plate the next time you serve yourself or eat out.
  • Try using smaller plates so less food looks like more. (If you've become less active, simply eating as much as you used to do might be too much.)
  • Eat only when you’re hungry. If you are eating to comfort feelings of stress, fear or depression, speak to your doctor about psychological counseling or medication to get to the root of negative feelings.

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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Diarrhea can result from many causes, including chemotherapy, medications, infection, food sensitivity, or stress. Severe or long-term diarrhea may cause dehydration and other health problems.

If you have diarrhea, suggestions include:

  • Try to drink at least 8 glasses of liquids each day. Drinking enough is especially important while you have diarrhea to prevent dehydration.
  • Good choices of fluids include water, diluted juices, broth or decaffeinated coffee or tea.
  • Caffeine in large amounts (regular coffee and tea or caffeinated soft drinks) may worsen diarrhea in some people.
  • Liquids at room temperature are easier to tolerate than those that are hot or cold.
  • Eat small amounts of food throughout the day instead of three large meals.
  • Include soluble fiber periodically throughout the day. Soluble fiber is found in oatmeal, barley, bananas, applesauce, and fruits such as apples and pears without the peel. Certain fiber supplements may be helpful, but talk to your physician or registered dietitian about which one to choose and how to take it (often without the large amount of liquid recommended on the product label).

Foods that may help diarrhea include:

  • low-fiber foods like white rice, noodles, white
  • bread and mashed potatoes
  • soft cooked or puréed vegetables;
  • skinned turkey or chicken, lean ground beef; cooked fish

Foods that may worsen diarrhea include:

  • foods that cause gas such as beans, onions, carbonated drinks and chewing gum
  • high-fiber foods such as broccoli, corn, beans, cabbage, and cauliflower
  • greasy, fatty, fried, or spicy foods
  • excessive amounts of sugar from high-sugar drinks, sweets or fruit packed in heavy syrup
  • sugar-free candies and gums that contain sorbitol (a sugar replacer that has a mild laxative effect)

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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Constipation should not be confused with an intestinal obstruction. If you cannot pass stools and are suffering from one or more of the following: nausea, vomiting, abdominal pain, or a swelling of the abdomen, report this to your doctor immediately.

If you have constipation, suggestions include:

  • Drink more liquids, aiming for 8 to 10 glasses a day. Good choices are water, fruit juice (especially prune juice), and tea.
  • Have a hot drink such as tea, broth, hot lemonade, hot apple cider or hot prune juice about 30 minutes before your usual time for a bowel movement.
  • Eat a large breakfast, including a hot drink and high-fiber foods like hot or cold bran cereal, whole wheat toast and fruit.
  • Try to get some exercise, such as taking a walk, every day. Talk to your doctor before starting a new exercise program.

Foods that may help constipation as long as you’re able to drink enough fluid include:

  • fresh vegetables and fruits such as potatoes with skins, prunes, carrots, oranges and berries
  • legumes including lentils, peas and beans
  • whole wheat bread
  • whole grain cereals

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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Nausea is a common side effect of cancer surgery, treatments and some medications. Vomiting may or may not accompany the queasy feeling of nausea.

If you experience nausea, suggestions include:

  • Eat six or more small meals during the day rather than three large meals. Eat slowly.
  • Keep the room well-ventilated; some patients find that certain food odors produce nausea.
  • Drink beverages between meals rather than with meals.
  • Drink beverages cool or chilled and sip through a straw.
  • If nausea in the morning is a problem, keep crackers at your bedside to nibble on before you get up.
  • Rinse out your mouth before and after eating. If there is a bad taste in your mouth, suck on hard candy such as peppermint or lemon.

Avoid lying down for about an hour after eating.

Foods that may help nausea include:

  • toast, saltine crackers, dry cereal or breadsticks
  • sherbet and popsicles
  • canned peaches, pears, fruit cocktail
  • hot cereal such as oatmeal
  • candied dried ginger
  • ice chips

Foods that may worsen nausea include:

  • fatty, greasy, fried or spicy foods
  • candy, cake, rich desserts
  • foods with strong odors

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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Dry Mouth

A dry mouth occurs most often after chemotherapy and radiation therapy to the head or neck area. The therapy can reduce the flow of saliva, making it difficult to chew and swallow. It may also change the way foods taste.

To relieve a dry mouth, suggestions that may help include:

  • Sip water or other beverages through a straw throughout the day to make it easier for you to talk and swallow.
  • Aim for 8 cups of liquid a day as a minimum.
  • Suck on ice cubes or chips, especially prior to radiation of head and neck areas.
  • Eat foods moistened with broth, gravy, sauces and salad dressings. Moist foods are easier to swallow.
  • Keep your lips moist with lip salves.

Foods that may help dry mouth include:

  • tart foods and beverages, such as lemonade, in small amounts, which may help your mouth produce more saliva
  • thick drinks, such as fruit nectars, at room temperature or cold

Foods that may worsen dry mouth include:

  • salty foods
  • alcohol

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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Difficulty Swallowing

Report any choking or coughing while eating to your doctor, especially if accompanied by a fever.

To make eating easier, you may want to try:

  • Take deep breaths before attempting to swallow. Exhale or cough after swallowing.
  • Aim for 8 cups of liquids each day as a minimum. Liquids at room temperature may be easier to swallow.
  • Mashed foods should not be too thick. Thin them out using broth, gravy, milk or water.
  • Thicken liquids to consistency suggested by your speech therapist or registered dietitian.
  • Avoid extremely hot or cold foods.
  • Purée foods so they are easier to swallow.
  • Add gelatin to cakes, cookies, crackers, sandwiches, puréed fruits and other cold foods to make them easier to swallow. (Mix one tablespoon unflavored gelatin in two cups liquid until dissolved and pour over food. Allow food to sit until it is saturated.)

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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Taste Change

Changes in how foods taste can result from chemotherapy, radiation therapy or the cancer itself. Dental problems may also cause taste changes. Each person’s sense of taste can be affected differently.

Depending on how your tastes have changed, some of the following ideas for improving flavor may work for you:

  • Foods may taste better if served cold or at room temperature.
  • Frozen fruits such as melon balls, grapes or orange wedges that are moist and slightly sweet may be appealing.
  • If red meat tastes metallic or unpleasant:
    • marinate meats in juice, soy sauce, barbecue sauce, Italian dressing or other flavorful liquid you find appetizing.
    • choose chicken, turkey, fish, tofu, beans, eggs or dairy products that don’t have a strong smell.
  • Adding sugar to some foods can help decrease salty, bitter or unpleasant tastes.
  • Rinse your mouth with baking soda solution and brush your teeth and tongue regularly.
    (Avoid alcohol-containing mouthwashes if your mouth is sore.)

More suggestions are available in AICR’s Nutrition of the Cancer Patient.

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