NorthBay Cancer Center - Radiation Oncology:
1020 Nut Tree Road, Vacaville, CA 95687
Whether your cancer treatment includes radiation therapy, chemotherapy, hormone therapy, biological immunotherapy, surgery or some combination, good nutrition is crucial before, during and after treatment. Cancer treatments can cause you to lose your appetite and energy, putting you at an increased risk for malnutrition.
The NorthBay Cancer Center provides nutrition education for cancer patients in the following areas:
Good nutrition and cancer treatment should go hand-in-hand. Eating healthy before treatment begins may help to increase your energy and improve your sleeping patterns. To prepare yourself and your home for your nutritional needs during cancer therapy, consider the following suggestions:
- Stock the refrigerator with plenty of your favorite foods so that you will not have to shop as often. Make sure these are foods you like to eat when you are not feeling well.
- Cook large portions of your favorite dishes in advance and freeze them in meal-sized portions.
- To save your energy, buy foods that are easy to prepare, such as peanut butter, pudding, frozen dinners, soup, canned fish or chicken, cheese and eggs.
- Ask family and friends to help you cook and shop.
- Talk to a registered dietitian about nutrition and cancer. They can help you get a handle on meal planning, grocery shopping, and reducing side effects of treatment, such as nausea and diarrhea.
- Talk to your doctor or registered dietitian about whether you should take a multivitamin.
- Plann ahead for meals. By planning ahead, you will have good food selections in your kitchen, even if you do not feel well enough to prepare an elaborate meal. Also, if you have been concerned in the past about weight gain, your focus will likely change to eating enough to keep your weight constant.
Symptoms Regarding Weight and Eating
Before treatment begins, cancer itself can cause problems that may result in eating challenges or weight loss. It is not uncommon to have lactose intolerance (intolerance to milk sugar), nausea, vomiting, poor digestion, or a feeling of early fullness, sleepiness and forgetfulness even before treatment.
Activity During Treatment
Cancer treatment may cause fatigue, which is not likely to inspire you to begin a new exercise program. Once you begin treatment, light, regular physical activity is very good for you. It will improve your appetite, stimulate digestion, prevent constipation, and provide additional energy. Physical activity will also help to decrease stress, improve mood, and maintain muscle tone. Always consult your doctor before beginning any exercise program.
When dealing with cancer or undergoing treatment, your food choices may be very different from what you are used to eating. Equally as important as nutrition is keeping your weight constant. In order to minimize weight changes, heal properly, and maintain the energy to cope with all the new challenges treatment may bring, you may be told to eat a wide variety of high-calorie and high-protein foods, including the following:
- Milk, cream and cheese
- Cooked eggs
- Sauces and gravies
- Butter, margarine and oil
High-Calorie, High-Protein Diet
Sometimes, professional recommendations about what to eat during your treatment may seem like the opposite of what you have always heard a healthy diet ought to include; however, following a high-calorie, high-protein diet may be encouraged, especially if you are feeling weak or are underweight. Although it can be a challenge to get enough nutrients because you may not feel like eating, proper attention to nutrition can assist in an easier recovery. Overall, try to make food choices that provide you enough calories (to maintain your weight), protein (to help rebuild tissues that cancer treatment may harm), nutrients such as vitamins and minerals, and fluids (essential for your body's functioning).
The following suggestions from the National Cancer Institute may be helpful if you have difficulty eating or a loss of appetite:
- Eat small, frequent meals (every one to two hours).
- Eat high-protein and high-calorie foods (including snacks).
- Keep snacks, such as peanut butter crackers, nuts, granola bars, or dried fruit on hand.
- Avoid foods low in calories and protein, and avoid empty calories (such as soda).
- To avoid nausea and improve your appetite, do not drink liquids with your meals.
- Try to eat when you are feeling the best, no matter what time of day.
- Use meal substitutes, such as high-calorie, high-protein drinks, when you do not feel like eating.
- Try to increase your appetite through light exercise or appetite stimulants.
- Take your medications with high-calorie fluids.
- Eat foods at room temperature.
- Avoid spicy foods or foods with strong odors.
- Add extra calories and protein to food by adding butter, skim milk powder, honey, or brown sugar.
Each individual's calorie and protein requirements vary depending on a number of factors, such as age, gender, body weight, and activity level. The current recommended daily allowance for protein for most adults is between 46 to 56 grams per day. It is important to discuss your individual nutrition requirements with your doctor or registered dietitian. In the case of some cancers, the metabolic processes can cause a situation known as hypermetabolism that affects how the body uses proteins, fats, and carbohydrates. With hypermetabolism, you may need to increase your calorie and protein intake. Be sure to discuss this with your doctor or registered dietitian.
What Foods are High in Protein?
Foods that are high in protein include:
- Meats such as beef, pork, lamb, chicken, turkey, and fish
- Dairy products such as milk, yogurt, cheese and cottage cheese
- Nuts and nut butters
- Dried beans and peas
What Foods are High in Calories?
Foods that are high in calories include:
- Butter and margarine
- Wheat germ
How Can I Add Protein & Calories to My Meals and Snacks?
1. Add powdered milk* to foods and beverages such as:
- Cooked cereal
- Ground meat
- Pancake batter
*powdered milk contains 33 calories and 3 grams of protein per tablespoon
2. Add eggs or egg substitutes** to meals such as:
- Cooked cereal
- Macaroni & Cheese
- Mashed Potatoes
- Meat Loaf
**each egg contains 80 calories and 6 grams protein
3. Eat cheese*** as a snack or add it, as tolerated, to:
***cheese contains 100 calories and 7 grams protein per ounce
- Use whole milk [150 calories and 8 grams protein per cup] in cooking and food preparation, as tolerated.
- Use peanut butter [95 calories and 4 grams protein per tablespoon) on toast, bagels, crackers, bananas, apples, and celery.
- Add Carnation Instant Breakfast (130 calories and 7 grams protein per packet) to milkshakes or milk.
- Add nonfat dry milk to whole milk to prepare high-protein milk.
While cancer treatments target fast-growing cancer cells in your body, fast-growing healthy cells can also be damaged. Examples of fast-growing cells include cells in the mouth, digestive tract, and hair. These may be affected by cancer treatment and can cause problems, such as your hair falling out, nausea and vomiting, or a metallic taste in your mouth. In order to prevent mouth problems in particular, maintaining good nutrition during cancer treatment is important. It is useful to eat well from the beginning of cancer therapy.
Stomatitis, or mucositis, is the presence of sores in the mouth caused by some anticancer drugs. In addition to being painful, mouth sores can become infected by the many germs that normally live in the mouth. They can make it difficult to swallow and chew as well. If you develop sores in your mouth, tell your doctor or nurse. You may need medication if the sores become painful or prevent you from eating. The following suggestions may help if you have mouth problems.
Foods to Eat:
Eat the following soft, soothing foods (cold or at room temperature), and puree cooked foods in a blender to make them smoother and easier to eat:
- Ice cream
- Baby food
- Soft fruits (bananas and applesauce)
- Mashed potatoes
- Cooked cereals
- Soft-boiled or scrambled eggs
- Cottage cheese
- Macaroni and cheese
Foods to Avoid:
Try to avoid irritating, acidic foods and juices, hot foods, spicy or salty foods, and rough or coarse foods such as:
- Tomato juice and citrus juice (orange, grapefruit, and lemon)
- Raw vegetables
For Mouth Dryness:
- Drink plenty of liquids
- Moisten dry foods with butter, margarine, gravy, sauces or broth
- Soften crisp, dry foods in mild liquids
- Eat soft and pureed foods
- Use lip balm or petroleum jelly if your lips become dry
- Carry a water bottle with you to sip from often
- Ask your doctor if you can suck on ice chips, popsicles, or sugar-free hard candy. You can also chew sugar-free gum*
*Sorbitol, a sugar substitute that is in many sugar-free foods, can cause diarrhea in many people. If diarrhea is a problem for you, check the labels of sugar-free foods before you buy them, and limit your use of them.
Nutritional Management of Treatment Side Effects
There is more to nutrition and cancer during treatment than simply getting enough calories and protein. The foods you choose also help you cope with side effects such as loss of appetite, nausea, vomiting, diarrhea, chewing and swallowing difficulties and taste changes.
As each person's individual medical profile and diagnosis are different, so will be the reaction to treatment. Side effects may be severe, mild or absent. Be sure to discuss with your cancer care team the possible side effects of treatment before treatment begins.
Nutritional Management of Loss of Appetite
There are many things that cause a loss of appetite. Nausea, vomiting or changes in food's taste or smell all may contribute to you potentially losing your appetite. Sometimes, the cancer treatment itself will make you feel like not eating. Your emotional state and how you cope with your cancer may also cause a loss of appetite. Talk to your doctor about these things because, in addition to the eating and nutrition tips here, there may be medications or other suggestions that will help you. Suggestions for managing a loss of appetite include the following:
- If you feel you cannot eat regular food for any meal, try liquid meal replacements.
- If you cannot eat very much at one time, eat throughout the day. Try eating small, frequent meals. Small high-protein, high-calorie snacks can make up for larger meals.
- Keep easy-to-prepare and nutritious foods within reach so you can have something whenever you feel like it. Do not forget to take a snack with you whenever you go out. Try these snack ideas:
- Cheese and crackers
- Ice cream
- Liquid supplements
- Peanut butter
- If you cannot eat solid foods and cannot drink liquid supplements, try to drink beverages during the day. Juice, soup or broth, and other similar fluids can provide important calories and nutrients.
- Change the way you prepare certain foods or the time you eat them to make them more attractive.
- Try soft, cool or frozen foods.
- If possible, try eating something at bedtime. It will not affect your appetite for the next meal.
- Take advantage of times when you have a good appetite and eat well.
- Do not drink too much while you eat, and stop drinking a half hour to an hour before you plan to have a meal. This may improve your appetite.
- Plan an enjoyable meal. Make food attractive and relax while you eat. Eat with family and friends.
- Do some physical activity each day even if you feel tired. Even a very short walk, a light housekeeping task, or playing with a pet can help you develop an appetite.