Before, during and after cancer treatment, adequate nutrition is essential. A balanced diet that meets your nutrient needs can help you maintain your weight and feel better overall. But side effects from cancer or its treatment can make obtaining adequate nutrition difficult. In addition to destroying cancer cells, treatment such as radiation, chemotherapy, hormone therapy and surgery may damage your healthy cells. This can create side effects that can affect your desire and ability to eat, potentially leading to weight loss and malnutrition.
Manage Nutrition-Related Side Effects
Common side effects include anorexia, or lack of appetite; dry mouth; sore throat or mouth; taste changes; difficulty swallowing; nausea; vomiting; diarrhea; constipation and fatigue. Depending on the side effects you are experiencing, your physician and dietitian will recommend specific ways to alleviate them. For example, if you are constipated, you may be advised to increase the fiber and fluids in your diet. If you are experiencing dry mouth, sucking on hard candies or ice chips, drinking fluids and eating moist foods may help you manage the problem.
Memorial Sloan Kettering Cancer Center provides a thorough patient education booklet, "Eating Well During and After Cancer Treatment," that outlines an array of tips for managing nutrition-related symptoms that you may experience as a result of your cancer treatment. If you experience treatment side effects, you will have to adjust your diet accordingly. You, your physician and your dietitian will work to ensure that you obtain the necessary nutrients, as a well-nourished patient is better able to tolerate treatment.
Meet Increased Calorie and Protein Needs
Cancer patients typically have increased protein and calorie requirements. Your requirements will differ, depending on your type of cancer and treatment, but your dietitian will educate you about your specific needs. You may need extra protein for tissue repair and the ability to fight off infection during and after treatment, according to the American Cancer Society. Lean meats, fish, beans, nuts, poultry, dairy and soy are all good sources of protein.
Because mouth sores, nausea, vomiting or other side effects may decrease your desire to eat, you may find it difficult to meet your increased needs. Eating several small meals throughout the day can help you consume more calories. Opt for high-calorie, high-protein foods, so that even a smaller amount of food will contribute significantly toward your intake goals. Adding cream, whole milk or sour cream to foods can increase the calorie content without increasing the volume of food. Although this may not sound like typical "healthy" eating practices, focusing on adequate calories and healing is most important. Drink high-calorie, high-protein beverages including milkshakes or oral liquid nutrition supplements as snacks between meals. Also, try to drink fluids between meals rather than during your meal to avoid filling up on fluids.
Minimize Weight Loss
One of the main goals of nutrition therapy during cancer treatment is to prevent wasting of muscle, bone, organs and other lean body mass. In a cancer patient, weight loss can be caused by the cancer itself or side effects of the treatment, such as vomiting or loss of appetite. To get yourself eating regularly, follow a planned eating schedule rather than waiting for your body to signal hunger, as your appetite may be decreased. Furthermore, incorporating high-calorie, high-protein foods and beverages, as well as staying as active as you can to increase your appetite can help you meet your needs and minimize weight loss.
If you have lost a significant percentage of your overall body weight over a short period of time, you may be deemed a high nutrition risk. For example, an unintentional weight loss of 4 to 5 percent in one month is considered significant, and a weight loss greater than this percentage in one month is considered severe. A dietitian may decide to use nutrition support to minimize further weight loss.
Following a Neutropenic Diet
All cancer patients should follow general food safety guidelines, as your ability to fight off infection is decreased, making you more susceptible to food-borne illness. But during treatment your immune function may weaken even further, and you may develop neutropenia. With neutropenia, your neutrophils, or infection-fighting white blood cells, are abnormally low, further increasing your risk of infection. During the time you are neutropenic, you will be placed on a neutropenic, or low-microbial, diet. While following a neutropenic diet, you will have to take certain precautions while preparing and storing food, grocery shopping and dining out. Included in the list of foods you should avoid are unpasteurized milk, cheese and juices, rare or medium-rare cooked meat, fish or poultry, sliced deli cold-cuts, raw or undercooked eggs and unwashed fruits or vegetables.
Additional Nutrition Support
If you are unable to meet your nutrient needs, your physician and dietitian may recommend additional nutrition support. If your gastrointestinal tract is working properly, they may recommend enteral nutrition, also known as tube feeding. A feeding tube may be placed in patients with head and neck cancer before beginning treatment. Enteral nutrition may either be used as a sole source of nutrients in patients unable to eat any food by mouth, or it may be used to supplement oral intake in patients able to eat only a small amount of food.
Enteral nutrition is typically the preferred method of nutrition support, but if your gut does not function properly for a prolonged time, you may be placed on parental nutrition. This involves delivering your nutrients via the bloodstream. Although oral intake is the best way to obtain your nutrients and should be used whenever possible, nutrition support can help minimize lean body mass losses and prevent or correct malnutrition in the cancer patient.
References
- National Cancer Institute: Eating Hints
- Memorial Sloan Kettering Cancer Center: Eating Well During and After Cancer Treatment
- National Cancer Institute: Nutrition Suggestions for Symptom Relief
- American Cancer Society: Nutrition for the Person with Cancer During Treatment
- American Cancer Society: Tips to Increase Calories and Protein
- MayoClinic.Com: Neutropenia
