Ten nutritional tips for chemotherapy patients

One of the common side effects of chemotherapy is appetite changes, specifically loss of appetite. While feelings of nausea and fatigue may make it hard for chemotherapy patients to eat, practicing good nutritional habits and maintaining weight during treatment is vital to recovery. 

Samantha Nola, dietitian with the LCRP
Samantha Nola, RD, CSO, LD, at the Nancy N. and J.C. Lewis Cancer & Research Pavilion

Chemotherapy drugs interfere with cell division and eventually cause cell death or failure to replicate. Unfortunately, these drugs cannot distinguish between healthy and malignant cells, resulting in injury to both. The side effects experienced from chemotherapy, such as nausea, taste changes, fatigue, mucositis and diarrhea, are frequently a result of damage to rapidly dividing cells.

These side effects of chemotherapy usually contribute to loss of appetite, says Samantha Nola, RD, CSO, LD, at the Nancy N. and J.C. Lewis Cancer & Research Pavilion.

“Very few patient experience just one symptom,” Nola says. “Commonly, patients experience a combination of these symptoms, which has a greater impact on one’s appetite.”

As a dietitian at the LCRP, Nola is commonly asked by patients, ‘Are there any foods I should be eating or any foods I should avoid?’ She helped come up with these 10 nutritional tips for chemotherapy patients:

1. Follow a plant-based diet with lean meats/proteins
A plant-based diet is recommended for chemotherapy patients because it helps protect your body and keeps you healthier during treatments, Nola says. A plant-based diet includes vegetables, fruits, whole grains, legumes, nuts, herbs and spices. Nola also recommends incorporating lean meats and proteins, such as chicken and fish. A plant-based diet also may help reduce the risk of cancer recurrence after treatment is complete. Certain foods in this diet may be hard to tolerate due to potential nutrition impact symptoms, such as diarrhea or vomiting.

2. Stick with bland, cold or room temperature foods to help with nausea
Hot foods tend to have stronger odors and flavors which can potentially cause nausea to be worse, Nola says. Some examples of foods that are better tolerated include:

  • Cold sandwiches
  • Cream of Wheat
  • Oatmeal
  • Cold cereals
  • Cottage cheese
  • Plain pasta
  • White rice
  • Crackers
  • Boiled eggs
  • Toast

3. You may want to avoid certain foods depending on the specific drug you are administered
Avoiding certain foods during chemotherapy depends on the type of cancer, chemotherapy drug and side effects caused by that drug, Nola says. For example, someone taking Procarbazine should avoid foods that contain tyramine, which is an amino acid found in foods like aged cheese, overripe fruits, soy products, beef and chicken livers. Be sure to talk to your physician and nutritionist about the drugs you will be taking and possible dietary side effects. 

4. Side effects of treatment also can indicate what foods to avoid
Not every patient experiences the same side effects from chemotherapy drugs. Side effects may include fatigue, mouth and throat sores, nausea and vomiting, diarrhea and constipation, amongst others.  If you are a patient experiencing nausea, you may want to eat bland and low-fat foods. Nola suggests avoiding strong flavors, fried and greasy foods and eating small, frequent meals. If, for example, the patient develops diarrhea from treatment, avoiding high-fiber foods, such as beans, broccoli and whole grains, and greasy foods is recommended, Nola says.

5. Pay attention to the types of carbohydrates, sugars you are eating
During the treatment process, chemotherapy patients should not be afraid of sugar. Limit simple carbohydrates such as cakes and cookies, and choose complex carbohydrates, such as whole grains and beans, more often, Nola says. Glucose is a form of sugar in the body that feeds every cell, so you don’t want to avoid carbs all together, especially if you are trying to maintain your weight. However, too much sugar, especially from sweets, can cause higher insulin levels and growth factors that may lead to growth of cancer cells. Also, don't worry too much about how much sugar you're eating during treatment because stress can cause blood sugar levels to rise.

6. Practice safe food handling
In addition to watching what you eat, it is important to practice proper food handling techniques during treatment due to the possibility of a weakened immune system caused by some cancer treatments, says Nola.  “You should always wash your hands well before preparing meals, wash fruits and vegetables, avoid unpasteurized foods and undercooked meats, fish and poultry.”

7. Stay hydrated
Hydration is very important and some patients may require more fluids depending on the type of chemotherapy administered. For example, a side effect of Cisplatin is kidney toxicity so it is recommended patients receive fluids before and after infusion. Cancer treatments that cause vomiting and diarrhea increases a patient’s risk of becoming dehydrated, Nola says. Water plays several important roles in the body including regulating body temperature, flushing waste products, carrying nutrients and oxygen to cells, moistening tissues, lubricating joints, and protecting organs and body tissues.

8. Consider calorie-dense beverages, sports drinks to help replace lost nutrients
Some patients may experience loss of appetite so severe that it becomes difficult to eat. Your physician and nutritionist may recommend calorie-dense beverages, including whole milk, Carnation Instant Breakfast, Boost and Ensure, in addition to drinking plenty of water. Also, for patients experiencing diarrhea and/or vomiting, sports drinks may be recommended to replace lost electrolytes.

9. Talk to your physician about caffeine intake
Avoiding or limiting caffeine depends on the type of drug administered and any side effects a patient is experiencing. Caffeine is a diuretic (causes frequent urination), and therefore, limiting caffeine consumption is beneficial to staying hydrated, Nola says. She also advises patients to consider the source of the caffeine, stating it is better to drink coffee or tea because they provide antioxidants whereas sodas do not. Caffeine should be avoided with certain chemotherapy drugs so it is important to discuss with your doctor.

10. Maintain your current body weight
For many patients undergoing treatment, physicians and nutritionist recommend maintaining their current body weight. Losing weight can interrupt or alter a patient’s treatment regimen. Weight loss may force breaks in treatment, which prolongs the process, early termination of treatment and increases your risk of infections, Nola says. There are some exceptions such as breast and prostate cancer, but each case is assessed on an individual basis. 

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