Adequate Nutrition During Treatment and Recovery

Maintaining adequate nutrition can be one of the most vexing challenges during cancer treatment and recovery—yet it is one of the most important. Various treatments for cancer can temporarily suppress the appetite. Or, depending on its location or progression, the disease itself can make eating difficult. Even anxiety and depression can result in a loss of appetite or desire to eat. But good nutrition is absolutely essential to recovering strength during treatment and sustaining a quicker and longer-lasting recovery.

Food Basics

There are certain essential nutrients that must be included in any well-balanced diet, especially for a cancer patient. These include:

• Protein for preservation and repair of tissue and the formation of antibodies to fight infection.
• Carbohydrates for energy.
• Vitamin A for healthy eyes, skin, hair, and resistance to infection.
• Vitamin C for healthy gums, skin, healing of wounds, strengthening of bones, and resistance to infection.
• Calcium for strengthening bones and teeth, muscle contractions, and blood clotting.
• Iron for building red blood cells to carry oxygen to all parts of the body.

In addition, thiamin-B1, riboflavin, niacin and other vitamins are necessary to help with treatment tolerance and recovery. Most of these can be derived by following standard guidelines concerning the daily intake of the four basic food groups:

• The meat group provides protein, niacin, iron, and thiamin-B1.
• The grain group provides carbohydrates, thiamin-B1, iron and niacin.
• The milk group provides calcium, riboflavin-B2 and protein.
• The fruit-vegetable group provides vitamins A and C.

If you are on a special diet, the basic four food groups can still be used. However, certain items within each category may have to be modified or eliminated. It is important to follow the specific advice of your doctor or nutritionist on which foods are allowed, how much, and how they should be prepared.

Also, since some foods may interact with medications, make sure to communicate regularly with your doctor, nutritionist and pharmacist, especially when new medications are prescribed or side effects occur.

Common Problems

In general, when appetite becomes a concern, you may want to plan meals and snacks that include your favorite foods. Preparing more frequent, smaller meals, may also be helpful. Despite such efforts, however, some common problems can still occur.

Changing Taste – The sensation of taste can be dramatically affected by cancer or its treatment. It may help to marinate foods in sweet fruit juices, Italian dressing, or sweet and sour sauces. Drink plenty of fluids, but avoid alcohol. Something as simple as sucking on candies can get rid of bad tastes.

Cramps, Heartburn, Bloating – These are common problems for cancer patients whose eating patterns have been altered. Eating slowly, or eating smaller, more frequent meals, can often take care of these problems. Avoid gas-forming foods such as cabbage, onions, nuts and colas. And do not eat fried, greasy and spicy foods.

Constipation - Constipation and irregularity are common side effects from certain medicines, or they can occur because of inactivity during treatment and recovery. Ask your doctor about stool softeners. Also, you should try to eat plenty of fresh fruit, vegetables and foods high in fibers; drink at least 8 glasses of water a day; avoid constipating foods like cheese, rice and bananas; and exercise as much as can be tolerated. You may also want to ask your doctor if there are other medications that may have fewer side effects.

Diarrhea – There are medicines available that can minimize diarrhea. It may also be helpful for you to eat smaller meals more frequently. However, avoid high fiber and greasy foods. Also, drink plenty of clear liquids, especially to replace fluid lost as a result of the diarrhea.

Nausea and Vomiting – Avoid meals that have pungent, strong aromas. Eat smaller, more frequent meals and chew slowly and thoroughly. Sometimes a brief rest after meals with your head elevated may provide relief. Avoid hot, spicy, strong-smelling foods, or fried, greasy foods. Fresh air and loose clothing may also help.

Sore Mouth – This is often a temporary side effect of cancer treatment, however it can have a significant impact on appetite. Drink plenty of fluids and suck on ice chips or Popsicles made of milk or non-acid juices. Use extra gravies or sauces when preparing meals. Rinsing your mouth thoroughly and often can also provide relief.

Changing Dietary Habits

Finally, an interesting article was just published in the European Journal of Clinical Nutrition. In a survey of 123 Finnish women with breast cancer, Dr. Hanna Lagstrom of the University of Turku found that only 9 percent of the patients believed that an unhealthy diet had contributed to their disease. Yet nearly a third of them (32 percent) significantly changed their dietary habits after their diagnosis.

Many of the women reduced their intake of animal fat, sugar and red meat, while eating more fruits, vegetables and dietary supplements. This was especially true for younger women. Lagstrom suggested that such dietary changes represented a way for women to exert some influence over their own well-being.

Unfortunately, less than 20 percent of the women in the study received nutritional advice from a doctor or nurse, and only 11 percent were advised by dieticians. One-third of the women relied solely on the mass media for nutritional information.

SOURCES:

The National Cancer Institute (http://www.nci.nih.gov)
The American Dietetic Association (http://www.eatright.org)
European Journal of Clinical Nutrition, December 2000; 54:844-848

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