Chemotherapy can make eating difficult as problems with nausea, a lack of saliva, mouth sores, diarrhea and constipation are common along with fatigue, anxiety and depression. Any one of these side effects would create nutritional issues and patients undergoing chemotherapy and/or radiation often face multiple challenges.

The cancer treatments and the disease itself create a need for additional calories and protein at a time when eating can be an unappealing chore. Various strategies can be employed to maximize nutrient and caloric intake under these adverse conditions.

Dealing with Poor Appetite

  • Daily exercise is an important factor in reducing the side effects of cancer drugs, elevating mood and increasing immune response at a time when the immune system is significantly compromised. Taking a walk before meals can often help stimulate appetite and improve the dining experience. 
  • Variety in food and beverages can aid in finding enough things that are palatable. It’s a good idea to try new foods and drinks. Things that you didn’t like before may now taste different and have more appeal. Also, foods that disagreed with you yesterday may taste good 24 hours later. 
  • Dining in different locations and with some source of pleasant distraction can also help. Eating outside in the fresh air can often be easier than in a stuffy room, filled with cooking odors. The presence of an interesting TV show or a friend can also help take your mind off uncomfortable feelings and facilitate food consumption. 
  • Don’t try to eat three big meals. Six small meals a day is much easier to get down and keep down. Have some high-protein, high-calorie food at every meal or snack to maximize intake. 
  • Try to drink very little with meals as this can cause you to fill up too fast. Instead, carry a drink with you at all times and sip from it often, aiming for half of your body weight in ounces daily. Avoid soft drinks and choose water or nutritive drinks such as shakes, smoothies or green tea instead.
  • Planning a menu in advance can aid in the daily decision of what to eat. Stock your freezer and pantry with a variety of foods you like and that are easy to prepare. It can be very helpful if you are able to cook some foods you like and freeze them in individual serving sizes. 
  • Many people find it easier to eat in the morning when they are refreshed from a night’s sleep. If this is the case for you, consider having your main meal early in the day. When you don’t feel like eating, but it is time for a meal, try a nourishing smoothie or a fruit popsicle. 
  • If only one or two things are acceptable or you cannot eat anything at all, just do the best you can. If this lasts more than two days, let your doctor know. Drink plenty of fluids, at least 6 to 8 cups a day. 
  • Keep food easily within reach and take something with you whenever you go out. Nuts and seeds are high in protein and calories as well as many other nutrients. They can accompany fresh or dried fruits and dark chocolate for a nutritious snack. 
  • If your physician allows, a small glass of wine or beer can be an aid to stimulating appetite. This may be helpful before or during a meal.

Sore Mouth or Throat

When you have a sore mouth or throat chewing and swallowing can be difficult. Choose foods that are soft and moist and that are lukewarm to cold.

Peach, pear and apricot nectars are better tolerated than acidic juices. Also, try drinking through a straw. Milkshakes and smoothies can be soothing and a good source of calories and protein.

Avoid alcohol, caffeine and tobacco as these can dry the mouth and throat as well as promote further irritation. Soft, cold foods such as cottage cheese, yogurt, pudding, watermelon, canned fruit and Jell-O can be easier to chew and swallow. Also, some frozen foods such as Popsicles, slushes and ice cream can help meet dietary needs.

Changed Sense of Taste or Smell

Sometimes foods, especially meat or other high-protein foods, can begin to have a bitter or metallic taste. Many foods lose flavor. Marinating meat, chicken or fish can enhance flavor and make food more appetizing. If food odors are objectionable, try serving food at room temperature, turning on a kitchen fan or eating outdoors.

Dry Mouth

This can cause many of the same problems with eating and drinking as sore mouth and throat. Soft, moist foods are best. Tart foods, such as oranges or lemon can promote the flow of saliva. Sipping a little water every few minutes can help you to swallow and talk more easily.

Nausea

If this is a problem, eat only small amounts, but eat frequently. Eat before you get hungry as hunger can intensify nausea. Eat slowly and rest after meals. Drink a little at a time throughout the day.

Have food and drink at room temperature or cold, as heat can worsen nausea. If you feel queasy upon wakening in the morning, try eating a couple of crackers before getting out of bed.

Foods That Are Soothing to the Stomach:

Plain toast and low-fat crackers Yogurt, pudding and sherbet Angel food and sponge cake Hot or cold cereal

Potatoes, rice and pasta Skinless baked or boiled chicken Canned fruits and vegetables Ginger Ale

Dietary Guidelines During and After Chemotherapy

Try to eat a wide variety of foods every day while emphasizing fruits and vegetables. Produce, legumes, whole grains, nuts and seeds supply the vitamins, minerals, antioxidants and fiber you need for healing and prevention.

The National Cancer Institute, the American Cancer Society and the American Institute for Cancer Research promote reliance on a plant-based diet for optimal nutrition and disease risk reduction. They all agree with U.S. Dietary Guidelines and the Center for Disease Control who recommend 7 to 13 servings of fruits and vegetables a day for adults.

If you go to www.cnpp.usda.gov/mypyramid, the government sponsored nutrition website, and type in your gender, age, and level of activity, it will tell you how many cups of fruit and vegetables you should consume each day. One-half cup is a serving.

During your cancer treatment you have a greater need for protein and calories. It’s best to avoid high-calorie junk foods as much as possible and focus on consuming nutritionally dense foods that can strengthen your body’s defenses.

Recipes:

Homemade Yogurt Pops

Open small containers of flavored yogurt and cut a slit in the foil covering to insert a Popsicle stick. Freeze. Thaw for a minute under warm running water to dislodge from the container.

Variation: Blend fresh or canned fruit, honey or preserves into whole milk yogurt and freeze as above.

Super Smoothie

Blend until smooth: 1 banana
Handful of frozen strawberries Handful of frozen blueberries
½ cup whole milk yogurt
½ cup soy or almond milk 2 tbsp protein powder

Add a spoon of honey if you like it sweeter. Try variations with other fruits, coconut, nuts, cream, coconut milk, nut butter or anything else you can find that appeals.

For More Information:

American Institute of Cancer Research, www.AICR.org

National Cancer Institute, www.cancer.gov

Care During Chemotherapy and Beyond, www.Chemocare.com

Fruits and Veggies More Matters, http://www.fruitsandveggiesmorematters.org/