Nutrition During Cancer Treatment

What nutrition meansExplain▾

Nutrition is what you eat and drink and how your body uses it. A healthy diet includes a variety of foods and liquids that provide the nutrients—vitamins, minerals, proteins, carbohydrates, fats, and water—your body needs.

Good nutrition for people with cancer may look different from what we usually call healthy. When you have cancer, you may need extra protein and calories, so your diet may include more meat, fish, eggs, dairy, fats, and plant-based proteins. The extra protein and calories help you keep your strength up to deal with side effects, prevent malnutrition, and maintain your best possible quality of life. A registered dietitian can help make sure you get the right amounts.

Plan aheadExplain▾

During treatment, you may be tired and not feel well, which can make it harder to shop, cook, and eat. Planning before treatment makes eating easier. Fill your kitchen with high-protein, high-calorie foods, stock up on items that need little cooking, keep easy-to-digest snacks like crackers on hand, and cook and freeze meals in advance. It's also okay to accept help—let friends and family shop and cook, and give them a grocery list.

How treatments affect eatingExplain▾

Both cancer and cancer treatments can cause side effects that affect taste, smell, appetite, and your ability to eat or absorb nutrients. Each treatment can cause different problems:

• Chemotherapy can cause loss of appetite, nausea and vomiting, constipation, diarrhea, dry mouth, mouth or throat sores, taste changes, trouble swallowing, and feeling full quickly.
• Hormone therapy can cause weight gain, fluid retention, nausea, high blood sugar, and fatigue.
• Immunotherapy can cause fatigue, fever, nausea and vomiting, and diarrhea.
• Radiation therapy to the digestive system can cause eating problems that depend on the area treated.
• Stem cell transplant can cause mouth and throat sores and diarrhea, plus a high infection risk.
• Surgery can cause loss of appetite, trouble chewing or swallowing, and early satiety.
• Targeted therapy can cause constipation, diarrhea, nausea, abdominal pain, taste changes, and dry or sore mouth.

Food safety mattersExplain▾

Some cancer treatments can weaken your immune system, making it harder to fight infections, including foodborne illness. Take special care in how you handle and prepare food: keep foods at safe temperatures, scrub raw vegetables and fruits, and use separate utensils, plates, and cutting boards for meats and produce.

Managing common eating problemsExplain▾

There are practical ways to manage each problem:

• Appetite loss and early satiety: eat high-protein, high-calorie foods, eat those first, drink fluids mostly between meals, and aim for 5 to 6 small meals a day.
• Nausea and vomiting: medicines can prevent or relieve these; sip fluids to avoid dehydration and replace lost electrolytes.
• Dry mouth: moisten food with sauces, sip water often, try tart foods to make saliva, and avoid tobacco and alcohol.
• Mouth sores: eat soft foods, cut food small, eat cold or room-temperature foods, and avoid citrus, spicy, salty, and crunchy foods.
• Sore throat and trouble swallowing: eat soft, moist foods, sit upright when eating, and stay away from hot, spicy, acidic, or crunchy foods.
• Taste and smell changes: use herbs, spices, and marinades, try plastic or bamboo utensils if food tastes metallic, and keep foods covered to reduce smells.

Many of these problems get better after treatment ends.

Nutrition screening and supportExplain▾

If you have trouble eating and keeping your weight up, your team may ask questions to check whether you are malnourished or at risk. If so, a registered dietitian can do a full assessment and build a nutrition care plan.

If, despite your best efforts, you can't eat enough to stay strong, nutrition support may help:

• Enteral nutrition gives nutrients in liquid form through a feeding tube into the stomach or small intestine.
• Parenteral nutrition gives nutrients directly into a vein through a catheter, when the stomach and intestines can't be used.

Your doctor or dietitian will discuss these options with you if they think they'll help.

Nutrition near the end of lifeExplain▾

If you are nearing the end of life, the goal shifts to comfort and quality of life rather than getting enough nutrients. People often feel little hunger, and sips of water, ice chips, and mouth care can help with thirst. Food and fluids should not be forced. You and your loved ones have the right to make informed decisions, and your care team and dietitian can explain the benefits and risks of nutrition support.