Nutrition During Cancer Treatment

• Some treatments make eating difficult and cause weight loss, especially treatment for head and neck cancers, lung cancer and gastrointestinal cancers. It is important to prevent or minimize weight loss during this time.
• Other treatments may make it easier to gain weight (i.e. treatment for breast or prostate cancer). It is important to prevent weight gain during this time. If your oncologist permits, it is desirable to lose 1 lb. per week by eating healthful food choices (vegetables, fruits, beans, legumes, whole grains, nuts, fish, poultry, low-fat dairy foods, less sugary foods, etc.).
• Ask your oncologist for a dietitian consult if you are having difficulty maintaining a healthy weight.

• Try to eat something 6-7 times a day. 
• Snack ideas include: nuts, deviled eggs, cottage cheese and fruit, yogurt, cheese toast, peanut butter and jelly sandwich, milkshakes made with Carnation Breakfast Essentials, commercial nutritional drinks (Ensure Plus, Boost Plus or generics), cheese and crackers, smoothies, cereal and milk, ½ meat sandwich, puddings, custard, etc.
• Think of food as medicine. Take snacks to your appointments and eat them while you travel or wait. Keep a small cooler packed with desired foods by the couch or to take in the car.
• Drink nutritional drinks throughout the day; drink as many as needed to maintain your weight.
• Let your family or friends help when they offer.  Tell them specifically what you would like. For example, “buy nutritional drinks” or “make soup” or “make deviled eggs”. Small portions are less overwhelming. Freeze small portions of food so you can easily reheat them during low energy days.

If you would like to use an app to count calories, you may try myfitnesspal.com or myplate calorie tracker or another app you find easier to use to give an estimate of caloric intake.

• Meat, fish, poultry: chicken or tuna salad, add cooked, diced meat to soups, casseroles or pasta.
• Eggs: egg salad, deviled eggs, hard-boiled eggs, scrambled eggs, eggnog (made with pasteurized egg product-do not use raw eggs).
• Dairy products: yogurt, cottage cheese, milkshakes made with instant breakfast.
• Cheese: add cheese to vegetables, soups, casseroles.
• Nuts, nut butters, sunflower seeds, beans, peas, chickpeas, soy products.
• Liquid nutritional drinks: Ensure Plus, Boost Plus, instant breakfast, protein drinks, smoothies.

• Add gravy, extra butter, mayonnaise, or oil during cooking or to prepared foods.
• Use whole milk, whipped cream, heavy cream, sour cream, cream cheese, cheese or cheese sauces in foods.
• Blend avocado into smoothies or dips or add slices to tolerated foods
• Add nuts or nut butters to foods.

Some cancer treatments can lower your white blood cell count, causing “neutropenia” which makes it harder to resist infections. If this happens, try to avoid exposure to possible infection-causing germs.

• Scrub/peel raw fruits and vegetables.
• Avoid raw fruits and vegetables that cannot be scrubbed or peeled.
• Avoid raw or undercooked meat, fish, seafood and eggs.
• Do not cross-contaminate ready-to-eat foods with raw meat, fish, seafood or eggs.
• Put perishable foods in the refrigerator within 2 hours of preparing them.
• Avoid salad bars, buffets, potlucks while white blood counts are low.

• Eat small amounts of food 6-8 times/day. Choose low-fat, bland foods: soups, oatmeal, fruit, sandwiches.
• Eat dry foods: crackers, dry cereal, bread sticks throughout the day.
• Take anti-nausea medication around the clock, as directed. If it does not work, ask your nurse what else to try.
• Choose cool or cold foods and avoid odors that may increase nausea.

• If you are vomiting, sip clear liquids (water, sports drinks, broth, flat soda, popsicles, apple juice) as often as possible to prevent dehydration.
• Call your physician and ask if you can try a different anti-nausea medication.

• Ask your nurse about laxatives and stool softeners, dosages and how often to use them.
• Slowly increase high fiber foods, unless restricted by your physician. Choose whole grains, fruits-especially prunes, vegetables, beans, peas and nuts. Fiber may not correct constipation if you are on pain medication.
• Drink 8-10 cups of liquid per day. Hot beverages may help stimulate a bowel movement.

• Drink clear liquids throughout the day to prevent dehydration. Choose lactose-free milk or ice cream.
• Clear liquids include broth or bouillon, sports drinks, flat soda, tea, grape juice.
• Foods that help lessen diarrhea: bananas, white rice, white bread/noodles/crackers, applesauce, canned peaches or pears, oatmeal, potatoes without the skin.
• Avoid foods with sorbitol, mannitol, xylitol.

• The goal is to stay on top of the pain by taking your pain medication around the clock, as prescribed. If your medication does not work well, ask your physician what else to try.
• Pain medication is constipating and food is not strong enough to prevent or correct it. Ask which laxative/stool softener to take, how much and how often to take it. Ask what else to try if that doesn’t work.  

• Avoid spicy, citrus, tomato products.
• Avoid rough foods like crackers, tortilla chips, croutons, pretzels, etc.
• Try soft foods like custard, cottage cheese, pasta and cheese, tuna noodle casserole, oatmeal or any warm cereal, cold cereals, yogurt, smoothies, milkshakes, nutritional drinks, soft fruit, and soups.
• Moisten your foods with gravies, sauces, broth, milk, oil, mayonnaise, or butter.
• Experiment with a blender: cook the food, put a small piece in blender with enough liquid to make it the consistency you can tolerate.  For example, blend baked chicken, potatoes, chicken broth and gravy.
• Pack as much protein and calories as possible into the small amounts of food you are able to eat. For example: use fortified milk (mix 4 tablespoons non-fat dry powdered milk in 1 cup whole milk) in any food you would use milk (cream soups, milkshakes, cereal, smoothies).