DIET DURING CANCER CHEMOTHERAPY

Health Topic

We all know that eating healthy food is important when we are well. But it is even more important when someone is receiving cancer treatment. Hence diet during cancer treatment is as important as any other components of cancer care. Eating the right kinds of foods during and after treatment can help in improving the response to chemotherapy and also can help to reduce the side effects overall enhancing the cancer treatment outcomes.

Here are some important points which you should know regarding diet and its relation with cancer and cancer treatment:
1) Is there a special diet during cancer treatment?

There are no particular special diet as such during cancer treatment. But some modifications will help to overcome or avoid some side effects and help to sail through treatment efficiently. Remember that cancer cannot be cured by diet alone, and there is insufficient evidence to prove that ‘special’ diets are beneficial. Some of these extreme diets may be harmful and interfere with the success of your treatment so please discuss them with your oncologist before you read and follow non scientific information. It is important  that you eat well and have more energy to tolerate your treatment with fewer side effects and to improve your body’s ability to heal. You need to eat energy generating foods, which help you maintain body weight. You need protein to maintain and renew the body’s tissues. You need vitamins and minerals to help the body assimilate the food you have eaten. You may be adviced some dietary modifications as per your diabetes and kidney/liver status.

2)  What food can be taken during chemotherapy?

 Generally, all proper routine homemade food can be taken during chemotherapy which can include: 
a.     Rice and chapatti/Staple food
b.    Cooked vegetables
c.    Washed and peeled fruits
d .   cereal and pulses (dal) 
e.    Milk and milk products, buttermilk, ghee
f.     Lean meats (poultry, fish), eggs, or nuts
g.    Plenty of Fluids, especially water. 

3)     Should Sugar be completely stopped for cancer patients??

There is no concrete scientific evidence till date to show that sugar increases cancer cell growth. All kinds of cells, including cancer cells, depend on blood sugar (glucose) for energy. But giving more sugar to cancer cells doesn't make them grow faster. Likewise, depriving cancer cells of sugar doesn't make them grow more slowly. In fact complete cutting off sugar in diet may lead to extreme weakness during chemotherapy so refrain from such extreme diets. There is some evidence that consuming large amounts of sugar is associated with weight gain and increase the risk of obesity and diabetes, which may increase the risk of cancer. So you can consume sugar in limits.

4)     What special precautions you need to take while preparing food during cancer treatment?

One of the most important things to be cared about during cancer treatment and chemotherapy is the food hygiene. This is to prevent any unwanted infections.First 7-10 days after chemotherapy are especially important since your immunity may be slightly lower. Please follow these guidelines in mind:

a.    Wash hands thoroughly before food preparation and eating.
b.    Wash fruit and vegetables thoroughly. Peel off fruits properly and check for any rotten parts.  Fruit whose skin is discarded can be consumed - banana, mango, papaya, apple etc. Skin of fruits like grapes has residue of pesticides, which does not wash off completely so better to avoid.
c.     Avoid raw and stale food.
d.    Cook meat/poultry/fish thoroughly.
e.    Avoid excessive spice or oil during preparation.
f.     Use pasteurized/boiled milk only.
g.    If eating away from home, avoid salads and raw/undercooked meats and eggs.
h.    Use boiled clean water for drinking or properly filtered /Aquagaurd water.

5)     What to do if appetite is reduced after chemotherapy?

It is quite common for people to have temporary problems such as nausea and loss of appetite during cancer treatment. Loss of appetite can inturn lead to weight loss during treatment which is not recommended. Here are some tips you may find helpful to stimulate appetite and prevent weight loss:

a.     Eat more frequent, but smaller meals.
b.     Make sure the meal looks appetizing, tempting the patient to eat.
c.     Blended & pureed foods are easier to eat.
d.     Milk shakes with fresh fruit are good options
e.     Dahi/lassi is easier to digest than full milk foods.
f.     
Chop your food into small pieces to make eating easier.
g.    Eat your main meal at whatever time of day suits you. Eat your favourite foods.
h.     Choose foods that do not have strong smell, which could set up nausea. Choose foods, which are quickly and easily digested. Avoid fried or fatty foods.Above all, please speak up about changes have happened in your taste. If you need extra salt, extra masala, extra sugar, ask the family to give it to you provided it suits your diet plan. Hunger prolongs nausea and hence eat small, frequent meals. Once the worst of nausea has passed, try a ginger, weak tea or green tea, soups or mint which can improve your taste and reduce nausea. 

6)     What to do if you have mouth sores?

You may have a sore mouth or difficulty in swallowing food.This may happen particularly during initial few days after chemotherapy. Few simple tips can help you sail through this problem easily:

a.     Try smooth or blended foods, or creamy consistency.
b.    Avoid foods that sting your mouth like acidic fruit (pineapple), or spicy and salty foods.
c.     Avoid rough crunchy foods like hard toast and nuts.
d.    Try drinking through a straw.
e.     Pay special attention to mouth hygiene to prevent infection and tooth decay. Use a gentle mouthwash after meals.

7)     What precautions to take to avoid constipation and diarrhoea?

You may sometimes experience changes in bowel function as a result of your treatment. These are generally short-term, but unpleasant while they last. Make sure you discuss with your oncologist about it first.Some simple tips to tackle constipation and diarrhoea are as follows:

CONSTIPATION:

    a. Drink at least 8 cups/glasses of fluid every day.
   
b. Add extra fibre to your meal like oats or dalia.
   
c. Eat some fruit and cooked vegetables daily. Avoid vegetables which give flatulence and gas. (peas, cucumber, onion)
   
d. Eat slowly, chew your food well. Drink slowly too, avoid swallowing air. 

DIARRHOEA:

    a.     Drink fluids between meals to prevent dehydration. Aim for 8 glasses of fluid a day.
   
b.     Eat small, light and frequent meals.
   
c.     You may find yourself unable to digest milk during treatment.
     d.     
If you have severe diarrhoea, please omit all fruit and vegetables, and eat a low residue diet for a few days. Low residue diet.
     e.     
Avoid pepper, strong curry with spices, and fatty foods.
   
f.      Add foods one at a time. Once you can tolerate them, add the next, and so on but keep eating soft diet at frequent intervals.

Following above simple dietary instructions will help you maintain your well being and nutrition throughout your cancer treatment.

Eat Well.. Stay healthy!!

 

Dr.Rahul S.Kulkarni

MD,DM ( Medical Oncology and Hematooncology)
European certification in Medical Oncology
Consultant Cancer Specialist
Pune

 

 
 
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