Wellness starts from within, and so it is important to maintain good nutrition both during and after your treatment. The Oncology Centre will gladly direct you on the right path to finding a dietician to suit your needs and provide you with sound advice on your diet. If you are able to eat a healthy diet with a variety of foods, it should give you a wide variety of vitamins and minerals. However, if your appetite is poor, you may wish to see a dietician who can check whether you are eating a balanced diet. Some of the problems that a dietician may be able to assist you with include:

• Loss of appetite
• Weight loss
• Taste changes
• Nausea and vomiting
• Constipation and diarrhoea

There may be times during your treatment when you are unable to eat well. Loosing weight or having reduced food intake can make it more difficult for you to cope with treatments. During these times you may need to change the balance of your diet to include new and different foods. It may also be helpful to alter when or how often you eat to make sure you are eating enough. These may be short-term or long-term changes depending on your treatment and health. When you are ill or having treatment you are more at risk of getting food poisoning. It is best to avoid foods like lightly cooked eggs, soft cheeses and pate. Remember that now is not the time to go on a weight loss or crash diet!

Diet is a lifestyle. A healthy balanced diet:

• Can have amazing taste
• Can have amazing variety
• Can have amazing flavour
• Can be flexible and innovative
• Comprises of all the food groups each day,
in proportion with the guidelines

All wholesome, healthy diets should provide proportionate foods from each of the food groups. We also need to include a small amount of unsaturated fats and plenty of water in to our diet.
Some example foods from each food group include:

• Grains

  – breads, oats & muesli, rice

• Vegetables and Legumes

  – broccoli, spinach, sweet potato, lettuce

• Fruit

  – banana, apple & berries

• Dairy

  – milk, yoghurt & cheese

• Lean meat

  – poultry, fish, eggs & alternatives – such as chicken breast, lean
  beef and lamb, soya etc

Food hygiene and safety is something that is also very important in diet. Being food safe can be described as making a deliberate effort to avoid foodborne illness through the practice of safe cooking and storage methods.

Below is a small and basic list of simple ways to keep yourself safe

• Do not store chicken in a fridge for more than 2-3 days. Freeze if you want to keep it for longer.
• Do not store raw meat and vegetables together.
• Always use separate cutting boards and knives for meat and other foods.
• Store raw meat at the bottom of the fridge to prevent dripping onto other foods.
• Make sure that you reheat meals thoroughly by stirring in-between heating.
• Avoid leaving homemade fruit juices for longer than 24hours.

 

Nutrients

 

Proteins

We need protein for growth, to repair body tissue, and to keep our immune systems healthy. When your body doesn’t get enough protein, it might break down muscle for the fuel it needs. This makes it take longer to recover from illness and can lower resistance to infection. People with cancer often need more protein than usual. After surgery, chemotherapy, or radiation therapy, extra protein is usually needed to heal tissues and help fight infection.

Good sources of protein include fish, poultry, lean red meat, eggs, low-fat dairy products, nuts and nut butters, dried beans, peas and lentils, and soy foods.

Fats

Fats play an important role in nutrition. Fats and oils are made of fatty acids and serve as a rich source of energy for the body. The body breaks down fats and uses them to store energy, insulate body tissues, and transport some types of vitamins through the blood.

You may have heard that some fats are better for you than others. When considering the effects of fats on your heart and cholesterol level, choose monounsaturated and polyunsaturated fats more often than saturated fats or trans fats.

Monounsaturated fats are found mainly in vegetable oils like olive, canola, and peanut oils.

Polyunsaturated fats are found mainly in vegetable oils like safflower, sunflower, corn, and flaxseed. They are also the main fats found in seafood.

Saturated fats are mainly found in animal sources like meat and poultry, whole or reduced-fat milk, cheese, and butter. Some vegetable oils like coconut, palm kernel oil, and palm oil are saturated. Saturated fats can raise cholesterol and increase your risk for heart disease. Less than 10% of your calories should come from saturated fat.

Trans-fatty acids are formed when vegetable oils are processed into solids, such as margarine or shortening. Sources of trans fats include snack foods and baked goods made with partially hydrogenated vegetable oil or vegetable shortening. Trans fats are also found naturally in some animal products, like dairy products. Trans fats can raise bad cholesterol and lower good cholesterol. Avoid trans fats as much as you can.

Carbohydrates

Carbohydrates are the body’s major source of energy. Carbohydrates give the body the fuel it needs for physical activity and proper organ function. The best sources of carbohydrates – fruits, vegetables, and whole grains – also supply needed vitamins and minerals, fiber, and phytonutrients to the body’s cells. (Phytonutrients are chemicals in plant-based foods that we don’t need to live, but that might promote health.)

Whole grains or foods made from them contain all the essential parts and naturally occurring nutrients of the entire grain seed. Whole grains are found in cereals, breads, and flours.. When choosing a whole-grain product, look for the words “whole grain,” “stone ground,” “whole ground,” “whole-wheat flour,” “whole-oat flour,” or “whole-rye flour.” Note that some bakeries will use whole-wheat flour along with white flour but label the product “whole wheat.” Look at the ingredient list to find out. Breads and other products labeled “100% whole wheat” don’t contain refined flour.

Fiber is the part of plant foods that the body can’t digest. There are 2 types of fiber. Insoluble fiber helps to move food waste out of the body quickly, and soluble fiber binds with water in the stool to help keep stool soft.

Other sources of carbohydrates include bread, potatoes, rice, spaghetti, pasta, cereals, corn, peas, and beans. Sweets (desserts, candy, and drinks with sugar) can supply carbohydrates, but provide very little in the way of vitamins, minerals, or phytonutrients.

Water

Water and liquids or fluids are vital to health. All body cells need water to function. If you don’t take in enough fluids or if you lose fluids through vomiting or diarrhea, you can become dehydrated (your body doesn’t have as much fluid as it should). If this happens, the fluids and minerals that help keep your body working can become dangerously out of balance. You get water from the foods you eat, but a person should also drink about eight 8 glasses of liquid each day to be sure that all the body cells get the fluid they need. You may need extra fluids if you’re vomiting, have diarrhea, or even if you’re just not eating much. Keep in mind that all liquids (soups, milk, even ice cream and gelatin) count toward your fluid goals.

Vitamins and minerals

The body needs small amounts of vitamins and minerals to help it function properly. Most are found naturally in foods. They are also sold as supplements in pill and liquid form. They help the body use the energy (calories) found in foods.

A person who eats a balanced diet with enough calories and protein usually gets plenty of vitamins and minerals. But it can be hard to eat a balanced diet when you’re being treated for cancer, especially if you have treatment side effects that last for a long time. In this case, your doctor or dietitian may suggest a daily multivitamin and mineral supplement. If your food intake has been limited for several weeks or months because of the effects of treatment, be sure to tell your doctor. You might need to be checked for vitamin or mineral deficiencies.

If you’re thinking of taking a vitamin or supplement, be sure to discuss this with your doctor first. Some people with cancer take large amounts of vitamins, minerals, and other dietary supplements to try to boost their immune system or even destroy cancer cells. But some of these substances can be harmful, especially when taken in large doses. In fact, large doses of some vitamins and minerals may make chemotherapy and radiation therapy less effective.

Antioxidants

Antioxidants include vitamins A, C, and E; selenium and zinc; and some enzymes that absorb and attach to free radicals, preventing them from attacking normal cells.

If you want to take in more antioxidants, health experts recommend eating a variety of fruits and vegetables, which are good sources of antioxidants.

Safety considerations

Many people believe that if they find a pill or supplement in stores, it’s safe and it works. The Food and Drug Administration (FDA) has rules to help ensure that supplements contain what their labels claim they do, but the supplement’s safety and its effects on the body are not addressed by any FDA rules. The FDA does not make manufacturers of these products print possible side effects on their labels. And the FDA can’t pull a dietary supplement or herbal product from the market unless they have proof that the product is unsafe.

Tell your cancer care team about any over-the-counter products or supplements you‘re using or are thinking about using. Take the bottle(s) to your doctor to talk about the dose and be sure that the ingredients do not interfere with your health or cancer treatments.

Managing eating problems caused by surgery, radiation, and chemotherapy

Different cancer treatments can cause different kinds of problems that may make it hard to eat or drink. Here are some tips on how to manage nutrition problems depending on the type of treatment you receive:
Surgery

After surgery, the body needs extra calories and protein for wound healing and recovery. This is when many people have pain and feel tired. They also may be unable to eat a normal diet because of surgery-related side effects. The body’s ability to use nutrients may also be changed by surgery that involves any part of the digestive tract (like the mouth, oesophagus, stomach, small intestine, pancreas, colon, or rectum).

Be sure to talk to your cancer care team about any problems you’re having so they can help you manage them.

Radiation therapy

The type of side effects radiation causes depends on the area of the body being treated, the size of the area being treated, the type and total dose of radiation, and the number of treatments.

The following chart shows possible eating-related side effects of radiation, according to the part of body being treated. Some of these side effects happen during treatment while others may not happen until after treatment.

 

 

Part of body being treated	Eating-related side effects that might happen during treatment	Eating-related side effects that might happen more than 90 days after treatment
Brain, spinal column	Nausea, vomiting	Headache, tiredness
Head or neck: tongue, voice box, tonsils, salivary glands, nasal cavity, pharynx (throat)	Sore mouth, hard to swallow or pain with swallowing, change in taste or loss of taste, sore throat, dry mouth, thick saliva	Dry mouth, damage to jaw bone, lockjaw, changes in taste and smell
Chest: lungs, esophagus, breast	Trouble swallowing, heartburn, tiredness, loss of appetite	Narrowing of the esophagus, chest pain with activity, enlarged heart, inflammation of the pericardium (the membrane around the heart), lung scarring or inflammation
Belly (abdomen): large or small intestine, prostate, cervix, uterus, rectum, pancreas	Loss of appetite, nausea, vomiting, diarrhea, gas, bloating, trouble with milk products, changes in urination, tiredness	Diarrhea, blood in urine, bladder irritation

 

 

Side effects usually start around the second or third week of treatment and peak about two-thirds of the way through treatment. After radiation ends, most side effects last 3 or 4 weeks, but some may last much longer.

If you’re having trouble eating and have been following a special eating plan for diabetes or some other chronic health condition, some of these general tips may not work for you. Talk to your cancer care team about how best to change your eating habits while you’re getting radiation.

Tell your cancer care team about any side effects you have so they can prescribe any needed medicines. For example, there are medicines to control nausea and vomiting and to treat diarrhea.

Chemotherapy

Chemotherapy (chemo) side effects depend on what kind of chemo drugs you take and how you take them.

Most people get chemo at an outpatient centre. It may take anywhere from a few minutes to many hours. Make sure you eat something beforehand. Most people find that a light meal or snack an hour or so before chemo works best. If you’ll be there several hours, plan ahead and bring a small meal or snack in an insulated bag or cooler. Find out if there’s a refrigerator or microwave you can use.

Some side effects of chemo go away within hours of getting treatment. If side effects last longer, tell your cancer care team. There are things that can be done to lessen eating-related side effects. Prompt attention to eating-related side effects can help keep up your weight and energy level and help you feel better.

If you’re having trouble eating and have been following a special eating plan for diabetes or some other chronic health condition, talk to your cancer care team about how best to change your eating habits while getting chemo.