Nutrition of the Cancer Patients
 

A healthy diet is very important for someone undergoing treatment for cancer. This is a time when there is much demand on the body. There are two main nutritional goals for someone living with cancer. They are :

  1. To maintain a healthy weight.
  2. To select and eat healthy foods that supply the body with fuel and nutrients for repair and healing.

This booklet (Reprinted with permission from the American Institute for Cancer Research) discusses eating for good nutrition throughout cancer therapy. Nutritional problems associated with cancer and cancer treatment are presented, along with tips to help you minimize these eating difficulties.
 

How Cancer Affects Nutritional Needs

Not only do eating habits and behaviors often change in a person with cancer, but the way the body uses nutrients changes as well.
 

Changes in Eating Habits and Eating Behavior

 

Eating the same types and the same amount of foods you enjoyed before your diagnosis of cancer may sometimes be difficult. Eating less is the usual response, but eating more is not uncommon either.


Side effects of cancer therapy may affect your eating habits. Some foods may taste less appealing to you and, as a result, you had before your diagnosis may be aggravated by cancer and its treatment. For example, if your were sensitive or allergic to certain foods before your cancer diagnosis, you may become more sensitive to them.

Coping with changes in your eating habits may seem overwhelming. You may feel anxious about eating enough of certain foods. Or you may become afraid of eating the "wrong" foods and eat very little at all. These reactions are normal. You can find tips for dealing with nutritional problems you may be experiencing in section four of this booklet.
 

Changes in The Way Your Body Uses Nutrients

The way the body uses nutrients is sometimes changed in people with cancer. These changes may be caused by the body's response to the tumor, the side effects of treatment, certain medications or some combinations of these reasons.


It is not uncommon to experience changes in the way your body handles sugar or in your blood handles sugar or in your blood sugar level. You may experience hyperglycemia (high blood sugar). It is less likely you will experience hypoglycemia (low blood sugar). If you encounter dietitian can advise you on ways to control your blood sugar through diet.


The Food Guide Pyramid lists the recommended number of servings from each food group. Some cancer patients, however, may have trouble consuming enough of a wide variety of foods to satisfy nutritional needs.


Common Vitamin and Mineral Deficiencies Experienced by Cancer Patients
 

Folate Vitamin A Vitamin C Copper
Iron Magnesium Zinc


These individuals may benefit from a multi-vitamin/mineral supplement. Such a supplement can help people reach the Recommended Dietary Allowance (RDA) of important nutrients. Many liquid meal replacement beverages can help satisfy protein requirements as well. Protein is important to maintain body strength.


It is important, however, not to take supplements in doses that would raise your intake in excess of the RDA. Excess amounts of these substances may interfere with the beneficial effects of certain cancer chemotherapies and or radiation therapy. If you are concerned about your intake of a specific vitamin or mineral, speak with your doctor. And always be sure to tell your doctor which nutrient supplements or herbal preparations you are taking (if any) and in what amounts.


How Treatment May Affect Nutrition

There are several different methods of treating cancer. Each may affect your nutritional needs and your eating habits.
 

Surgery

Surgery is often the preferred treatment for tumors that have not spread. Through surgery, the tumor and any nearby tissue that may contain cancer cells are removed. Sometimes healthy tissue may have to be removed from around the tumor to help keep the cancer from spreading. Whether or not surgery is used depends on the type of cancer, its location and how much it has spread to other parts of the body.

 

Surgery can cause temporary or permanent nutritional challenges. The operation itself will increase your need for calories to do the extra work of healing. You may be advised to eat slightly more calories and protein to provide enough nutrients for healing. Long-term nutritional problems may result when parts of the digestive system or gastrointestinal (G.I.) tract are removed or altered through surgery. Difficulty with chewing and swallowing and poor absorption of nutrients in the intestine may occur. You can find help dealing with these problems in section four of this booklet.
 

Radiation Therapy

 


Radiation therapy uses high energy waves to damage cancer cells so they are unable to multiply. It may be used either alone or in combination with surgery or chemotherapy.

Radiation may be used before surgery to shrink a tumor or after surgery to destroy any cancer cells that may remain in the area.


Radiation treatments can lead to nutritional problems just as surgery can. These usually occur when the G.I. tract is in the treatment and last only a short time, such as irritation of the mouth, tongue and throat, milk intolerance, nausea, vomiting or diarrhea. Other problems may appear months after therapy and are longer lasting, such as dry mouth, stricture or narrowing of the esophagus and mal-absorption of nutrients. You can find help in dealing with these problems in section four of this booklet.
 

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells by disrupting their ability to grow and multiply. Chemotherapy may be used alone or along with radiation and/or surgery. Unlike surgery or radiation, chemotherapy is "systemic." This means it can affect the entire body rather than just part of it.

 

The drugs used in chemotherapy interfere with cells as they divide and reproduce. Cancer cells are affected most because they divide and reproduce more often than normal cells. But normal cells can also be affected, and when this happens side effects may occur.

 

The most common side effects of chemotherapy include nausea, vomiting, hair loss and fatigue. Other common side effects include infection, bleeding and anemia. Some chemotherapy drugs can cause constipation or diarrhea. Others may cause a strange taste in the mouth, making eating unpleasant. Still other drugs can cause water retention and bloating. These effects may lead to weight loss, weight gain or other nutritional problems. You can find help in dealing with nutritional problems in section four of this booklet.
 

Cancer Surgery and Nutrition
 

Area of Cancer Surgical Procedures Possible Nutrition Problems
Head, Neck, Tongue Removal of all or part of the affected area Makes chewing and swallowing difficult.
Jaw Removal of jaw bone Requires tube feeding
Esophagus Removal (esophagectomy) with reconstruction using muscle from the intestine. Food may leak into the lungs or the new esophagus may narrow.
Stomach Removal (gastrectomy) or partial removal Food may travel to the intestines too quickly or low blood sugar may develop.
Small intestine Opening created outside the body (jejunostomy or ilestomy) or removal Poor absorption of nutrients, vitamin B-12 deficiency, salt and water imbalance, blocked bowels.
Pancreas Removal Poor absorption of nutrients, diabetes
Large Intestine Removal (colectomy) with or without an opening created outside the body (colostomy) Poor absorption of nutrients and water.

Radiation and Nutrients
 

Location of Cancer Area of Treatment Short-Term Effects Long-Term Effects

Brain, Mouth, Esophagus, Thyroid

Head and Neck

Irritation of mouth, tongue, esophagus

Dry mouth, tooth decay, stricture of esophagus, loss of taste

Stomach, Liver, Pancreas, Gallbladder, Kidney

Abdomen

Irritation of stomach, diarrhea, milk intolerance, nausea and vomiting

Some of these symptoms may continue in some patients.

Breast, Lung Upper torso

Irritation of stomach and esophagus

Some of these symptoms may continue in some patients.

Colon, Rectum Lower torso Diarrhea

Some of these symptoms may continue in some patients.

Prostate, Uterus, Ovaries, Cervix, Bladder

Pelvis

Diarrhea, mal-absorption

Some of these symptoms may continue in some patients.

 

Hormone Therapy

This treatment may include the use of drugs to block the body's production of hormones, or surgery to remove hormone-producing organs, Hormone therapy is most commonly used to treat cancers of the breast, prostate, ovary and endometrium.

Hormone therapy can cause a number of side effects including nausea, vomiting, swelling, weight gain and hot flashes. Some hormones cause an increase in appetite.
 

Biological Therapy

Biological therapy, also called immuno-therapy, is a relatively new form of cancer therapy. In this form, the body's immune system is used to help fight cancer. Interferon and interleukin-2 are used to enhance the ability of white blood cells treatment, their effects on nutrition are not yet known. However, these agents may produce " flu-like" symptoms, including diarrhea.
 

Chemotherapy and Nutrition

Chemotherapy and Nutrition

Irritation and inflammation of mouth, tongue, throat

Diarrhea

Constipation

Nausea

Vomiting

Taste Changes

Appetite changes (increased, decreased)

Weight changes (increased, decreased)

Milk intolerance

Food aversions

Gene Therapy

A very new form of cancer treatment, gene therapy is still in its investigational stages. This approach to cancer treatment involves replacing a cancer-causing gene, or oncogene, with a normal gene. The effects of gene therapy on nutrition of the patient are currently unknown.
 

Complementary/Alternative Medicine

Complementary/alternative medicine (CAM) consists of a wide variety of approaches and therapies not included in conventional medicine. People may use CAM treatments alone or in addition to mainstream treatments, which is called and "integrative" approach. Examples of CAM include herbal treatments, homeopathy, acupuncture, macrobiotic diets and spiritual healing.

Although certain complementary/alternative therapies for cancer may appear to help some people, scientific evidence providing their effectiveness is often lacking. These therapies should therefore be approached with great caution.

Keep in mind that just because a therapy is "natural" does not guarantee that it is harmless. Unproven treatments could be ineffective, toxic (combining certain herbs with certain drugs, for example) or could prevent the patient from seeking timely conventional and effective treatment for cancer. Complementary therapies should complement, but never replace, traditional approaches to cancer treatment.

It is important to tell your doctor if you are using any complementary/alternative therapies as part of your overall treatment so he or she can take that into account when planning your conventional treatment.
 

Tips for Handling Problems Related to Nutrition

 

 

So far we have described what kinds of challenges you may encounter, depending on the type of cancer treatment you receive. Now we will discuss what you can do about them. In this section, you will find tips for handling nutritional problems.

It is important to remember that these suggestions are not meant to replace talking to your doctor. Speak with him or her about any changes in your eating patterns and any problems you may have with appetite, eating or digestion. Your doctor may refer you to a registered dietitian specializing in nutritional care of the cancer patient.
 

Weight Loss and Loss of Appetite

Weight loss is very common in cancer patients. It can be caused by many factors, including loss of appetite, increased demand for energy, changes in the way the body processes and absorbs food, physical difficulty in eating due to surgery, side effects of treatment or feelings of anxiety or depression.

Severe weight loss and under nutrition can interfere with the work of the heart, liver, kidneys and other important organs in the body. Also, when a patient is undernourished, the ability to heal and to fight off infections is weakened.

Here are some tips for getting back on the road to a healthy weight. Your doctor and registered dietitian can help you determine your healthy weight goal and your individual calorie and nutrient needs.
 

If you Have Lost Weight:

  • Eat several small meals a day instead of three large meals.
  • Keep favorite foods around the house. That way you may find yourself eating more often.
  • When eating a meal, eat high-protein foods first, when your appetite is strongest. Some examples of high-protein foods are beans, tofu, chicken, fish, meat, yogurt, eggs and nuts.
  • Eat the most when you feel hungriest. If you are very hungry at lunch, make that your largest meal of the day, even if you would typically eat a smaller lunch.
  • Go for a walk before mealtime to stimulate your appetite.
  • Take an interest in food by trying new recipes and products or occasionally eating in a restaurant.
  • Experiment with new or different seasonings.
  • Make mealtimes more leisurely -take your time at the table.
  • Drink beverages between meals instead of with meals. Drinking a beverage while you eat can make you feel full faster.
  • Sip on higher-calorie beverages during the day such as juice, nectar, milk or a fruit and yogurt smoothie.
  • Ask your physician or registered dietitian about liquid nutritional supplements. They come in a variety of calorie levels and flavors and are easy to swallow and digest. Some products may taste better than others, so you may want to give several of them a try.
     

Weight Gain

Weight gain is not uncommon in cancer patients. Weight gain may result from taking a medication, such as tomoxifen for breast cancer or certain antidepressants. Chemotherapy may cause a false menopause, which is commonly accompanied by weight gain. For other patients, a change in eating behavior, due to stress, fear or depression, may mean an increase in food intake and subsequent weight gain. Some patients with nausea feel better when they eat more frequently. Fluid retention, which causes swelling (edema), may be another reason your weight may increase. Tell your doctor about any excess weight so he or she can determine the cause.

The following tips can help patients who are gaining weight-for reasons other than fluid retention-to maintain a healthy weight. (If you have fluid retention) Some patients are overweight when they begin cancer therapy. The following suggestions will be helpful for these individuals as well.
 

If you gained weight:

  • Select healthy foods, including a variety of vegetables, fruits, whole grains and beans. These foods are naturally low in calories and loaded with nutrients and fiber, which can help you fell full.
  • Pay attention to your portion sizes. Try measuring out the serving size listed on the label of the foods you eat most often. Remember what this portion looks like on a plate the next time you serve yourself or eat out. This can help you get a handle on how much you are eating.
  • Eat only when you are hungry. Eating to comfort feelings of stress, fear or depression will not alleviate those emotions. Speak to your doctor about psychological counseling or medication to get to the roof of negative feelings.
  • Ask your doctor if there is an effective medication that does not promote weight gain.

Diarrhea

Diarrhea can result from many causes, including chemotherapy, radiation therapy to the abdomen, certain medications, infection, food sensitively, emotional upset or removal of part of the stomach, intestines or colon. Severe diarrhea or long-term diarrhea may cause dehydration, nutrient loss and other health problems. Call your doctor if you have severe diarrhea.

If you have diarrhea:

  • Aim for eight glasses of liquids each day. Drinking enough is especially important while you have diarrhea to prevent dehydration.
  • Good choices of fluids include water, diluted juices, broth or decaffeinated coffee or tea. Large amounts of coffee and tea do not count toward your total: the caffeine may cause you to lose fluids.
  • Liquids at room temperature are easier to tolerate than those that are very hot or very cold.
  • Ask your doctor about medications that may be helpful for diarrhea.
Food to Try Foods to Avoid

Some people find relief by eating the following foods:
  • Low-fiber foods like white rice, noodles, white bread, mashed potatoes and cream of wheat
  • Soft cooked or pureed vegetables.
  • Soft, canned or cooked fruit without skins, such as bananas and applesauce.
  • Skinned turkey or chicken, lean ground beef, cooked fish and thoroughly cooked eggs.





The following foods may worsen diarrhea:
  • Foods and beverages that cause gas such as beans, onions, carbonated drinks and chewing gums.
  • High-fiber foods such as broccoli, corn, beans, cabbage, peas and cauliflower.
  • Some milk and diary products, except for yogurt, which is generally well-tolerated.
  • Raw vegetables and fruits, nuts
  • Greasy, fatty, fried, very sweet or very spicy foods.
  • Alcoholic beverages and caffeinated beverages
  • Sugar-free candies and gums that contain sorbitol (a sugar replacer that has a mild laxative effect).

 

Constipation

 

Constipation can be result of certain cancer drugs, medications, a diet without enough fluid or fiber, a reliance on tube feedings or a lack of physical activity. Constipation should not be confused with an intestinal obstruction. If you cannot pass stools and are suffering from one or more of the following: nausea, vomiting, abdominal pain or a swelling of the abdomen, report this to your doctor immediately.

 

If you have constipation:

  • Drink more liquids, aiming for eight glasses a day. Drinking enough is especially important while you have constipation to help keep stools soft. Good choices are water, prune juice, warm juices, decaffeinated teas and hot lemonade.
  • Have a hot drink about one half hour before your usual time for a bowel movement.


Foods to Try
  • Fresh vegetables and fruits such as potatoes with skins, prunes, carrots, oranges and berries.
  • Legumes including lentils, peas and beans whole white bread.
  • Whole wheat bread.
  • Wheat bran added to foods such as casseroles and hot cereals.
  • Whole grain cereals.
  • If you develop gas, limit broccoli, cabbage, cauliflower, cucumbers, onions, carbonated drinks and beans. Using the anti-gas product "Bean-o" (widely available in pharmacies), may allow you to keep eating high-fiber foods without discomfort.
  • Eat a large breakfast, including a hot drink and high-fiber foods like hot or cold cereal, whole wheat toast and fruit.
  • Increase your physical activity. Try to get some exercise, such as taking a walk, everyday. Talk to your doctor before starting a new exercise program.
  • Talk to your doctor about using a fiber supplement. Be sure to drink plenty of fluids if you use a fiber supplement.
  • Laxatives may be occasionally necessary. Your doctor can make specific suggestions.
 

 

Nausea

Nausea is a common side effect of cancer surgery, chemotherapy, radiation therapy, immuno-therapy and some medications. Vomiting may or may not accompany the queasy feeling of nausea. Nausea can prevent you from eating enough.

 

If you Experience Nausea:

  • Eat small amounts of food often and slowly. Eat six or more small meals during the day rather than three large meals.
  • Keep the room well-ventilated, since some patients find that the odors of some foods may produce nausea.
  • Drink beverages between meals rather than with a meal.
  • Drink beverages cool or chilled and sip through a straw.
  • Eat foods a room temperature or cooler: hot foods can aggravate nausea.
  • Eat sitting up. Also, rest sitting up or reclined with your head raised for about an hour after eating.
  • Rinse out your mouth before and after eating. If there is a bad taste in your mouth, such on hard candy such as peppermint or lemon.
  • Don't force yourself to eat favorite foods when you feel nauseated. It may cause you to permanently dislike them.
  • If nausea in the morning is a problem, keep crackers at your bedside to nibble on before you get up.

 

Foods to Try Foods to Avoid

These foods can help your Nausea:
  • Toast, saltine crackers, dry cereal or breadsticks
  • Yogurt
  • Sherbet and popsicles.
  • Canned peaches, pears, fruit cocktail.
  • Skinned chicken (not fried)
  • Hot cereal such as oatmeal
  • Clear liquid such as water, broth, cranberry juice and flat soda.
  • Candied dried ginger.
  • Ice chips.

These foods may make your Nausea worse:
  • Fatty, greasy, fried or spicy foods
  • Candy, cake, rich desserts
  • Foods with strong odors





 

 

Food Odors and Nausea

If the smell of food cooking or cooling nauseates you, try:

 

Anticipatory Nausea

Sometimes nausea can occur even before a treatment session or other event begins.
Your brain remembers how your felt after previous sessions and anticipates feeling that way again. This is called "anticipatory nausea" and there are several things can do to prevent it from happening or to lessen the discomfort.

  • Try to distract yourself during the activities you associate with your treatment.
  • Practice relaxation or medication techniques to take your mind off the treatment.
  • Sometimes changing something in the environment or in the routine can help. For example, if the smell from the alcohol wipe used to clean you skin before an injection makes you feel nauseated, another kind of skin cleanser might be substituted.

 

Vomiting

Vomiting can follow nausea. It can be brought on by treatment, food odors, gas in the stomach or motion. Contact your doctor if you are vomiting for more that 24 hours.

 

If you Experience Vomiting:

  • Do not eat or drink until you have the vomiting under control.
  • Sit upright after vomiting.
  • Once vomiting is under control, try drinking small amounts of clear liquids such as cranberry juice, cool broth or flat soda (carbonated beverages may cause burping which can stimulate vomiting in some people).
  • When you are able to keep down clear liquids, try eating small amounts of soft foods such as cream of wheat, pudding, frozen yogurt or gelatin.
  • Once you can tolerate soft foods, gradually work your way back to your regular diet.

 

Sore Mouth, Tongue and Throat

Soreness of the mouth, tongue and throat can result from cancer therapy or other reasons. See your doctor if you have a sore mouth to be sure it is not the result of a correctable dental problem. Try to arrange to see your dentist before you begin cancer treatment, or in between treatments, to take care of any work that needs to be done. Soreness usually clears up with time.
 

FOOD TO TRY FOODS TO AVOID

Bland, soft foods are easy to chew and swallow.
  • Bananas, applesauce, watermelon, canned fruits.
  • Peach, pear and apricot, nectars
  • Pureed or mashed vegetables such as mashed potatoes
  • Oatmeal or other cooked cereal
  • Cottage cheese, Yogurt, milkshakes
  • Custards, puddings, gelatin
  • Macaroni and cheese, scrambled eggs, ground meals.

Avoid foods that can irritate your mouth.
  • Citrus fruits or juices such as grapefruit, orange, lemon and lime.
  • Spicy or salty foods.
  • Pickled or vinegary foods
  • Tomato-based foods such as chili, salsa, spaghetti sauce and pizza
  • Rough, coarse or dry foods.
  • Hot spices, such as pepper, chili powder, nutmeg, cloves, curry and horseradish.

 

If you have a sore mouth, tongue or throat:

  • Cook goods until they are soft and tender.
  • Cut foods into very small pieces or grind or puree them. Make moist stews and casseroles, or mix foods with thin gravies or sauces to make them easier to swallow.
  • Serve foods cold or at room temperature. Hot and warm foods can irritate a sore mouth and throat. Cold foods such as sherbet or Popsicles may soothe soreness.
  • Use a straw for drinking fluids.
  • Avoid alcohol and tobacco. They can irritate the delicate membranes in your mouth.
  • Rinse your mouth several times a day with water or a baking soda mixture (combine one quart water and one tablespoon baking soda) to remove foods and promote healing. Avoid commercial mouthwashes; most are too harsh for a tender mouth.
  • Use a toothbrush with soft bristles.
  • Remove your dentures (except during eating) if your gums are sore. Keep your dentures clean.
  • Ask your physician about special mouthwashes and anesthetic lozenges and sprays that can numb the mouth and throat long enough for you to eat meals.
  • If you experience bleeding of the gums during treatment, arrange to see your dentist or a
    periodontist, and be sure to tell your doctor as well.
  • If you see small, white patches in your mouth, tell your physician or nurse. This may be evidence of an infection that may require special attention.

 

Dry Mouth

A dry mouth occurs most often after chemotherapy and radiation therapy to the head or neck area. The therapy can reduce the flow of saliva. This may make it difficult to chew and swallow. It may also change the way goods taste. To relieve a dry mouth, follow the suggestions given below:

 

To relieve a dry mouth:

 

Difficulty Swallowing

Problems with swallowing can be the result of cancer and its treatment, such as surgery to the head and neck. Or it may be due to other reasons. Talk to your doctor if you are experiencing difficulty swallowing.

 

To make Eating Easier:

 

Stricture

Sometimes surgery of radiation therapy can cause the esophagus to narrow, making it difficult for food to pass through to the stomach. This is called stricture. Your surgeon may be able to widen the opening or insert a feeding tube to bypass the problem until it heals. Try drinking liquids, which will pass through the esophagus more easily. And keep your head elevated both during and after drinking or eating.

 

Feeling Full Quickly

Feeling full quickly after eating a small amount of food is not uncommon, especially if you have upper abdominal surgery. Not eating enough can weaken the body and delay healing.

 

If you feel full quickly when eating:

  • Eat small meals throughout the day. Keep healthy snacks on hand to eat between meals.
  • Avoid fried or greasy foods. Gat stays in your stomach longer than carbohydrates or protein.
  • Avoid foods that give you gas.
  • Drink your beverages between rather than during meals. Drinking a beverage during a meal can fill you up more quickly.
  • Rest with your head elevated after meals.
  • If your eat small meals and are finding it difficult to eat frequently during the day, fortify your meals with foods that are rich in calories and nutrients. Try adding nonfat dry milk, wheat germ or ground meat to soups, hot cereals, casseroles or other dishes.
  • Ask a health professional about drinking a liquid meal replacement beverage to provide needed calorie and nutrients.

Keep in mind that even though it is important to eat, it is also important to maintain a healthy weight. Therefore, it is unwise to force yourself if you are feeling full or are not longer hungry.

 

Taste Changes

Changes in how foods taste can be the result of chemotherapy, radiation therapy or the cancer itself. Dental problems may also cause taste changes. Some patients complain of bitter or metallic tastes, especially when eating foods high in protein such as meat. Each person's sense of taste can be affected differently. Depending on how your tastes have changes, some of the following ideas for improving flavor may work for you.

 

To Improve Flavor:

  • Choose and prepare foods that look and small good to you. Foods may taste better if served cold or at room temperature.
  • Frozen fruits such as melon balls, grapes or orange wedges may be appealing.
  • If red meat tastes different, choose chicken, turkey, fish, tofu, beans, eggs or dairy products that don't have a strong smell.
  • Marinate meats in juice, soy sauce, barbecue sauce, Italian, dressing or other flavorful liquid you find appetizing.
  • Use seasonings such as onion, garlic, herbs and spices if you find their flavors appealing.
  • Adding sugar to some foods can help decrease salty, bitter or unpleasant tastes.
  • Tart foods and beverages such as oranges, lemon yogurt or lemonade may be appealing. (Do not eat these foods if your mouth is sore).
  • Use non-metallic utensils to eat with if you have a bitter or metallic taste in your mouth.
  • Rinse your mouth and brush your teeth and tongue regularly. (Avoid commercial mouthwashes if you mouth is sore).

 

Milk or Lactose Intolerance

If you were able to digest milk and milk products easily before you began radiation or chemotherapy treatment, but now develop cramps and diarrhea after you drink milk or eat certain dairy foods , then may be suffering from acquired milk or lactose intolerance. The cancer therapy has probably temporarily inactivated those enzymes in your intestinal tract that digest lactose, which is the carbohydrate (sugar) in milk. In most patients, the condition eventually reverses itself. The following measures may be helpful in the meantime.

 

If you are Lactose Intolerant:

Avoid the milk or dairy products that give you problems. Yogurts and aged cheeses may be easier to tolerate. Look for a reduced lactose milk or milk that contains "Lactaid:, and enzyme product that helps you digest the lactose in milk.

Lactaid and other enzyme products are available in capsule, pill or liquid drop form. Look for them in pharmacies.

Try calcium-fortified drinks or foods. Read food labels to find fortified selections. Speak with your doctor or registered dietitian about whether you could benefit from taking a calcium supplement.

 

Fluid Retention

Sometimes patients gain extra weight during treatment without eating extra calories. This weight gain may be due to swelling or edema. Certain drugs, such as prednisone, can cause the body to retain fluid as can a nutritional deficiency. If you notice weight gain, tell your doctor so he or she can determine the cause.

 

If you are Retaining Fluids:

  • Drink enough water during the day.
  • Eat less salt and foods with less sodium.
  • Stay as physically active as possible.
  • Elevate your legs when resting.
  • Your physician can prescribe medication to help minimize fluid retention.

 

Fatigue

Although fatigue is not a specific nutritional problem, feeling tired can certainly make it harder to prepare and eat nourishing meals.

 

If you are Experience Fatigue:

  • Consider asking friends and relatives for help.
  • Use frozen dinners. There are dozens of healthful varieties now available.
  • Meal-making is easier if you use convenience products such as frozen or canned fruits and vegetables, canned beans, prepared pasta sauces and instant brown rice. Read labels to look for products that are low in sodium and high in nutrients.
  • Have healthy snacks on hand. Keep foods like dried fruit (raisins, dates, apricots), cheese and whole grain crackers, graham crackers and snack-size puddings in the house.
  • Prepare blended fruit and yogurt shakes and keep them in the refrigerator for between meal
    snacks.
  • When you are feeling better, prepare large quantities of your favorite meals and freeze the leftovers in meal-size portions.
  • Consider buying prepared foods from your grocery store, phoning for carryout or delivery food, or having meals delivered from "Meals on Wheels" or another meal delivery service in your area.

SOURCE: American Institute of Cancer Research. (www.aicr.org)