Nutrition During Chemo - What You Need to Know

by Jane Ashley

Nutrition during chemotherapy is a much debated topic — in chat rooms, in groups like WhatNext.com, on the internet — plus friends and coworkers giving us advice. Go vegan, sugar feeds cancer, don’t eat meat or drink veggie smoothies. It’s no wonder that patients are confused about what to eat during chemo.

5 Servomgs

What’s most important?

According to most experts, unintentional weight loss may lead to worse outcomes in patients. When we don’t eat properly, we become malnourished and lose weight.

In the two weeks after my first chemotherapy infusion, I lost over 3 pounds. My beginning weight was 128 lbs. I was exhausted during the week after my first chemo and barely ate; the second week, I ate a little but gave into my stress, anxiety and fatigue. I was shocked when I learned at my next appointment for my second cycle of chemo that I had lost over 3 lbs.

My oncologist had outlined my treatment plant. I was going to have 12 cycles of this chemotherapy regimen. I quickly did the math and calculated that at this weight loss rate, I would be down to less than 95 pounds by the end of treatment. It was at that moment that I made a pledge to myself that I had to be proactive about maintaining my weight. I used a weight calculator to estimate how many calories a day I had to eat to maintain my weight. My oncologist told me at my second appointment that she didn’t care what I ate — she said “eat what you are able to tolerate and once you’re done with treatment, you can transition to healthier eating.” I was able to maintain my weight throughout treatment (except for right after my complex surgery).

What is malnutrition?

Malnutrition is when our bodies don’t get enough nutrients, including essential vitamins and minerals and sufficient protein. Research shows that most cancer patients don’t consume enough vital nutrients during treatment … potentially causing delay in treatments.

Malnutrition can lead to cancer cachexia, a condition of weight loss and muscle wasting away that leads to declining immune, physical, and mental function.

If we’re overweight when we begin treatment, don’t look at treatment as a good way to lose weight. Even a 5 percent weight loss might lead to a poorer outcome. Unless you have been advised by your treatment team to lose weight, try your best to eat enough to maintain your weight.

What should I eat?

Chemotherapy and radiation therapy can lead to change in our taste buds. We just have to experiment to find foods that appeal to us and that we can tolerate. Here are the basics that we need to remember.

Protein. If we’re sedentary during treatment, women need about 46 grams of protein daily and men need about 56 grams. Lean meats, seafood, beans, lentils and dairy all count towards our protein intake. Protein helps our bodies rebuild muscle and repair damage caused by our cancer.
Fruits and vegetables. Eat five half-a-cup servings of fruits and vegetables daily. Choose a wide variety of colors to get a complete array of vitamins and minerals. Carrots, broccoli or Brussel sprouts, squash, sweet potatoes — banana, kiwi, cantaloupe, watermelon, apples or pears.
Dairy. Depending on your weight, choose low-fat or full-fat dairy products. They provide calcium and protein — milk, ice cream, frozen yogurt, cottage cheese, sour cream and yogurt. Greek and Icelandic yogurt are high in protein providing 10-15 grams of protein.
Carbohydrates. Starchy vegetables like potatoes, beans and peas are filling and provide energy over a long period of time. Whole-grain pasta and bread is metabolized more slowly and helps lower blood sugar levels.
Beverages. Avoid sodas. Drink water, coffee, green and black tea and herbal teas instead. Dilute fruit juice with water to avoid blood sugar spikes – eating the whole fruit is best. Remember to stay hydrated.

Milkshake

How can I get enough calories?

Use the calorie calculator to determine how many calories you need daily to maintain your weight. Divide that number by 4 or 5. Many patients find that it is easier to eat a smaller quantity more often. Here are some helpful tricks.

Sandwich. Use the same amount of meat and cheese to make half a sandwich. Half of a sandwich is easier to commit to eating if you’re tired or queasy.
• Split pea or bean soup. Packed with protein and fiber, try either of these thick soups served over some jasmine or basmati rice. They are comfort food that is tasty and easy on the digestive system.
Yogurt. Greek and Icelandic yogurt have 10-15 grams of protein, about one-quarter of a woman’s daily protein requirement. You’ll get lots of calcium too. Admittedly, we may have to acquire a “taste” for these styles of yogurt but they pack of lot of nutrition in a little cup.
Eggs. Eggs are another food packed with nutrition. They’re easy to digest. A cheese omelet is packed full of protein, calcium and good taste.
Grits or oatmeal. Oatmeal topped with a little brown sugar, dried fruit and half-n-half tastes good and provides fiber. If you’re from the South, melt your favorite cheese into slow-cooked stone ground grits (House Autry is my favorite brand).
Milkshakes. Many patients find that milkshakes are delicious, easy to digest and filled with calories and nutrition. If you have a sore throat from radiation, milkshakes are your best food friend.
Grilled cheese sandwich. Put extra cheese into a grilled cheese sandwich.
Loaded baked potato. Make yourself a loaded baked potato with real butter, sour cream and shredded cheddar cheese.

Half A Sandwich

Weigh yourself once a week to ensure that you’re maintaining your weight. That week off chemo offers an opportunity to eat a little more to prevent weight loss.

If you’re not able to eat healthy foods (because of mouth sores, diarrhea, gas, nausea, sore throat from radiation), then eat whatever you can eat — ice cream, warm brownies, Half-n-Half over cream of wheat, or Boost Plus. Forget the myth that sugar feeds cancer. Eat whatever you can. 

Jello with ice cream, canned peaches and cottage cheese, apple pie or cheese cake. Just eat.

Be sure to tell your oncologist if you’re having difficulties eating. They might prescribe an appetite stimulant to help you.

Don’t feel guilty about eating what you can tolerate. Cancer survivors will tell you that they ate what they could so that their treatments could stay on schedule. This is not the time to lose weight.

Do you have any tips for getting through chemo and keeping your weight and nutrition up? How did you manage? Please leave a comment below. 

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