Managing Eating Problems During Treatment
Coping with Side Effects Loss of Appetite Weight Loss Weight Gain Sore Mouth or Throat Dry Mouth Dental and Gum Problems Changed Sense of Taste or Smell Nausea Vomiting Diarrhea Lactose Intolerance Constipation Fatigue and Depression Preventing Food-Borne Illness Extra Vitamins and Minerals - Will They Help? What About Alternative Therapies?
All the methods of
treating cancer - surgery, radiation therapy, chemotherapy, hormone therapy,
and biological therapy (immunotherapy) - are very powerful. Although these
treatments target the fast-growing cancer cells in your body, healthy cells can
also be damaged. Healthy cells that normally grow and divide rapidly, such as
those in the mouth,
digestive tract, and hair, are often affected by cancer
treatments. The damage to healthy cells is what produces the unpleasant side
effects that cause eating problems.
Table 1 shows some of the effects that can occur as a result of
cancer treatment.
Side effects of cancer treatment vary from patient to patient. The part of the
body being treated, the type and length of treatment, and the dose of treatment
determine whether side effects will occur.
The good news is that not everyone has side effects during treatment, and most
side effects go away when treatment ends. Side effects can also be
well-controlled with new drugs. Talk to your doctor about possible side effects
from your treatment and what can be done about them.
Some eating problems are caused by the treatment itself. Other times, patients
may have trouble eating because they are upset, worried, or afraid. Losing your
appetite and nausea are two normal responses to feeling nervous or fearful.
Once you get into your treatment period and have a better sense of what to
expect and how you will react, these anxiety-related eating problems should get
better.
While you are in the hospital or undergoing treatment, talk to your doctor,
nurse, or a registered dietitian. They can answer your questions and give you
suggestions for specific meals, snacks, and foods, and for dealing with any
eating problems you may have. They can also help with dietary preferences that
reflect various cultural and ethnic backgrounds. Feel free to talk to them if
problems arise during your recovery as well. Ask them what has worked for other
patients.
Remember, there aren't any hard and fast nutrition rules during cancer
treatment. Some patients may continue to enjoy eating and have a normal
appetite throughout most of their cancer treatment. Others may have days when
they don't feel like eating at all; even the thought of food may make them feel
sick. Here are some things to keep in mind:
-
When you can eat, try to eat meals and snacks with sufficient protein and
calories; they will help you keep up your strength, prevent body tissues from
breaking down, and rebuild tissues that cancer treatment may harm.
-
Many people find their appetite is better in the morning. Take advantage of
this and eat more then. Consider having your main meal of the day early, and
have liquid meal replacements later on if you don't feel so interested in
eating (see the information on liquid meal
replacements).
-
If you don't feel well and can eat only one or two things, stick with them
until you are able to eat other foods. Try a liquid meal replacement for extra
calories and protein.
-
On those days when you can't eat at all, don't worry about it. Do what you can
to make yourself feel better. Come back to eating as soon as you can, and let
your doctor know if this problem doesn't get better within a couple of days.
-
Try to drink plenty of
fluids, especially on those days when you don't feel like
eating. Water is essential to your body's proper functioning, so getting enough
fluids will ensure that your body has the water it needs. For most adults, 6-8
cups of fluid a day are a good target. Try carrying a water bottle with you
during the day. That may help you get into the habit of drinking plenty of
fluids.
Tables 2
and 3
include many examples of fluids you can try.
This section offers practical hints for coping with treatment side effects that
may affect your eating. These suggestions have helped other patients manage the
same eating problems that you may have. Try all the ideas to find what works
best for you. Share your needs and concerns with your family and friends,
particularly those who prepare meals for you.
Let them know that you appreciate their support. Tell them about
Special Notes for Caregivers.
At the end of Eating Hints, you will find two items that may be especially
useful as you go through treatment and use this booklet. The first, "Keeping
Track of Side Effects," is a chart that you copy and use to
monitor how you feel as you go through treatment. Use the second, "Notes," to jot down questions or concerns that you want to discuss with your
health care team.
Loss of appetite or poor appetite is one of the most common problems that
occurs with cancer and its treatment. No one knows exactly what causes loss of
appetite. It may be caused by the treatments or by the cancer itself. Emotions
such as fear or depression can also take away a person's appetite. Ask a nurse
or social worker about ways to lessen these emotional difficulties. Sometimes
it is the side effects of treatment such as nausea, vomiting, or changes in
food's taste or smell that make a person feel like not eating. If this is the
cause, work with your doctor or nurse to get the side effects under better
control.
For some people, loss of appetite happens for just a day or two; for others,
it's an ongoing concern. Whatever the reason, here are some suggestions that
might help:
-
Try liquid or powdered meal replacements, such as "instant
breakfast," during times when it is hard for you to eat food.
-
Try frequent small meals throughout the day, rather than fewer big ones. It may
be easier to eat more that way, and you won't get so full.
-
Keep snacks within easy reach so you can have something whenever you feel like
it. Cheese and crackers, muffins, ice cream, peanut butter, fruit, and pudding
are good possibilities. Take a portable snack with you when you go out, such as
peanut butter crackers or small boxes of raisins. You can find more snack ideas
in
Table 4.
-
Even if you don't feel like eating solid foods, try to drink beverages during
the day. Juice, soup, and other fluids like them can give you important
calories and nutrients. Milk-based drinks also provide protein.
Tables 2
and 3
give lots of examples of fluids.
-
If possible, try having something at bedtime. It won't affect your appetite for
the next meal.
-
Sometimes, changing the form of a food will make it more appetizing and help
you eat better. For example, if eating whole, fresh fruit is a problem, try
mixing fruit into a milkshake. (Banana
Milkshake Recipe)
-
Try softer, cool, or frozen foods, such as yogurt, milkshakes, or popsicles.
-
Take advantage of times when you do feel well, and have a larger meal then.
Many people have a better appetite first thing in the morning, when they are
well rested.
-
During meals, sip only small amounts because drinking may make you feel full.
If you want to have more than just a small amount to drink, have it 30-60
minutes before or after a meal.
-
Make mealtimes as relaxed and pleasant as possible. Presenting food or meals in
an attractive way may also help.
-
If your doctor allows, have a small glass of wine or beer during a meal. It may
help to stimulate your appetite.
-
Regular exercise may help your appetite. Check with your doctor to see what
options are open to you.
Commercial Products to Improve
Nutrition
If you cannot get enough calories and protein from your diet, commercial meal
replacements such as drinks, "shakes," and "instant
breakfast" powders may help. Other products also can be added to any food
or beverage. These supplements are high in protein and calories and have extra
vitamins and
minerals. They come in liquid, pudding, and powder forms. Most
commercial meal replacements contain little or no
lactose. However, it is important to check the label if you are
sensitive to lactose. Your nurse or a registered dietitian can tell you which
products are best for you and which ones are available in your area.
Most of these products need no refrigeration until you open them. That means
you can carry them with you and have them whenever you feel hungry or thirsty.
They are also good chilled as between-meal or bedtime snacks. You may want to
take a can with you when you go for treatments or other times when you may have
a long wait.
Many supermarkets and drugstores carry a variety of commercial liquid meal
replacements. If you don't see these products on the shelf, ask the store
manager if they can be ordered.
|
Many cancer patients lose weight during their cancer treatment. This is partly
due to the effects of the cancer itself on the body. Also, if you've lost your
appetite and are eating less than usual because of your treatment or emotional
worries, you may lose weight. Table 5:
How to Increase Calories and Table 6:
How to Increase Protein will give you some ideas for slowing weight
loss or even gaining a few pounds. The tips under
Loss of Appetite
may help, too.
Here are three simple recipes that show you how to increase the calories and
protein of familiar foods:
Fortified Milk
High-Protein Milkshake
Peanut Butter Snack Spread
Instant Dry Milk as a Protein Powder
For extra protein in dishes, consider adding a little nonfat instant dry milk to
scrambled eggs, soup, cereal, sauces, and gravies.
Some patients find their weight does not change during treatment. They may even
gain weight. This is particularly true for breast, prostate, and ovarian cancer
patients taking certain medications or who are on hormone therapy or
chemotherapy.
It is important not to go on a diet right away if you notice weight gain.
Instead, tell your doctor so you can find out what may be causing this change.
Sometimes, weight gain happens because certain anticancer drugs can cause your
body to hold on to excess fluid. This condition is called
edema. The weight comes from the extra water. If this is the
case, your doctor may ask you to talk with a registered dietitian for
guidelines on limiting the amount of salt you eat. This is important because
salt causes your body to hold extra water. Your doctor may also want to
prescribe a
diuretic. This is a medication that causes your body to get rid of excess fluid.
Breast cancer patients with a primary diagnosis of cancer may be different.
Over half of them may actually gain weight rather than lose during treatment.
Because of this, many of the recommendations for breast cancer patients do
emphasize a lower fat, reduced calorie diet similar to those provided to
patients
after cancer treatment
has been completed.
Weight gain may also be the result of increased appetite and eating extra food
and calories. If this is the case and you want to stop gaining weight, here are
some tips that can help. Talk to a registered dietitian for more guidance:
-
Emphasize fruits, vegetables, and breads and cereals.
-
Choose lean meats (lean beef or pork trimmed of fat, chicken without skin) and
low-fat dairy products (skim or 1% milk, light yogurt).
-
Cut back on added butter, mayonnaise, sweets, and other extras.
-
Choose low-fat and low-calorie cooking methods (broiling, steaming).
-
Avoid eating high-calorie snacks between meals.
-
If you feel up to it, increase the amount of exercise you get.
Mouth sores, tender gums, and a sore throat or esophagus often result from
radiation therapy, chemotherapy, or infection. If you have a sore mouth or
gums, see your doctor to be sure the soreness is a treatment side effect and
not an unrelated dental problem. The doctor may be able to give you medicine
that will control mouth and throat pain. Your dentist also can give you tips
for the care of your mouth. Certain foods will irritate an already tender mouth
and make chewing and swallowing difficult. By carefully choosing the foods you
eat and by taking good care of your mouth, teeth, and gums, you can usually
make eating easier. Here are some suggestions that may help:
Try soft foods that are easy to chew and swallow, such as:
-
milkshakes
-
bananas, applesauce, and other soft fruits
-
peach, pear, and apricot nectars
-
watermelon
-
cottage cheese, yogurt
-
mashed potatoes, noodles
-
macaroni and cheese
-
custards, puddings, and gelatin
-
scrambled eggs
-
oatmeal or other cooked cereals
-
pureed or mashed vegetables, such as peas and carrots
-
pureed meats
Here's a simple blender recipe that's easy on a sore mouth:
Fruit and Cream
-
Avoid foods or liquids that can irritate your mouth. These include:
-
oranges, grapefruits, lemons, or other citrus fruit or juice
-
tomato sauces or juice
-
spicy or salty foods
-
raw vegetables, granola, toast, crackers, or other rough, coarse, or dry foods
-
commercial mouthwashes that contain alcohol
-
Cook foods until they are soft and tender.
-
Cut foods into small pieces.
-
Use a blender or food processor to puree your food.
-
Mix food with butter, margarine, thin gravy, or sauce to make it easier to
swallow.
-
Use a straw to drink liquids.
-
Use a smaller-than-usual spoon, such as a baby spoon.
-
Try foods cold or at room temperature. Hot foods can irritate a tender mouth
and throat.
-
Try drinking warm bouillon or salty broth; it can soothe throat pain.
-
Try sucking on ice chips.
-
If swallowing is hard, tilting your head back or moving it forward may help.
-
If your teeth and gums are sore, your dentist may be able to recommend a
special product for cleaning your teeth.
-
Rinse your mouth often with water to remove food and bacteria and to promote
healing.
-
Ask your doctor about anesthetic lozenges and sprays that can numb your mouth
and throat long enough for you to eat meals.
Chemotherapy
and radiation therapy in the head or neck area can reduce the flow of saliva
and cause dry mouth. When this happens, foods are harder to chew and swallow.
Dry mouth also can change the way foods taste. Some of the ideas for sore mouth
and throat may help. The suggestions below also may help you deal with dry
mouth.
-
Have a sip of water every few minutes to help you swallow and talk more easily.
Consider carrying a water bottle with you so you always have some handy.
-
Try very sweet or tart foods and beverages, such as lemonade; these foods may
help your mouth make more saliva. (Do not try this if you also have a tender
mouth or sore throat and the sweet or tart foods make it worse.)
-
Suck on hard candy or popsicles or chew gum. These can help make more saliva.
-
Eat soft and pureed foods, which may be easier to swallow.
-
Keep your lips moist with lip salves.
-
Moisten food with sauces, gravies, and salad dressings to make it easier to
swallow.
-
If your dry mouth problem is severe, ask your doctor or dentist about products
that coat, protect, and moisten your mouth and throat. These are sometimes
called "artificial saliva."
Cancer and cancer treatment can cause tooth decay and other problems for your
teeth and gums. For example, radiation to the mouth can affect your salivary
glands, making your mouth dry and increasing your risk of cavities. Changes in
eating habits also may add to the problem. Your doctor and dentist should work
closely together to fix any problems with your teeth before you start
treatment. If you eat often or eat a lot of sweets, you may need to brush your
teeth more often. Brushing after each meal or snack is a good idea. Here are
some other ideas for preventing dental problems:
-
Be sure to let your doctor know about any dental problems you are having.
-
Be sure to see your dentist regularly. Patients who are receiving treatment
that affects the mouth - for example, radiation to the head and neck - may need
to see the dentist more often than usual.
-
Use a soft toothbrush. Ask your doctor, nurse, or dentist to suggest a special
kind of toothbrush and/or toothpaste if your gums are very sensitive.
-
Rinse your mouth with warm water when your gums and mouth are sore.
-
If you are eating foods high in sugar or foods that stick to your teeth, be
sure to brush or rinse your mouth afterward so that the sugar won't damage your
teeth, or use sugar-free varieties. (Sorbitol, a sugar substitute that is
contained in many sugar-free foods, can cause diarrhea in many people. If
diarrhea is a problem for you, check the labels of sugar-free foods before you
buy them and limit your use of them.)
Your sense of taste or smell may change during your illness or treatment.
Foods, especially meat or other high-protein foods, can begin to have a bitter
or metallic taste. Many foods will have less taste. Chemotherapy, radiation
therapy, or the cancer itself may cause these problems. Dental problems also
can change the way foods taste. For most people, changes in taste and smell go
away when their treatment is finished.
There is no foolproof way to prevent changes to your sense of taste or smell
because each person is affected differently by illness and treatments. However,
the tips below should help if you have this problem. (If you also have a sore
mouth, sore gums, or a sore throat, talk to your doctor, nurse, or registered
dietitian. They can suggest ways to help you without hurting the sore areas.)
-
Choose and prepare foods that look and smell good to you.
-
If red meat, such as beef, tastes or smells strange, try chicken, turkey, eggs,
dairy products, or mild-tasting fish instead.
-
Help the flavor of meat, chicken, or fish by marinating it in sweet fruit
juices, sweet wine, Italian dressing, or sweet-and-sour sauce.
-
Try using small amounts of flavorful seasonings, such as basil, oregano, or
rosemary.
-
Try tart foods, such as oranges or lemonade, that may have more taste. A tart
lemon custard might taste good and will also provide needed protein and
calories. (If you have a sore mouth or throat, tart or citrus foods might cause
pain or discomfort.)
-
If smells bother you, try serving foods at room temperature, turning on a
kitchen fan, covering foods when cooking, and cooking outdoors in good weather.
-
Try using bacon, ham, or onion to add flavor to vegetables.
-
Visit your dentist to rule out dental problems that may affect the taste or
smell of food.
-
Ask your dentist or doctor about special mouthwashes and good mouth care.
Nausea, with or without vomiting, is a common side effect of surgery,
chemotherapy, radiation therapy, and biological therapy. The disease itself, or
other conditions unrelated to your cancer or treatment, may also cause nausea.
Some people have nausea or vomiting right after treatment; others don't have it
until two or three days after a treatment. Many people never experience nausea.
For those who do, nausea often goes away once the treatment is completed. Also,
there are now drugs that can effectively control this side effect. These
medications, called
antiemetics, are often given at the beginning of a chemo-therapy session to prevent
nausea.
Whatever the cause, nausea can keep you from getting enough food and needed
nutrients. Here are some ideas that can help:
-
Ask your doctor about antiemetics that might help you control nausea and
vomiting.
-
Try foods that are easy on your stomach, such as:
-
toast, crackers, and pretzels
-
yogurt
-
sherbet
-
angel food cake
-
cream of wheat, rice, or oatmeal
-
boiled potatoes, rice, or noodles
-
skinned chicken that is baked or broiled, not fried
-
canned peaches or other soft, bland fruits and vegetables
-
clear
liquids
-
ice chips
-
carbonated drinks
-
Avoid foods that:
-
are fatty, greasy, or fried
-
are very sweet, such as candy, cookies, or cake
-
are spicy or hot
-
have strong odors
-
Eat small amounts, often and slowly. Eat before you get hungry, because hunger
can make feelings of nausea stronger.
-
If nausea makes certain foods unappealing, then eat more of the foods you find
easier to handle.
-
Avoid eating in a room that's stuffy, too warm, or has cooking odors that might
disagree with you.
-
Drink fewer liquids with meals. Drinking liquids can cause a full, bloated
feeling.
-
Slowly drink or sip liquids throughout the day. A straw may help.
-
Have foods and drinks at room temperature or cooler; hot foods may add to
nausea.
-
Don't force yourself to eat favorite foods when you feel nauseated. This may
cause a permanent dislike for those foods.
-
Rest after meals, because activity may slow digestion. It's best to rest
sitting up for about an hour after meals.
-
If nausea is a problem in the morning, try eating dry toast or crackers before
getting up.
-
Wear loose-fitting clothes.
-
If nausea occurs during radiation therapy or chemotherapy, avoid eating for 1
to 2 hours before treatment.
-
Try to keep track of when your nausea occurs and what causes it (specific
foods, events, surroundings). (see
chart) If possible and if it helps, change your diet or
schedule. Share the information with your doctor or nurse.
Vomiting may follow nausea and may be brought on by treatment, food odors, gas
in the stomach or bowel, or motion. In some people, certain associations or
surroundings, such as the hospital, may cause vomiting. As with nausea, some
people have vomiting right after treatment, while others don't have it until a
day or more after treatment.
If vomiting is severe or lasts for more than a day or two, contact your doctor.
He or she may give you an
antiemetic
medication to control nausea and vomiting.
Very often, if you can control nausea, you can prevent vomiting. At times,
though, you may not be able to prevent either. Relaxation exercises or
meditation may help you. These usually involve deep rhythmic breathing and
quiet concentration, and can be done almost anywhere. If vomiting does occur,
try these suggestions to help prevent further episodes:
-
Do not eat or drink anything until you have the vomiting under control.
-
Once the vomiting is under control, try small amounts of clear liquids, such as
water or bouillon.
Table 2
gives you more examples of clear liquids. Begin with 1 teaspoonful every 10
minutes, gradually increasing the amount to 1 tablespoon every 20 minutes.
Finally, try 2 tablespoons every 30 minutes.
-
When you are able to keep down clear liquids, try a full-liquid diet or a
soft diet.
Table 3
gives examples of full-liquid foods. Continue taking small amounts as often as
you can keep them down. If you feel okay, gradually work up to your regular
diet. If you have a hard time digesting milk, you may want to try a soft diet
instead of a full-liquid diet, because a full-liquid diet includes a lot of
milk products. Ask a registered dietitian for information about a soft diet.
Diarrhea may have several causes, including chemotherapy, radiation therapy to
the abdomen, infection, food sensitivities, and emotional upset. Work with your
doctor to identify the cause of your diarrhea so that it can be successfully
treated.
During diarrhea, food passes quickly through the bowel before your body has a
chance to absorb enough vitamins, minerals, and water. This may cause
dehydration, which means that your body does not have enough
water to work well. Long-term or severe diarrhea may cause problems, so contact
your doctor if the diarrhea is severe or lasts for more than a couple of days.
Here are some ideas for coping with diarrhea:
-
Drink plenty of fluids to replenish what you lose with the diarrhea.
Tables 2
and 3
give examples of fluids to try.
-
Eat small amounts of food throughout the day instead of three large meals.
-
Eat plenty of foods and liquids that contain
sodium and
potassium, two important minerals that help your body work
properly. These minerals are often lost during diarrhea. Good high-sodium
liquids include bouillon or fat-free broth. Foods high in potassium that don't
cause diarrhea include bananas, peach and apricot nectar, and boiled or mashed
potatoes. Sports drinks contain both sodium and potassium and have easily
absorbable forms of carbohydrates.
-
Try these foods:
-
yogurt, cottage cheese
-
rice, noodles, or potatoes
-
farina or cream of wheat
-
eggs (cooked until the whites are solid; not fried)
-
smooth peanut butter
-
white bread
-
canned, peeled fruits and well-cooked vegetables
-
skinned chicken or turkey, lean beef, or fish (broiled or baked, not fried)
-
Avoid:
-
greasy, fatty, or fried foods if they make your diarrhea worse
-
raw vegetables and the skins, seeds, and stringy fibers of unpeeled fruits
-
high-fiber vegetables, such as broccoli, corn, dried beans, cabbage, peas, and
cauliflower
-
Avoid very hot or cold food or beverages. Drink liquids that are at room
temperature.
-
Limit foods and drinks that contain caffeine, such as coffee, some sodas, and
chocolate.
-
If you have a sudden, short-term attack of diarrhea, try having nothing but
clear liquids for the next 12 to 14 hours. (see
chart) This lets your bowel rest and replaces the important
fluids lost during the diarrhea. Make sure your doctor or nurse knows about
this problem.
-
Be careful when using milk and milk products. The lactose they contain can make
diarrhea worse. Most people, though, can handle small amounts (about 1-1/2
cups) of milk or milk products.
Special Diets for Special Needs
When you have special needs because of your cancer or treatment, your doctor or
registered dietitian may prescribe a special diet. For example, a soft diet may
be best if your mouth, throat, esophagus, or stomach is sore. Or, if your
treatment makes it difficult for you to digest dairy products, you may need to
follow a low-lactose diet. Other special diets include a clear-liquid diet, a
full-liquid diet, and a fiber-restricted diet.
Some special diets are well balanced and can be followed for long periods of
time. Others, however, should be followed for only a few days because they may
not provide enough nutrients for the long term. If you think you need a special
diet, talk with your doctor and a registered dietitian. Together, you can work
out a plan. You also should work with your doctor and dietitian if you are
already on a special diet for a disease such as diabetes, kidney, or heart
disease.
|
Lactose intolerance
means that your body can't digest or absorb the milk sugar called lactose.
Milk, other milk-based dairy products (such as cheese and ice cream), and foods
to which milk has been added (such as pudding) may contain lactose.
Lactose intolerance may occur after treatment with some antibiotics, with
radiation to the stomach or with any treatment that affects the digestive
tract. The part of your intestines that digests lactose may not work properly
during treatment. For some people, the symptoms of lactose intolerance (gas,
cramps, diarrhea) disappear a few weeks or months after the treatments end or
when the intestine heals. For others, a permanent change in eating habits may
be needed.
If you have this problem, your doctor may advise you to follow a diet that is
low in foods that contain lactose. Talk to a registered dietitian to get advice
and specific tips about how to follow a low-lactose diet. Your supermarket
should carry milk and other products that have been modified to reduce or
eliminate the lactose. You can also make your own low-lactose or lactose free
foods. Here's a simple recipe for a lactose-free pudding:
Lactose-Free Double Chocolate Pudding).
Some anticancer drugs and other drugs, such as pain medications, may cause
constipation. This problem also can occur if your diet lacks enough fluid or
fiber, or if you've been in bed for a long time. Here are some suggestions for
preventing and treating constipation:
-
Drink plenty of liquids - at least eight 8-ounce glasses every day. This will
help to keep your stools soft. Another way to think about fluids is to try to
drink at least 1/2 oz. per pound of your body weight.
-
Have a hot drink about one-half hour before your usual time for a bowel
movement.
-
Check with your doctor to see if you can increase the fiber in your diet (there
are certain types of cancer for which a high-fiber diet is not recommended). If
you can, try foods such as whole-grain breads and cereals, dried fruits, wheat
bran, wheat germ; fresh fruits and vegetables; dried beans and peas. Eat the
skin on potatoes. Make sure you also drink plenty of fluids to help the fiber
work. Here's is an easy recipe that might help relieve constipation:
Apple/Prune Sauce.
-
Get some exercise every day. Talk to your doctors or a physical therapist about
the amount and type of exercise that's right for you.
If these suggestions don't work, ask your doctor about medicine to ease
constipation. Be sure to check with your doctor before taking any laxatives or
stool softeners.
All the methods of treating cancer treatment are powerful. Treatment may go on
for weeks or months. It may even cause more illness or discomfort than the
initial disease. Many patients say they feel exhausted and depressed, and
unable to concentrate. Fatigue during cancer treatment can be related to a
number of causes: not eating, inactivity, low blood counts, depression, poor
sleep, and side effects of medicine. It is important for you to raise the issue
with your health care team if you are having fatigue. Together, you can decide
what is causing the problem, since many of the causes can be treated.
Fatigue and depression aren't eating problems in and of themselves, but they
can affect your interest in food and your ability to shop and prepare healthy
meals. Here are some suggestions that may help:
-
Talk about your feelings and your fears. Being open about your emotions can
make them seem more manageable. Consider talking with your nurse or social
worker, who can help you find ways to lessen your worries and fears.
-
Become familiar with your treatment, possible side effects, and ways of coping.
Being knowledgeable and acting on that knowledge will help you feel more in
control. Don't be afraid to talk with your doctor and ask questions.
-
Make sure you get enough rest:
-
take several naps or rest breaks during the day, rather than one long rest
-
plan your day to include rest breaks
-
make rest time special with a good book in a comfortable chair or a favorite
video with a friend
-
try easier or shorter versions of your usual activities; don't push yourself to
do more than you can manage.
-
Save your favorite foods for times that aren't associated with treatment
sessions. That way, they won't be linked to an uncomfortable or distressing
event.
-
Take short walks or get regular exercise, if possible. Some people find this
helps to lessen their fatigue and raise their spirits.
Cancer patients undergoing treatment can develop a weakened immune system
because most anticancer drugs decrease the body's ability to make white blood
cells, the cells that fight infection. That's why cancer patients should be
especially careful to avoid infections and food-borne illnesses. Here are some
tips to help you prevent food-borne illness:
-
Wash all raw fruits and vegetables well. If it can't be well washed (as with
raspberries), avoid it. Scrub rough surfaces, like the skin of melons, prior to
cutting.
-
Carefully wash your hands and food preparation surfaces (knives, cutting
boards) before and after preparing food, especially after handling raw meat.
-
Thaw meat in the refrigerator, not on the kitchen counter.
-
Be sure to cook meat and eggs thoroughly.
-
Avoid raw shellfish and use only pasteurized or processed ciders and juices and
pasteurized milk and cheese.
The Food and Drug Administration has published a
booklet that includes these and other tips for preventing food-borne
illness.
Many cancer patients want to know whether vitamins, minerals, or other dietary
supplements (such as
phytochemicals) will help "build them up" or help fight their cancer. We know that
patients who eat well during cancer treatment are better able to cope with
their disease and any side effects of treatment. However, there is no
scientific evidence that dietary supplements or herbal remedies can cure cancer
or stop it from coming back.
The NCI strongly urges you to depend on traditional, healthy foods for
vitamins, minerals, and other nutrients. Talk to your doctor, nurse, registered
dietitian, or a pharmacist before taking any vitamin or mineral supplements.
Too much of some vitamins or minerals can be just as dangerous as too little.
Large doses of some vitamins may even stop your cancer treatment from working
the way it should. To avoid problems, don't take these products on your own.
Follow your doctor's guidance.
You may hear or read about many different kinds of treatments people have tried
to cure their disease. A therapy is called complementary when it is used in
addition to conventional treatments; it is often called alternative when it is
used instead of conventional treatment. A number of medical centers are
evaluating the scientific aspects of complementary and alternative therapies
and developing studies to test them. Many of these treatments have not been
thoroughly studied, and we have no proof that they work or that they are safe.
Other treatments have been studied, and we know they don't help or are harmful.
It is important to talk with your doctor or nurse if you are considering trying
any of these treatments, because some therapies may interfere with your
standard treatment or may be harmful when used with conventional treatment. He
or she can talk to you about any research that has been done and whether or not
the treatment is safe or would interfere with your treatment. NCI strongly
urges you to follow a treatment program prescribed by a doctor who uses
accepted and proven methods or treatments. People who depend upon
unconventional treatments alone may lose valuable treatment time and reduce
their chances of controlling their cancer and getting well.
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