Your Diet Is an Important Part of Your Treatment
Before Treatment Begins
Managing Eating Problems During Treatment
Special Notes for Caregivers
After Treatment Ends
Recipes
Figure and Tables
Resources
Your Diet Is an Important Part of Your Treatment
Your
diet
is an important part of your treatment for cancer. Eating the right kinds of
foods before, during, and after your treatment can help you feel better and
stay stronger.
The National Cancer Institute (NCI) has prepared this information to help you
learn about your diet needs during treatment and to help you cope with side
effects that may affect eating. It is designed for cancer patients and their
families and other caregivers. The information here has been gathered from many
sources and reflects the tried-and-true experience of cancer patients and the
doctors, nurses, and dietitians who work with them.
A
registered dietitian is your best source of
information about your diet. The information here will add to what the
dietitian can tell you. Feel free to ask for help or advice when you need it.
Writing down your questions in advance will help you make sure you get the
information you need. Ask the dietitian to repeat or explain anything that is
not clear. She or he can also explain anything in this book if you have a
question and can give you more detailed information. Your doctor or nurse can
also give you helpful advice and can refer you to a registered dietitian. If
you cannot get a referral, call the American Dietetic Association's (ADA)
toll-free nutrition hotline. The information specialist you talk to can help
you find a registered dietitian in your area. The
Resources 1 section at the end of Eating Hints provides the telephone
number and other contact information for the ADA.
Before Treatment Begins
When your cancer was first diagnosed, your doctor talked to you about a
treatment plan. This may have involved
surgery,
radiation therapy,
chemotherapy,
hormone therapy, and
biologic immunotherapy
or some combination of those treatments.
All of these methods of treating cancer kill
cells. In the process of killing the cancer cells, some healthy
cells are also damaged. That is what causes the side effects of cancer
treatment. Side effects that can affect your ability to eat include:
-
loss of appetite
-
changes in weight (either losing or gaining weight)
-
sore mouth or throat
-
dry mouth
-
dental and gum problems
-
changes in sense of taste or smell
-
nausea/vomiting
-
diarrhea
-
lactose intolerance
-
constipation
-
fatigue and/or depression
You may or may not have any of these side effects. Many factors determine
whether you will have any and how severe they will be. These factors include
the type of cancer you have, the part of your body being treated, the type and
length of treatment, and the dose of treatment. The good news is that if you do
have side effects they can often be well-controlled. Most side effects also go
away after treatment ends. Your doctor or nurse can tell you more about your
chances of having side effects and what they might be like.
Recommendations about food and eating for cancer patients can be very different
from the usual suggestions for healthful eating. This can be confusing for many
patients because these new suggestions may seem to be the opposite of what
they've always heard.
Nutrition recommendations usually stress eating lots of fruits,
vegetables, and whole grain breads and cereals; including a moderate amount of
meat and dairy products; and cutting back on fat, sugar, alcohol, and salt.
More information and tips on these recommendations are covered in the section
After Treatment Ends 2.
Nutrition recommendations for cancer patients may focus on helping you eat more
higher
calorie foods that emphasize
protein. Recommendations might include eating or drinking more
milk, cream, cheese, and cooked eggs. Other suggestions might include
increasing your use of sauces and gravies, or changing your cooking methods to
include more butter, margarine, or oil. Sometimes, nutrition recommendations
for cancer patients suggest that you eat less of certain high-
fiber
foods because these foods can aggravate problems such as diarrhea or a sore
mouth.
Nutrition recommendations for cancer patients are different because they are
designed to help build up your strength and help you withstand the effects of
your cancer and its treatment. When you are healthy, eating enough food to get
the
nutrients
you need is usually not a problem. During cancer treatment, however, this can
become a challenge, especially if you have side effects or simply don't feel
well.
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Until your treatment actually starts, you won't know exactly what, if any, side
effects you may have or how you'll feel. One way to prepare is to think of your
treatment as a time for you to concentrate on yourself and on getting well.
Here are some other ways to get ready:
Think Positively
-
Many people have few or no eating-related side effects. Even if you do, they
may be mild, and most go away after cancer treatment ends. Also, there are new
drugs now that can work well to control side effects.
-
Having a positive attitude, talking out your feelings, becoming well-informed
about your cancer and treatment, and planning ways to cope can all help reduce
worry and anxiety, make you feel more in control, and help you keep your
appetite.
-
Give food a chance. Even if you do have eating problems, you'll have days when
eating is a pleasure.
Eat a Healthy Diet
-
A healthy diet is vital for a person's body to work its best. This is even more
important for cancer patients.
-
If you've been eating a healthy diet, you'll go into treatment with reserves to
help keep up your strength, prevent body
tissue from breaking down, rebuild tissue, and maintain your
defenses against
infection.
-
People who eat well are better able to cope with side effects. You may even be
able to handle higher doses of certain treatments. For example, we know that
some cancer treatments are actually much more effective if the patient is
well-nourished and getting enough calories and protein in his or her diet.
-
Don't be afraid to try new foods. Some things you may never have liked before
may taste good to you during treatment.
Plan Ahead
-
Stock the pantry and freezer with favorite foods so that you won't need to shop
as often. Include foods you know you can eat even when you are sick.
-
Keep foods handy that need little or no preparation, for example, pudding,
peanut butter, tuna fish, cheese, and eggs.
-
Do some cooking in advance and freeze in meal-sized portions.
-
Talk to friends or family members about helping with shopping and cooking. Or,
ask a friend or family member to manage that job for you.
-
Talk to a registered dietitian about your concerns and what you might expect.
She or he can give you ideas and help you plan meals. Ask for help in
developing a grocery list with foods that might help with potential side
effects, such as constipation or nausea. Ask about what has worked for other
patients.
Managing Eating Problems During Treatment
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 3 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 4
and 3 5
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 6.
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 7," is a chart that you copy and use to
monitor how you feel as you go through treatment. Use the second, "Notes 6," 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 8.
-
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 4
and 3 5
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 9)
-
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.
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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 10 and Table 6:
How to Increase Protein 11 will give you some ideas for slowing weight
loss or even gaining a few pounds. The tips under
Loss of Appetite 12
may help, too.
Here are three simple recipes that show you how to increase the calories and
protein of familiar foods:
Fortified Milk 13
High-Protein Milkshake 14
Peanut Butter Snack Spread 15
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 2
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 16
-
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 7) 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 4
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 5
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 4
and 3 5
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 7) 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 17).
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 18.
-
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 19 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.
![](https://webarchive.library.unt.edu/eot2008/20090510020719im_/http://www.cancer.gov/images/spacer.gif) |
Special Notes for Caregivers
There is much that you can do to help your friend or loved one through the period of cancer treatment. Read over the tips and suggestions in
Managing Eating Problems During Cancer Treatment. 20 Many may be useful to you as you prepare food or meals for the patient.
In addition, here are some other things to remember that will help you cope:
- Be prepared for the patient's tastes to change from day to day. Some days he or she won't want favorite foods because they don't taste good. Other times, he or she will be able to eat a dish that couldn't be tolerated just the day before.
- Have food within easy reach at home. For example:
- a snack-pack of applesauce or pudding and a spoon on the bedside table if the patient isn't feeling well that day
- a bag of cut-up carrots on the top shelf of the refrigerator
- Have meals and snacks ready so the patient can have something to eat when he or she is ready.
- Be prepared for times when the patient is able to eat only one or two foods for a few days in a row, until side effects diminish. Even if he or she can't eat at all, still encourage plenty of fluids.
Tables 2 4
and 3 5 contain a variety of examples of fluids, and the section on "Coping with Side Effects 21" has lots of ideas for getting enough fluids.
- Talk to the patient about needs and concerns, and about ideas that might work best. A willingness to be flexible and supportive no matter what will help the patient feel in control of the situation.
- Try not to push the patient into eating and drinking. Encourage and support without being overwhelming.
![](https://webarchive.library.unt.edu/eot2008/20090510020719im_/http://www.cancer.gov/images/spacer.gif) |
After Treatment Ends
Most eating-related side effects associated with radiation, chemotherapy, or
other treatments go away after cancer treatment ends. If you have had side
effects, you should gradually begin to feel better, and your interest in food
and mealtimes will come back. Sometimes, though, side effects persist,
especially weight loss. If this happens to you, talk to your doctor and work
out a plan together for how to address the problem.
After cancer treatment ends and you're feeling better, you may want to think
again about the traditional guidelines for healthy eating. Just as you wanted
to go into treatment with all the reserves that such a diet could give you,
you'll want to do the best for yourself at this important time. There's no
current research that suggests that the foods you eat will prevent your cancer
from recurring. But, we do know that eating right will help you regain your
strength, rebuild tissue, and help you feel well. Here are the fundamentals:
-
Focus on eating a variety of foods every day. No one food contains all the
nutrients you need.
-
Emphasize fruits and vegetables. Raw or cooked vegetables, fruits, and fruit
juices provide the vitamins, minerals, and fiber you need.
-
Emphasize breads and cereals, especially the whole grain varieties, such as
whole wheat bread, oats, and brown rice. These foods are good sources of
complex carbohydrates, vitamins and minerals, and fiber.
-
Go easy on fat, salt, sugar, alcohol, and smoked or pickled foods. Choose
low-fat milk products, and small portions (no more than 6-7 oz. a day) of lean
meat and poultry without skin. Try lower-fat cooking methods, such as broiling,
steaming, and poaching.
The U.S. Department of Agriculture and U.S. Department of Health and Human
Services have published materials to help Americans learn how to choose a
healthy diet. The
Resources 1
section at the end of this booklet gives you information on how to get these
materials. If you have any questions about guidelines for healthy eating, or
whether such guidelines are right for you at this time, talk to a registered
dietitian.
Some patients need to have treatments that last a long time. Others may have
surgery to remove part of their stomach or intestines. These patients may have
ongoing eating-related concerns. If this is your situation, talk to your doctor
and a registered dietitian. He or she can give you more information about the
long-term issues that you will deal with and can help you develop an individual
diet plan.
Even if your treatment is over and you're feeling much better, you still may not
feel completely back to your old self. Here are some ways to help you ease back
to regular meals and mealtimes, without overdoing it:
-
Make simple meals using familiar, easy-to-prepare recipes.
-
Cook enough for two or three meals, then freeze the remainder for a later meal.
-
Take advantage of the supermarket's salad bar and prepared foods to make
cooking easier.
-
Think about ways you used to make mealtime special and try them again.
-
Don't be afraid to ask a friend or family member for help with cooking or
shopping.
Recipes
1 whole ripe banana, sliced
Vanilla extract (few drops)
1 cup milk
Place all ingredients into a blender.
Blend at high speed until smooth.
Yield:
1 serving
Serving size: Approximately 2 cups
If made with whole milk:
Calories per serving: 255 calories
Protein per serving: 9 grams
If made with 2% milk:
Calories per serving: 226 calories
Protein per serving: 9 grams
If made with skim milk:
Calories per serving: 190 calories
Protein per serving: 9 grams
1 quart whole milk
1 cup nonfat instant dry milk
Pour liquid milk into a deep bowl.
Add dry milk and beat slowly with beater until dry milk is dissolved (usually
less than five minutes).
Refrigerate and serve cold.
Note: If it tastes too strong, start with 1/2 cup of dry milk powder and
gradually work up to 1 cup.
Yield:
1 quart
Serving size: 1 cup
Calories per serving: 211 calories
Protein per serving: 14 grams
Use
fortified milk when making:
-
macaroni and cheese
-
puddings and custards
-
cream sauces for vegetables
-
mashed potatoes
-
cocoa
-
French toast or pancake batter
-
soup
1
cup fortified milk
2 tbsp butterscotch, chocolate, or your favorite fruit syrup or sauce
1/2 cup ice cream
1/2 tsp vanilla extract
Put all ingredients in a blender.
Blend at low speed for 10 seconds.
Yield: 1 serving
Serving size: Approximately 1-1/2 cups
Calories per serving: 425 calories
Protein per serving: 17 grams
1
tbsp nonfat instant dry milk
1 tbsp honey
1 tsp water
5 tbsp smooth peanut butter
1 tsp vanilla extract
Combine dry milk, water, and vanilla, stirring to moisten.
Add honey and peanut butter, stirring slowly until liquid blends with peanut
butter.
Spread on crackers.
Mixture also can be formed into balls, chilled, and eaten as candy.
Keeps well in refrigerator but is difficult to spread when cold.
Yield: 6 tbsp
Serving size: 3 tbsp
Calories per serving: 279 calories
Protein per serving: 11 grams
1 cup whole milk
1 cup vanilla ice cream or frozen yogurt
1 cup canned fruit (heavy syrup), including juice (peaches, apricots, pears)
Almond or vanilla extract to taste
Blend ingredients and chill well before serving.
Yield:
2 servings
Serving size: 1-1/2 cups
If made with ice cream:
Calories per serving: 302 calories
Protein per serving: 7 grams
If made with frozen yogurt:
Calories per serving: 268 calories
Protein per serving: 9 grams
2
squares baking chocolate (1 oz each)
1 cup nondairy creamer, soy formula or lactose-free milk
1 tbsp cornstarch
1/4 cup granulated sugar
1 tsp vanilla extract
Melt chocolate in small pan or on foil.
Measure cornstarch and sugar into saucepan.
Add part of the liquid and stir until cornstarch dissolves.
Add the remainder of the liquid.
Cook over medium heat until warm.
Stir in chocolate until mixture is thick and comes to a boil.
Remove from heat.
Blend in vanilla and cool.
Yield: 2 servings
Serving size: 3/4 cup
Calories per serving: 382 calories
Protein per serving: 1 gram
1/3 cup unprocessed bran
1/3 cup applesauce
1/3 cup mashed stewed prunes
Blend all ingredients and store in refrigerator.
Take 1-2 tablespoons of this mixture before bedtime, then drink 8 oz. of water.
Note: Make sure you drink the water, or else it will not work to relieve
constipation.
Yield:
16 servings
Serving size: 1 tbsp
Calories per serving: 10 calories
Figure and Tables
Cancer Treatment
|
How it Can Affect Eating
|
What Sometimes Happens: Side Effects
|
Surgery
|
Increases the need for good nutrition. May slow digestion. May lessen the
ability of the mouth, throat, and stomach to work properly. Adequate nutrition
helps wound-healing and recovery.
|
Before surgery, a high-protein, high-calorie diet may be prescribed if a
patient is underweight or weak. After surgery, some patients may not be able to
eat normally at first. They may receive nutrients through a needle in their
vein (such as in
total parenteral nutrition), or through a tube in their nose or
stomach.
|
Radiation Therapy
|
As it damages cancer cells, it also may affect healthy cells and healthy parts
of the body.
|
Treatment of head, neck, chest, or breast may cause:
-
Dry mouth
-
Sore mouth
-
Sore throat
-
Difficulty swallowing (dysphagia)
-
Change in taste of food
-
Dental problems
-
Increased phlegm Treatment of stomach or pelvis may cause:
-
Nausea and vomiting
-
Diarrhea
-
Cramps, bloating
|
Chemotherapy
|
As it destroys cancer cells, it also may affect the digestive system and the
desire or ability to eat.
|
-
Nausea and vomiting
-
Loss of appetite
-
Diarrhea
-
Constipation
-
Sore mouth or throat
-
Weight gain or loss
-
Change in taste of food
|
Biological Therapy (Immunotherapy)
|
As it stimulates your immune system to fight cancer cells, it can affect the
desire or ability to eat.
|
-
Nausea and vomiting
-
Diarrhea
-
Sore mouth
-
Severe weight loss
-
Dry mouth
-
Change in taste of food
-
Muscle aches, fatigue, fever
|
Hormonal Therapy
|
Some types can increase appetite and change how the body handles fluids.
|
-
Changes in appetite
-
Fluid retention
|
-
Bouillon
-
Clear, fat-free broth
-
Clear carbonated beverages
-
Consomme
-
Cranberry/grape juice
-
Fruit-flavored drinks
-
Fruit ices without fruit pieces
|
-
Fruit ices without milk
-
Fruit punch
-
Honey
-
Jelly
-
Plain gelatin dessert
-
Popsicles
|
-
Sports drinks
-
Strained citrus juice
-
Strained lemonade/limeade
-
Strained vegetable broth
-
Tea
-
Water
|
-
All fruit juices and nectars
-
Bouillon, broth
-
Butter/cream/oil/margarine
-
Carbonated beverages
-
Cheese soup
-
Coffee/Tea
-
Fresh or frozen plain yogurt
-
Fruit drinks
-
Fruit punch
-
Honey/jelly/syrup
|
-
Ice milk
-
Liquid meal replacements
-
Milk, all types
-
Milkshakes
-
Pasteurized eggnog
-
Plain cornstarch pudding
-
Plain gelatin desserts
-
Potatoes pureed in soup
-
Refined/strained cooked cereal
|
-
Small amounts of strained meat in broth or gelatin
-
Smooth ice cream
-
Soft or baked custard
-
Strained lemonade/limeade
-
Strained or blenderized soup
-
Thin fruit purees
-
Tomato juice
-
Tomato puree for cream soup
-
Vegetable juice
-
Water
|
-
Applesauce
-
Bread, muffins, and crackers
-
Buttered popcorn
-
Cakes and cookies made with whole grains, fruits, nuts, wheat germ, or granola
-
Cereal
-
Cheese, hard or semisoft
-
Cheesecake
-
Chocolate milk
-
Crackers
|
-
Cream soups
-
Dips made with cheese, beans, or sour cream
-
Fruit (fresh, canned, dried)
-
Gelatin salads and desserts
-
Granola
-
Hard-boiled and deviled eggs
-
Ice cream frozen yogurt, popsicles
-
Juices
-
Milkshakes, "instant breakfast" drinks
|
-
Nuts
-
Peanut butter
-
Pita bread and hummus
-
Pizza
-
Puddings and custards
-
Sandwiches
-
Vegetables (raw or cooked)
-
Whole or 2% milk
-
Yogurt
|
Butter and Margarine
|
-
Add to soups, mashed and baked potatoes, hot cereals, grits, rice, noodles, and
cooked vegetables.
-
Stir into cream soups, sauces, and gravies.
-
Combine with herbs and seasonings, and spread on cooked meats, hamburgers, and
fish and egg dishes.
-
Use melted butter or margarine as a dip for seafoods and raw vegetables, such
as shrimp, scallops, crab, and lobster.
|
Whipped Cream
|
-
Use sweetened on hot chocolate, desserts, gelatin, puddings, fruits, pancakes,
and waffles.
-
Fold unsweetened into mashed potatoes or vegetable purees.
|
Milk and Cream
|
-
Use in cream soups, sauces, egg dishes, batters, puddings, and custards.
-
Put on hot or cold cereal.
-
Mix with noodles, pasta, rice, and mashed potatoes.
-
Pour on chicken and fish while baking.
-
Use as a binder in hamburgers, meatloaf, and croquettes.
-
Use whole milk instead of low-fat.
-
Use cream instead of milk in recipes.
-
Make hot chocolate with cream and add marshmallows.
|
Cheese
|
-
Melt on top of casseroles, potatoes, and vegetables.
-
Add to omelets.
-
Add to sandwiches.
|
Cream Cheese
|
-
Spread on breads, muffins, fruit slices, and crackers.
-
Add to vegetables.
-
Roll into balls and coat with chopped nuts, wheat germ, or granola.
|
Sour Cream
|
-
Add to cream soups, baked potatoes, macaroni and cheese, vegetables, sauces,
salad dressings, stews, baked meat, and fish.
-
Use as a topping for cakes, fruit, gelatin desserts, breads, and muffins.
-
Use as a dip for fresh fruits and vegetables.
-
For a good dessert, scoop it on fresh fruit, add brown sugar, and refrigerate
until cold before eating.
|
Salad Dressings and Mayonnaise
|
-
Use with sandwiches.
-
Combine with meat, fish, and egg or vegetable salads.
-
Use as a binder in croquettes.
-
Use in sauces and gelatin dishes.
|
Honey, Jam, and Sugar
|
-
Add to bread, cereal, milk drinks, and fruit and yogurt desserts.
-
Use as a glaze for meats, such as chicken.
|
Granola
|
-
Use in cookie, muffin, and bread batters.
-
Sprinkle on vegetables, yogurt, ice cream, pudding, custard, and fruit.
-
Layer with fruits and bake.
-
Mix with dry fruits and nuts for a snack.
-
Substitute for bread or rice in pudding recipes.
|
Dried Fruits
(raisins, prunes, apricots, dates, figs)
|
-
Try cooking dried fruits; serve for breakfast or as a dessert or snack.
-
Add to muffins, cookies, breads, cakes, rice and grain dishes, cereals,
puddings, and stuffings.
-
Bake in pies and turnovers.
-
Combine with cooked vegetables, such as carrots, sweet potatoes, yams, and
acorn and butternut squash.
-
Combine with nuts or granola for snacks.
|
Eggs
|
-
Add chopped, hard-cooked eggs to salads and dressings, vegetables, casseroles,
and creamed meats.
-
Make a rich custard with eggs, milk, and sugar.
-
Add extra hard-cooked yolks to deviled-egg filling and sandwich spread.
-
Beat eggs into mashed potatoes, vegetable purees, and sauces. (Be sure to keep
cooking these dishes after adding the eggs because raw eggs may contain harmful
bacteria.)
-
Add extra eggs or egg whites to custards, puddings, quiches, scrambled eggs,
omelets, and to pancake and French toast batter before cooking.
|
Food Preparation
|
-
Bread meat and vegetables.
-
If tolerated, saute and fry foods when possible, because these methods add more
calories than do baking or broiling.
-
Add sauces or gravies.
|
Hard or Semisoft Cheese
|
-
Melt on sandwiches, bread, muffins, tortillas, hamburgers, hot dogs, other
meats or fish, vegetables, eggs, desserts, stewed fruit, or pies.
-
Grate and add to soups, sauces, casseroles, vegetable dishes, mashed potatoes,
rice, noodles, or meatloaf.
|
Cottage Cheese/
Ricotta Cheese
|
-
Mix with or use to stuff fruits and vegetables.
-
Add to casseroles, spaghetti, noodles, and egg dishes, such as omelets,
scrambled eggs, and souffles.
-
Use in gelatin, pudding-type desserts, cheesecake, and pancake batter.
-
Use to stuff crepes and pasta shells or manicotti.
|
Milk
|
-
Use milk instead of water in beverages and in cooking when possible.
-
Use in preparing hot cereal, soups, cocoa, and pudding.
-
Add cream sauces to vegetables and other dishes.
|
Nonfat Instant Dry Milk
|
-
Add to regular milk and milk drinks, such as pasteurized eggnog and milkshakes.
-
Use in casseroles, meatloaf, breads, muffins, sauces, cream soups, mashed
potatoes, puddings and custards, and milk-based desserts.
|
Commercial Products
|
-
See the section on "Commercial Products to Improve Nutrition" on page
10.
-
Use "instant breakfast" powder in milk drinks and desserts.
-
Mix with ice cream, milk, and fruit or flavorings for a high-protein milkshake.
|
Ice Cream, Yogurt, and Frozen Yogurt
|
-
Add to carbonated beverages, such as ginger ale or cola.
-
Add to milk drinks, such as milkshakes.
-
Add to cereal, fruit, gelatin desserts, and pies; blend or whip with soft or
cooked fruits.
-
Sandwich ice cream or frozen yogurt between cake slices, cookies, or graham
crackers.
-
Make breakfast drinks with fruit and bananas.
|
Eggs
|
-
Add chopped, hard-cooked eggs to salads and dressings, vegetables, casseroles,
and creamed meats.
-
Add extra eggs or egg whites to quiches and to pancake and French toast batter.
-
Add extra egg whites to scrambled eggs and omelets.
-
Make a rich custard with eggs, high-protein milk, and sugar.
-
Add extra hard-cooked yolks to deviled-egg filling and sandwich spreads.
-
Avoid raw eggs, which may contain harmful bacteria, because your treatment may
make you susceptible to infection. Make sure all eggs you eat are well cooked
or baked; avoid eggs that are undercooked.
|
Nuts, Seeds, and Wheat Germ
|
-
Add to casseroles, breads, muffins, pancakes, cookies, and waffles.
-
Sprinkle on fruit, cereal, ice cream, yogurt, vegetables, salads, and toast as
a crunchy topping; use in place of bread crumbs.
-
Blend with parsley or spinach, herbs, and cream for a noodle, pasta, or
vegetable sauce.
-
Roll banana in chopped nuts.
|
Peanut Butter
|
-
Spread on sandwiches, toast, muffins, crackers, waffles, pancakes, and fruit
slices.
-
Use as a dip for raw vegetables, such as carrots, cauliflower, and celery.
-
Blend with milk drinks and beverages.
-
Swirl through soft ice cream and yogurt.
|
Meat and Fish
|
-
Add chopped, cooked meat or fish to vegetables, salads, casseroles, soups,
sauces, and biscuit dough.
-
Use in omelets, souffles, quiches, sandwich fillings, and chicken and turkey
stuffings.
-
Wrap in pie crust or biscuit dough as turnovers.
-
Add to stuffed baked potatoes.
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Beans/Legumes
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Cook and use peas, legumes, beans, and tofu in soups or add to casseroles,
pastas, and grain dishes that also contain cheese or meat. Mash cooked beans
with cheese and milk.
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Resources
You may want more information for yourself, your family, and your doctor. The following National Cancer Institute (NCI) services are available to help you.
Cancer Information Service (CIS)
Provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. Information specialists translate the latest scientific information into understandable language and respond in English, Spanish, or on TTY equipment.
Toll-free: 1-800-4-CANCER (1-800-422-6237)
TTY: 1-800-332-8615
Cancer.gov 22
NCI's Web site provides comprehensive information about cancer causes and
prevention, screening and diagnosis, treatment and survivorship; clinical trials;
statistics; funding and training; and the Institute's programs and research activities.
The ADA is a professional society of registered dietitians and other
professionals working in food- and nutrition-related fields. For
a referral to a registered dietitian in your area and to listen
to recorded food and nutrition messages, call the ADA's consumer
nutrition hotline at 1-800-366-1655. Or, visit the ADA's home page on the World
Wide Web at http://www.eatright.org.
Cancer patients, their families and friends, and others may find
the following National Cancer Institute books useful. They are available
free of charge by calling 1-800-4-CANCER.
The
National Cancer Institute and the U.S. Department of Agriculture
and U.S. Department of Health and Human Services have published
several materials on healthy eating. You may find them helpful after
your treatment is over. They include:
The
Food and Drug Administration (FDA) has published a booklet called
"The Unwelcome Dinner Guest: Preventing Food-Borne Illness 19,"
which contains useful information and tips on symptoms of food-borne
illness, safe food storage, safe cooking and storing temperatures,
safe food handling, and other topics related to preventing food-borne
illness. Cancer patients and others with weakened immune systems
need to be careful about food-borne illness, so this booklet may
be especially helpful. To get up to 10 free copies write the FDA
Office of Consumer Affairs:
Food and Drug Administration
Office of Consumer Affairs
5600 Fishers Lane
Room 1685, HFE 88
Rockville, MD 20857
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