Cancer & Nutrition

Managing Side Effects

• Lack of Appetite, Nausea & Vomiting

  • Treat as indicated with anti-nausea medications. Use exactly as prescribed by your doctor or nurse.
  • Ginger: add chopped dried extracts into tea two to three times daily – 940mg powdered ginger root once daily for nausea prevention; 250mg powdered ginger root four times daily for nausea management. If you are on Coumadin or other blood thinners, talk to the nutritionist about the appropriate quantity to consume.
  • Try small frequent snacks of bland foods such as oatmeal, plain pasta, rice, potatoes, broths (avoid ’empty stomach’ which may worsen nausea).
  • Completely avoid food smells. Avoid preparing food for yourself if possible, focus on foods with minimal odors and short cooking times. Eat foods at room temperature to reduce aromas.
  • Avoid eating in a warm, stuffy room.
  • Avoid large quantities of fluids with meals/snacks.
  • Rinse out mouth before and immediately after meals.
  • Sip warm, natural ginger ale (higher ginger content) – sip ginger tea or chamomile tea.Avoid peppermint tea – this may cause more reflux.
  • Sit up to eat. Do not lay down after eating for at least one hour.
  • Avoid fatty, greasy, fried, rich foods such as fatty meats, french fries, desserts (high fat will delay stomach emptying).

• Increasing Calories for Weight Gain

  • Protein Powder (such as whey or soy): Use to make shakes and smoothies:
    • Mix 1 scoop powder with 1/2 cup 2% milk; 1/2 cup ice cream, yogurt, or Boost® supplement; and fruit or flavorings (such as peanut butter or Hershey’s syrup).
  • Grated or Sliced Cheese: Add to soups, sandwiches, mashed potatoes, egg dishes, or main entrées such as casseroles, noodles, meatloaf, and sauces.
  • Powdered Milk: Add to cream soups, oatmeal, smoothies and shakes, casseroles, breads, puddings and custards, and desserts.
    • High Protein Milk Recipe: Mix 1 cup dry powdered milk with 1 quart of milk. Stir and refrigerate over night. Use in place of regular milk.
  • Peanut Butter: Mix into oatmeal, smoothies or shakes; melt onto ice cream, add to vanilla or chocolate pudding. Make peanut butter sandwiches or spread on crackers, toast or muffins.
  • Nuts: Eat as a snack; mix into salads, breads, pancakes or waffles; and sprinkle on ice cream and puddings. Grind and add to foods if unable to chew.
    • Roll a banana in peanut butter or chocolate and then roll in nuts – freeze and eat frozen.
  • Wheat Germ: Mix into oatmeal and cereal, smoothies, puddings and custards, or yogurt. Sprinkle on ice cream, toast with peanut butter, or pasta dishes. Mix into meatloaf, stuffings, or bread recipes.
  • Eggs: Add chopped eggs to salads and casseroles. Beat eggs into mashed potatoes. Add extra eggs to bread and pancake recipes.
  • Milk/Cream: Use in place of water in making oatmeal and soups.
  • Cottage Cheese: Eat as a snack mixed with fruit, nuts or salsa. Add to casseroles or egg dishes such as quiches, scrambled eggs and soufflés. Add to spaghetti or noodles. Add to pudding or yogurt.
  • Meat or Fish: Add to soups (such as adding canned tuna to vegetable soup, or chopped meat to chicken or beef soup), and casseroles. Use in omelets, quiches, sandwich fillings. Add to stuffed baked potatoes.
  • Canola or Olive Oil: Drizzle onto your dinner vegetables and meats AFTER you plate them to eat. Mix 1 tablespoon into your serving of smoothies, cottage cheese, yogurt, mashed potatoes, oatmeal, grits, rice, noodles/pasta. Toast bread with olive oil.
    • Use canola oil for sweet foods because it does not add flavor. Use olive oil for savory foods.
  • Dried Fruit and Granola: Eat as a snack or sprinkle onto yogurt, oatmeal, salads, cottage cheese, puddings, sweet potatoes, and squash. Add to muffin and bread recipes.

• Constipation

  • Drink eight to 10 cups of fluid each day. Try water, prune juice, other warm juices, and teas.
  • Try drinking a warm liquid, such as soup or tea half an hour before normal time for a bowel movement.
  • Add other sources of liquid to the diet such as soup or popsicles.
  • Add two tablespoons ground flaxseed to daily diet.
  • Slowly add high-fiber foods to the diet, try foods such as whole-grain breads and cereals, raw and cooked fruits and vegetables with the skins and peels, and beans and peas.
    • If you increase fiber in your diet, be sure to increase fluid as well or you may become more constipated.
  • Snack on dried fruit such as apricots, raisins, prunes, and dates.
  • Increase physical activity, even if by a small amount. Try taking a short walk about one hour before your normal time for a bowel movement.
  • Eat a good breakfast; include a hot drink and high-fiber foods.
  • Mix three parts wheat bran cereal, two parts applesauce, and one part prune juice. Eat this three times per day or more as needed, to promote a bowel movement. This works well on toast or in oatmeal.
  • If gas is a problem, avoid carbonated drinks, broccoli, cabbage, cauliflower, dried beans and peas, onions, Brussels sprouts, Swiss chard, radishes, turnips, and watercress. Limit talking at meals to avoid swallowing air, do not use a straw, and avoid chewing gum.

• Diarrhea

  • Eat small frequent meals and snacks that are bland and low in fat. These are digested easier.
  • Drink plenty of fluids such as broths and diluted juices.
  • Drink fluids between meals, not with them.
    • Choose non-carbonated, non-caffeinated fluids.
  • Sports drinks (such as Gatorade) or Pedialyte can help replace lost electrolytes.
    • Homemade Electrolyte Replacement Recipe: 1 teaspoon salt, 1 teaspoon baking soda, 1 tablespoon corn syrup, 6 ounces can frozen orange juice, 6 cups water. Mix all ingredients together. Refrigerate.
  • Limit milk and milk products, these may make diarrhea worse.
    • Substitute milk with Lactaid, soy milk, or rice milk.
  • Avoid very hot, very cold, spicy, or very sweet foods – these can exacerbate symptoms.
  • Avoid fatty and fried foods.
  • Avoid insoluble fiber. This is found in skins of fruits, vegetables, potatoes, bran, seeds and nuts, wheat germ, whole grain and wheat, and many vegetables such as corn and leafy greens.
  • Include soluble fiber. This is found in oatmeal, barley, rice, and the inside of apples and pears.
  • Benefiber is an over-the-counter soluble fiber supplement that may increase regularity and decrease frequency of bowel movements. Mix 1 Tbsp with 8 oz water and drink. Repeat twice daily.
  • Probiotic Supplements (Culturelle or New Chapter All-Flora): These help replenish the good bacteria that normally reside in the intestines. They also help to feed your gut cells to keep them healthy and better able to absorb nutrients.

• Sore Mouth & Mucositis

  • Be fastidious with mouth care to prevent secondary bacterial infection of mouth lesions.
  • Eat soft, bland foods such as creamed soups, cooked cereals, yogurt, pudding, mashed potatoes, eggs, custards, casseroles, smoothies and shakes.
  • Drink liquids and semi-soft solids through a straw to bypass mouth areas with sores and lesions.
  • Blend or moisten foods with yogurt, tofu, pudding, soft cereals such as oatmeal and cream of wheat, warm water, juice, milk, soy milk, rice milk, etc.
  • Try non-acidic juices such as apple, apricot, peach or pear nectar, and grape juice (do not use grape juice if diarrhea is present).
  • Avoid tart, acidic, or salty beverages and foods; pickled items; tomato-based foods; alcohol; caffeine; and tobacco.
  • Try powdered glutamine dissolved in liquid at 10 grams three times daily, swish and swallow, may be contraindicated if renal and/or hepatic function is severely impaired.
  • Try anti-inflammatory approach such as capsaicin taffy recipe.
  • Include soft, probiotic containing foods such as yogurt and kefir (fermented milk). If you have severe immunosuppression (your white blood cell counts are very low), do not include probiotics.

• Dry Mouth & Thick Saliva

  • Drink eight to 12 cups (8 ounce cups) of fluid each day.
  • Sip 100% pure, papaya juice to stimulate saliva and break up secretions.
  • Use lemons and lemon juice to help increase production of saliva. Be careful if you have mouth sores or mucositis, as citrus and acidic foods may irritate them and cause pain.
  • Use fluids other than water, such as non-acidic juices, to aid with hydration and increase calorie intake.
  • Try stews and casseroles that contain plenty of liquid, such as those made with soups as the base ingredient.
  • Try soft cooked chicken and fish; tofu; thinned cereals, such as oatmeal made with plenty of water or milk; popsicles; shakes; smoothies; and slushies; warm soups and stews; and canned fruit in its liquid.
  • Blend or moisten foods with yogurt; tofu; pudding; soft cereals such as oatmeal, cream of wheat and malt-o-meal; warm water; juice; milk; soy milk; rice milk, etc.
  • Add broth, sauces, gravy, or soup to soften and moisten foods.
  • Use yogurt, juice, or jelly to make foods ‘slide’ down a dry throat easier.
  • Avoid or limit caffeinated foods and beverages such as coffee, caffeinated tea, and colas.
  • Avoid alcoholic beverages including beer, wine, and mixed drinks – alcohol will dry the mouth further.
  • Avoid dry foods including tough meats, raw vegetables, breads, pretzels, rice, chips, muffins, and cakes.
  • Avoid commercial mouthwashes – these contain alcohol which will dry the mouth further.