Oncology (Cancer)

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TREATING AND MANAGING COMPLEX CONDITIONS



How is food medicine?

Nutrition is important to you while undergoing cancer treatment. The right foods and amounts of food can help you maintain strength and support your immune system. They may also minimize hospital visits and help improve overall treatment outcomes. Here are some tips for nourishing your body during this time:

Nutrition Guidelines:
  • Include plenty of fruits and vegetables (at least 1-2 servings at each meal)
  • Eat high fiber foods such as beans, legumes, seeds, and whole grains
  • Focus on healthy fats like olive oil, avocado, fish, nuts, and nut butters
  • Limit processed and refined grains, flours, sugars
  • Drink plenty of fluids (at least ½ of your body weight in ounces each day)
  • Be physically active for at least 30 minutes, 5 days/week
  • If you are having frequent side effects from your treatment, it may be helpful to see a registered dietitian for personalized nutrition. Kroger Health offers telenutrition services to meet with a dietitian one-on-one from the comfort of your home.

What to eat each day:
  • Fruits and vegetables – 5+ servings a day. Fruits and vegetables contain antioxidant properties. Cruciferous vegetables such as broccoli, cauliflower, kale, cabbage and Brussel sprouts are especially good and are rich in phytochemicals.1
  • Whole grains – Aim to consume 25-30 grams of fiber daily. Whole grains are unprocessed foods that are high in complex carbohydrates, fiber, and phytochemicals as well as vitamins and minerals.1
  • Lean protein – Include a source of lean protein at all meals. Lean proteins include fish, beans, chicken breast, eggs, nuts, nut butters, and tofu. Minimize your intake of cured, pickled, and smoked foods. Try to make at least 1-2 meals/day “plant-based” where you include only eat plant-based sources of protein (e.g., beans, nuts, nut butters, tofu).1

Managing Symptoms & Side Effects

Various cancer treatments can often cause additional side effects that can reduce your appetite or desire to eat. Consider incorporating some of the tips below to address various side effects:2

Nausea & Vomiting:

If experiencing nausea and/or vomiting, try to:

  • Eat smaller more frequent meals 5-6 times daily, as this is often better tolerated than larger meals.
  • Eat cold foods rather than warm foods as they often have less odor.
  • Focus on easy to tolerate foods including applesauce, canned fruit, baked chicken, crackers, pretzels, rice, toast, popsicles, sherbet, and bananas.
  • Take small, slow sips of liquids throughout the day.
  • Speak with your doctor about scheduling anti-nausea medications prior to meals.
  • Avoid spicy, high fat, very sweet, or strong-smelling foods.

Taste Changes:

Sometimes different cancer treatments and medications can alter the taste of food. If you experience a change in taste, here are some tips to make your food more palatable:

  • Consume cold foods and beverages.
  • Try strongly flavored foods such as chocolate, lasagna, spaghetti, or barbecued foods.
  • Try tart or spicy foods, unless you also have mouth sores.
  • Eat proteins without strong odors such as poultry, eggs and dairy products, rather than those with strong odors such as beef and fish.
  • Add sauces to foods to increase flavor.
  • Try eating something sweet, such as cranberry sauce, jelly or applesauce with meals.
  • Experiment with new combinations of seasonings or adding sugar or salt to enhance the flavor.
  • Try eating with plastic silverware and glass cups and plates to avoid taste changes caused by metal while eating.

Mouth Sores:

If mouth sores are present, try:

  • Foods that are lukewarm or cold, rather than hot.
  • Tender and soft foods.
  • Drinking through a straw to bypass mouth sores.
  • High-protein, high-calorie foods to speed healing of the sores.
  • Nutrition supplemental drinks.
  • Soft foods such as creamed soups, cheeses, mashed potatoes, cooked eggs, custards, puddings, cooked cereals, and pasteurized eggnog.
  • Cold foods such as milkshakes, ice cream, cottage cheese, yogurt, watermelon, gelatin, or slushies.

Foods that should be avoided when mouth sores are present:

  • Tart or acidic foods such as citrus fruits and juices and pineapple.
  • Salty foods, including broth.
  • Strong spices such as peppers, chili powder, nutmeg, and cloves.
  • Coarse foods such as raw fruits and vegetables, dry toast, grainy cereals and breads, or crunchy snacks.
  • Alcoholic beverages.

Dry Mouth:

If dry mouth is making eating more challenging:

  • Add sauces, gravies, broth, and dressings to food.
  • Suck ice chips, popsicles, gum, or sugarless hard candies to keep your mouth moist.
  • Eat moist foods such as hot cereals, canned or fresh fruit, casseroles, soups, or stews.
  • Add tart foods to your diet to stimulate saliva, unless you also have mouth sores. Examples could be oranges, lemons, and lemon drops.
  • Sip small amounts of liquids with your meals.

Avoid eating and drinking:

  • Meats without sauces
  • Bread products, crackers and dry cakes
  • Very hot foods and beverages
  • Alcoholic beverages
  • Large amounts of caffeine

Diarrhea:

If experiencing diarrhea, try to:

  • Eat small meals.
  • Drink extra fluids to prevent dehydration. However, try to drink most fluids in between meals to prevent early appetite loss during mealtimes.
  • Consume easy to tolerate foods such as bananas, potatoes, and rice.

Avoid eating and drinking the following when you have diarrhea:

  • High fiber foods such as whole grains, raw vegetables, fruits with skin, popcorn, or nuts
  • Carbonated beverages
  • Beans, broccoli, cauliflower, and cabbage
  • Spicy foods
  • Foods with high fat/rich sauces
  • Caffeine
  • Most dairy products

Constipation:

If experiencing constipation after certain medications or treatments, try to:

  • Drink warm beverages.
  • Eat high-fiber foods like raw fruits and vegetables, whole wheat bread and cereals, dried fruit, dried peas and beans.
  • Engage in light exercise, such as walking.

Cancer Related Fatigue:

Sometimes cancer itself or cancer treatments can lead to a lack of energy or feeling weak. Fatigue may be improved by lifestyle and diet changes. Here are a few strategies that may help:

  • Eat 5-6 smaller meals per day to provide your body with energy every few hours.
  • Choose foods that are easy to chew.
  • Include a protein source at each meal to help improve immunity and keep muscles strong. Examples of high protein foods include eggs, meat, beans, milk, dairy products, soy, and peanut butter and almond butter.
  • Drink plenty of water throughout the day to avoid dehydration as dehydration can worsen fatigue.
  • When feeling well and you have more energy, prepare extra meal portions and freeze in smaller containers to eat later.

Weakened Immune Systems:

If you have a weakened immune system due to cancer and its treatment, it’s difficult for your body to protect itself against infection-causing germs. Therefore, certain food safety precautions must be taken to prevent food borne illness.

At home, be sure to:

  • Wash hands with warm, soapy water before and after preparing food and before eating.
  • Refrigerate foods at or below 40° F.
  • Keep hot foods hot (warmer than 140° F) and cold foods cold (cooler than 40° F).
  • Wash fruits and vegetables well under running water before eating.
  • Wash tops of canned foods with soap and water before eating.
  • Avoid pre-cut produce (e.g cut fruit from the grocery store).
  • Put perishable foods in the refrigerator within 2 hours of buying or preparing them.
  • Use a clean knife to cut different foods.
  • Clean counters and cutting boards well and often.
  • Cook meat and poultry to the proper temperatures using a food thermometer (165 ° F for most meats).

At the grocery store:

  • Check “sell-by” and “use-by” dates on all foods and pick the freshest products.
  • Choose fruits and vegetables without bruises or blemishes.
  • Avoid sliced deli meats unless heated in the microwave for 30 seconds before consuming.
  • Do not eat from buffets or salad bars.
  • Do not eat yogurt and ice cream products from self-serve machines.
  • Do not eat foods that are bought from self-serve containers or bulk bins.

Suggested Shopping List

Fruit:
  • Bananas
  • Strawberries
  • Blueberries
  • Apples

Vegetables:
  • Avocados
  • Spinach
  • Green Beans
  • Sweet Potatoes
  • Zucchini
  • Broccoli

Protein:
  • Peanut Butter
  • Eggs
  • Canned Tuna
  • Rotisserie Chicken, Whole
  • Salmon
  • Black Beans

Dairy:
  • Shredded Mozzarella Cheese
  • Milk
  • Greek Yogurt
  • Butter

Grains:
  • 100% Whole Wheat Bread
  • Granola
  • 100% Whole Wheat Pita
  • Whole Grain Crackers
  • 100% Whole Wheat Pasta
  • Oatmeal

Extra:
  • Tomato Sauce
  • Hummus
  • Canned Soup

Frequently Asked Questions


There is no specific diet for when you are undergoing cancer treatment. However, the main nutritional goals include getting enough: calories (energy) and nutrients from healthy foods, protein to help maintain lean body mass and muscle mass, and fluids to stay hydrated.


You can still follow a normal, healthy diet while undergoing cancer treatment that includes fruits and vegetables, whole grains, lean proteins, and healthy fats. It’s important to remember every patient is different. What works for some may not work for others as people experience symptoms and side effects differently.

Many people have heard the statement “sugar feeds cancer” and feel that they need to completely avoid all sugar in order to no longer “feed” the cancer cells. To understand the role of sugar in cancer, it’s important to first understand sugar’s role in our bodies.


Our bodies need sugar (specifically glucose) to have energy. Every cell of our body needs sugar to live. The sugar that we need comes from two sources: 1) Our bodies break down the carbohydrates we eat (think: bread, oats, sweets) into sugar and 2) If we don’t get enough sugar from our food, our body will make its own sugar.


There is no conclusive research showing that eliminating dietary sources of carbohydrates and sugar results in slower cancer growth. Instead, severe carbohydrate restriction can cause the body work harder than usual to make the glucose that it needs. If all sugar is removed from the diet, the body will then make the sugar that it needs from fat and protein. This requires more energy and can stress your body further.


We also need carbohydrates to maintain healthy cell function in our bodies. Cancer cells use sugar for energy just like any other cell. We cannot “choose” which cells are fed by avoiding sugar. For those who are undergoing treatment for cancer, it is vital to feed your healthy cells by providing them with adequate amounts of carbohydrates, fats, and protein.


Avoiding sugar altogether will not help cancer treatment and could leave your healthy cells low on the energy that they need. Instead of cutting out carbohydrates altogether, focus on eating whole grains and complex carbohydrates such as: whole wheat bread, brown rice, quinoa, and oats.

It’s important to incorporate plenty of produce into your diet, regardless of how it was grown. Despite the overwhelming health benefits of fruits and vegetables, many Americans do not consume the recommended amount of produce: 2.5-4 cups of vegetables a day and 1.5-2.5 cups of fruit a day for an adult, depending on your age and sex.5 Consuming more fruits and vegetables can support your health. You can choose which fruits and vegetables you want to consume given your own needs, preferences, and budget. Organic or conventionally grown produce – whether its fresh, frozen, or canned -- are all safe and nutritious options. It is important to rinse all fruit and vegetables under running water before using, including items you need to peel.

Whole soy foods (like tofu, edamame, and soy milk) can be included in moderate amounts, which means one to two servings/day. Not only is soy safe in moderate amounts, but research shows that soy contains isoflavones, a phytonutrient with anti-cancer properties. Up to three servings of whole soy foods per day may not increase a breast cancer survivor’s risk of recurrence or death. Whole soy foods are recommended over isolated soy protein or isoflavone supplements because whole soy foods provide a wider variety of nutrients and other bioactive compounds, many of which have anti-cancer effects.6

References:

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