Dietary Guidelines for Cancer Patients: Eating for Strength and Well-being, Resúmenes de Nutrición

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Nutrition for the Person With

Cancer During Treatment

A Guide for Patients and Families

• Introduction
• Benefits of good nutrition during cancer treatment
  • Nutrients
• Cancer and cancer treatment affect nutrition
• Before treatment begins
  • Make plans now
• Once treatment starts
  • Eat well
  • Snack as needed
  • Tips to increase calories and protein
  • Don’t forget about physical activity
• radiation, and chemotherapy Managing eating problems caused by surgery,
  • Surgery
  • Radiation therapy
  • Chemotherapy
• For people with weakened immune systems
  • Food-handling tips
  • Do not cross-contaminate
  • Cook foods well
  • Grocery shopping
  • Dining out
• How to cope with common eating problems
  • Appetite changes
  • Constipation
  • Diarrhea
  • Fatigue
  • Mouth dryness or thick saliva
  • Mouth sores
  • Nausea
  • Swallowing problems
  • Taste and smell changes
  • Weight gain
• Nutrition after treatment ends
  • Tips for healthy eating after cancer
• To learn more
  • More American Cancer Society information
  • National organizations and websites*
• Recipes to try
  • High-calorie, high-protein shake and drink recipes
  • Homemade soup recipes

Nutrition for the Person With

Cancer During Treatment:

A Guide for Patients and Families

Nutrition is an important part of cancer treatment. Eating the right kinds of foods before, during, and after treatment can help you feel better and stay stronger. Not everyone has nutrition-related side effects, but this guide will help you address them if and when they come up. You don’t have to read straight through all the information here. You can just read the sections you need and use what applies to you.

Benefits of good nutrition

during cancer treatment

Good nutrition is especially important if you have cancer because both the illness and its treatments can change the way you eat. Cancer and cancer treatments can also affect the way your body tolerates certain foods and uses nutrients. The nutrient needs of people with cancer vary from person to person. Your cancer care team can help you identify your nutrition goals and plan ways to help you meet them. Eating well while you’re being treated for cancer might help you:

• Feel better.
• Keep up your strength and energy.
• Maintain your weight and your body’s store of nutrients.
• Better tolerate treatment-related side effects.
• Lower your risk of infection.
• Heal and recover faster.

Nutrients

Proteins We need protein for growth, to repair body tissue, and to keep our immune systems healthy. When your body doesn’t get enough protein, it might break down muscle for the fuel it needs. This makes it take longer to recover from illness and can lower resistance to infection. People with cancer often need more protein than usual. After surgery, chemotherapy, or radiation therapy, extra protein is usually needed to heal tissues and help fight infection. Good sources of protein include fish, poultry, lean red meat, eggs, low-fat dairy products, nuts and nut butters, dried beans, peas and lentils, and soy foods. Fats Fats play an important role in nutrition. Fats and oils are made of fatty acids and serve as a rich source of energy for the body. The body breaks down fats and uses them to store energy, insulate body tissues, and transport some types of vitamins through the blood. You may have heard that some fats are better for you than others. When considering the effects of fats on your heart and cholesterol level, choose monounsaturated and polyunsaturated fats more often than saturated fats or trans fats. Monounsaturated fats are found mainly in vegetable oils like olive, canola, and peanut oils. Polyunsaturated fats are found mainly in vegetable oils like safflower, sunflower, corn, and flaxseed. They are also the main fats found in seafood.

Fiber is the part of plant foods that the body can’t digest. There are 2 types of fiber. Insoluble fiber helps to move food waste out of the body quickly, and soluble fiber binds with water in the stool to help keep stool soft. Other sources of carbohydrates include bread, potatoes, rice, spaghetti, pasta, cereals, corn, peas, and beans. Sweets (desserts, candy, and drinks with sugar) can supply carbohydrates, but provide very little in the way of vitamins, minerals, or phytonutrients. Water All body cells need water to function. If you don’t take in enough fluids or if you lose fluids through vomiting or diarrhea, you can become dehydrated (your body doesn’t have as much fluid as it should). You get water from the foods you eat, but a person should also drink about eight 8-ounce glasses of liquid each day to be sure that all the body cells get the fluid they need. Keep in mind that all liquids (soups, milk, even ice cream and gelatin) count toward your fluid goals. Vitamins and minerals The body needs small amounts of vitamins and minerals to help it function properly. Most are found naturally in foods. They are also sold as supplements in pill and liquid form. They help the body use the energy (calories) found in foods. A person who eats a balanced diet with enough calories and protein usually gets plenty of vitamins and minerals. But it can be hard to eat a balanced diet when you’re being treated for cancer, especially if you have treatment side effects that last for a long time. In this case, your doctor or dietitian may suggest a daily multivitamin and mineral supplement.

If you’re thinking of taking a vitamin or supplement, be sure to discuss this with your doctor first. These substances can be harmful, especially when taken in large doses. In fact, large doses of some vitamins and minerals may make chemotherapy and radiation therapy less effective. Antioxidants Antioxidants include vitamins A, C, and E; selenium and zinc; and some enzymes that absorb and attach to free radicals, preventing them from attacking normal cells. If you want to take in more antioxidants, health experts recommend eating a variety of fruits and vegetables, which are good sources of antioxidants. Taking large doses of antioxidant supplements or vitamin-enhanced foods or liquids is usually not recommended while getting chemo or radiation therapy. Talk with your doctor to find out the best time to take antioxidant supplements. Phytonutrients Phytonutrients or phytochemicals are plant compounds like carotenoids, lycopene, resveratrol, and phytosterols that are thought to have health-protecting qualities. They’re found in plants such as fruits and vegetables, or things made from plants, like tofu or tea. Phytochemicals are best taken in by eating the foods that contain them rather than taking supplements or pills. Herbs Herbs have been used to treat disease for hundreds of years, with mixed results. Today, herbs are found in many products, like pills, liquid extracts, teas, and ointments. Many of these products are harmless and safe to use, but others can cause

Cancer and cancer treatment

affect nutrition

During cancer treatment you might need to change your diet to help build up your strength and withstand the effects of the cancer and its treatment. When your cancer was first diagnosed, your doctor talked with you about a treatment plan. This may have meant surgery, radiation therapy, chemotherapy, hormone therapy, biologic therapy (immunotherapy), or some combination of treatments. All of these treatments kill cancer cells. But in the process, healthy cells are damaged, too. This damage is what causes cancer treatment side effects. Some of the more common side effects that can affect eating are:

• Loss of appetite (anorexia)
• Sore mouth or throat
• Dry mouth
• Dental and gum problems

• Changes in taste or smell
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Feeling very tired all the time (fatigue)
• Depression We have a lot more information on the different side effects of cancer treatment. Call us or visit our website for more details.

Before treatment begins

Until you start treatment, you won’t know what, if any, side effects you may have or how you will feel. One way to prepare is to look at your treatment as a time to focus on yourself and on getting well. Here are some other ways to get ready:

Once treatment starts

Eat well

Your body needs a healthy diet to function at its best. This is even more important if you have cancer. In fact, some cancer treatments work better in people who are well-nourished and are getting enough calories and protein. Try these tips:

• Don’t be afraid to try new foods. Some things you may never have liked before may taste good during treatment.
• Choose different plant-based foods. Try eating beans and peas instead of meat at a few meals each week.
• Try to eat a variety of fruits and vegetables every day, including citrus fruits and dark-green and deep-yellow vegetables. Colorful vegetables and fruits and plant-based foods contain many natural health-promoting substances.
• Choose high-nutrient foods, and limit the amount of sugary drinks and highly processed foods.

Snack as needed

During cancer treatment your body often needs extra calories and protein to help you maintain your weight and heal as quickly as possible. If you’re losing weight, snacks can help you meet those needs, keep up your strength and energy level, and help you feel better. Try these tips to make it easier to add snacks to your daily routine:

• Eat small snacks throughout the day.
• Keep a variety of protein-rich snacks on hand that are easy to prepare and eat. These include yogurt, cereal and milk, half a sandwich, a bowl of hearty soup, and cheese and crackers.

• Avoid snacks that may make any treatment-related side effects worse. If you have diarrhea, for example, avoid popcorn and raw fruits and vegetables. If you have a sore throat, do not eat dry, coarse snacks or acidic foods.
• If you’re able to eat normally and maintain your weight without snacks, then don’t include them. Some quick-and-easy snacks Angel food cake Gelatin made with juice, milk, or fruit Popcorn, pretzels Cereal (hot or cold) Granola or trail mix Puddings, custards Cheese (aged or hard cheese, cottage cheese, cream cheese, and more) Homemade milk shakes and smoothies Sandwiches such as egg salad, grilled cheese, or peanut butter Cookies Ice cream, sherbet, and frozen yogurt Soups (broth based or hearty) Crackers Juices Sports drinks Dips made with cheese, beans, yogurt, or peanut butter Milk by itself, flavored, or with instant breakfast powder Vegetables (raw or cooked) with olive oil, dressing, or sauce Eggnog (pasteurized) Muffins Yogurt (low fat or Greek) Fruit (fresh, frozen, canned, dried) Nuts, seeds, and nut butters Microwave snacks

High-protein foods Milk products* Add grated cheese to baked potatoes, vegetables, soups, noodles, meat, and fruit. Use milk in place of water for hot cereal and soups. Add Greek yogurt, powdered whey protein, or cottage cheese to favorite fruits or blended smoothies. Eggs Keep hard-cooked eggs in the refrigerator. Chop and add to salads, casseroles, soups, and vegetables. Make a quick egg salad. All eggs should be well-cooked to avoid the risk of harmful bacteria. Pasteurized egg substitute is a low-fat alternative to regular eggs. Meats, poultry, and fish Add cooked meats to soups, casseroles, salads, and omelets. Mix diced or flaked cooked meat with sour cream and spices to make dip. Beans, legumes, nuts, and seeds Sprinkle seeds or nuts on desserts like fruit, ice cream, pudding, and custard. Also serve on vegetables, salads, and pasta. Spread peanut or almond butter on toast and fruit or blend in a milk shake.

Don’t forget about physical activity

Physical activity has many benefits. It helps you maintain muscle mass, strength, stamina, and bone strength. It can help reduce depression, stress, fatigue, nausea, and constipation. It can also improve your appetite. So if you don’t already exercise, talk to your doctor about how to start a moderate exercise plan. High-calorie foods Butter* Melt over potatoes, rice, pasta, and cooked vegetables. Stir melted butter into soups and casseroles and spread on bread before adding other ingredients to your sandwich. Milk products Add whipping or heavy cream to desserts, pancakes, waffles, fruit, and hot chocolate; fold it into soups and casseroles. Add sour cream to baked potatoes and vegetables. Salad dressings Use regular (not low-fat or diet) mayonnaise and salad dressing on sandwiches and as dips with vegetables and fruit. Sweets Add jelly and honey to bread and crackers. Add jam to fruit. Use ice cream as a topping on cake. *Adapted from Eldridge B, and Hamilton KK, Editors, The Complete Resource Kit for Oncology Nutrition, Academy of Nutrition and Dietetics, 2013.