Eating well means having a range of foods to get all the nutrients and fibre your body needs. The five main food groups are:
- fruit and vegetables
- starchy foods including bread, pasta, rice and potatoes
- dairy and alternatives
- meat, fish, eggs, beans and other sources of protein
- oils and spreads
If you aren’t able to eat enough or are losing weight, you may need more energy (calories) and protein in your diet. Ask your doctor to refer you to a dietitian for help. Your hospital may well have a dietitian who is specially trained in looking after people with cancer. They can help you plan the diet that‘s right for you. You might need to eat foods that you wouldn’t normally be recommended to eat when you’re in good health.
You can boost energy in your everyday foods by choosing high-calorie and high-fat options. For instance use full-fat milk or cream, use plenty of butter or margarine and add sugar to puddings. Eat several small, high-energy, high-protein snacks throughout the day. You can also get liquid or meal supplements which add extra energy and protein to your diet. These may be useful if you find you can’t eat enough food to keep up your health. Your dietitian can advise you and assess whether these would be helpful for you. You can buy these from a pharmacy or you may get a prescription from your doctor or dietitian.
There’s uncertainty around taking vitamin and dietary supplements during cancer. If you’re thinking of taking a supplement, speak to your nurse or doctor before you do.
Some supplements may cause side-effects like skin sensitivity or a bad reaction. Experts also don’t know how much supplements might interact with cancer treatments. It’s possible that they may stop them from working very well. And it’s important not to take too much of a supplement as high doses might be harmful to you.
But on the other side of the scale, it’s possible that they can play a part in reducing some symptoms of cancer or help with the side-effects of treatment, particularly in those who are finding it hard to eat.
Experts need to do more research to find out which supplements are the most helpful and which are safe to take.
Taking a multivitamin daily may be suitable for you if you’re finding it hard to get all the nutrients you need through food alone. Talk to your healthcare team for more information.
There are many ways to help yourself enjoy your food and eat well if you have cancer. Here are just a few tips.
- If you’re feeling tired just eat when you feel awake enough. You don’t have to wait for meal times.
- Fill up your fridge and freezer with healthy foods that aren’t time consuming to cook or prepare. If you can, get someone to help with food preparation or buy healthy ready meals.
- If you only have a small appetite, eat five or six small meals a day instead of three large meals. Keep snacks nearby for when you feel like eating.
- If you feel sick, avoid fried and fatty foods, or those with a strong smell. Try bland food like crackers or plain toast. Don’t lie down after eating.
- Choose foods that look and smell good to you. If food tastes strange try adding extra flavours, like herbs, garlic or lemon juice.
- If food smells put you off, try eating meals at room temperature. Keeping foods and drinks covered might help.
- Finely chop your ingredients and eat soft foods if you’re having difficulty chewing, swallowing or have a sore and/or dry mouth.
If you’re finding it hard to eat and drink, talk to your dietitian for some some help.
Your body needs plenty of water to replace what you lose each day. When your body doesn’t have as much water as it should, you become dehydrated. If you have cancer you may be at risk of dehydration for a number of reasons. You may have vomiting or diarrhoea as a side-effect of your treatment and these can make you lose a lot of water. You may find it difficult to drink much because you haven’t got much of an appetite or a sore mouth from your chemotherapy.
If you’re dehydrated your symptoms may include:
- dry mouth and skin
- muscle weakness
- urine which is darker than normal
- a reduced amount of urine
As a basic guide, most people need about 2 to 2.5 litres of fluid each day (about seven to eight medium-sized glasses).
Ways to help stay hydrated
- Replace lost fluids from diarrhoea or vomiting with fluids like chicken or vegetable broth, tomato juice and fruit juice. If you’re finding you’re having this side-effect a lot, speak to your doctor about how they can adjust your treatment to reduce this.
- If you feel you may be becoming dehydrated, drink more. Water is a good choice but you don’t have to stick to water. Try squash, milk, fruit juices or caffeine-free tea.
- You can also get water from foods, such as fruit and vegetables.
- A good tip is to take a water bottle with you when you go out so that you can take frequent sips. Don’t wait until you feel thirsty – making a conscious effort to drink regularly will help you stay hydrated.
- Steer clear of foods and drinks that might lead to dehydration such as caffeinated drinks and those that have a lot of sugar in them.
If you have cancer, and especially if you’re having treatment, you may need to drink less alcohol or even none at all. Some types of chemotherapy are affected by the amount of alcohol you drink, and their side-effects might be worse if you drink. Alcohol can also irritate mouth sores caused by some cancer treatments.
Your cancer treatment can also increase your risk of other conditions such as osteoporosis, which can be made worse by drinking alcohol.
For some types of cancer, drinking too much alcohol on a regular basis may increase the risk of it coming back. Or your risk of new cancers developing might increase.
Always speak to your doctor before drinking alcohol if you’re taking medicines or having treatment for cancer.
There’s a lot of information out there about different approaches to particular diets and their effects on cancer. Some of the popular diets you may have heard of include Gerson therapy, macrobiotic diets and the plant programme. None of them have any firm proof that they work and some can even do harm. The best thing to do is eat a healthy, balanced diet. And, depending on your individual circumstances, tailor your diet with the help of your dietitian to get all the nutrients you need.
It’s common to have difficulties with eating or drinking during and after cancer. It’s important to speak to your doctor or nurse if you’re having problems. They can refer you to a dietitian who will be able to give you practical advice and support on eating well and staying hydrated. There are also support groups where you can meet people who may have similar experiences. Ask your doctor or nurse for more information.
- Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 2012; 62(4):242–74. doi:10.3322/caac.21142
- Cancer and leukaemia. Oxford handbook of nutrition and dietetics (online). Oxford Medicine Online. www.oxfordmedicine.com, published January 2012 (online)
- Nutrition for the person with cancer during treatment: a guide for patients and families. American Cancer Society. www.cancer.org, published 6 September 2014
- Nutrition recommendations during and after treatment. Cancer.net. www.cancer.net, published March 2014
- Nutrition in cancer care. National Cancer Institute. www.cancer.gov, published 12 March 2014
- A healthy, varied diet. British Nutrition Foundation. www.nutrition.org.uk, published February 2014
- Living with and after cancer – eating well. Macmillan Cancer Support. www.macmillan.org.uk, reviewed 1 April 2012
- Diet problems with cancer. Cancer Research UK. www.cancerresearchuk.org, reviewed 8 April 2014
- Dennert G, Horneber M. Selenium for alleviating the side effects of chemotherapy, radiotherapy and surgery in cancer patients. Cochrane Database of Systematic Reviews 2006, Issue 3. doi:10.1002/14651858.CD005037.pub2
- Hardy ML. Dietary supplement use in cancer care: help or harm. Hematol Oncol Clin North Am 2008; 22(4):581–617. doi:10.1016/j.hoc.2008.04.012
- The safety of vitamins and diet supplements. Cancer Research UK. www.cancerresearchuk.org, reviewed 24 October 2014
- Risks and side-effects of dietary supplements. American Cancer Society. www.cancer.org, published 22 November 2013
- Eating hints: before, during, and after cancer treatment. National Cancer Institute at the National Institutes of Health. www.cancer.gov, published 30 September 2009
- Sickness. Other ways of controlling sickness. Cancer Research UK. www.cancerresearchuk.org, reviewed 26 June 2013
- EFSA Panel on dietetic products, nutrition and allergies (NDA): Scientific opinion on dietary reference values for water. EFSA Journal 2010; 8(3):1459 – 507 doi:10.2903/j.efsa.2010
- Dehydration. Cancer.net. www.cancer.net, published June 214
- Alcohol use and cancer. American Cancer Society. www.cancer.org, published 12 February 2014
- Osteoporosis risk and hormone therapy. Cancer Research UK. www.cancerresearchuk.org, reviewed 15 August 2014
- Kwan ML, Kushi LH, Weltzein W, et al. Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. JCO 2010; 28(29). doi:10.1200/JCO.2010.29.2730
- The Eatwell Guide. Public Health England. www.gov.uk, updated March 2016
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