Managing Nutrition-Related Side Effects of Cancer Treatment
Tips You Can Chew On
by Carly Roop, RD, LDN, CSO
Many studies have found that good nutrition plays a role in improved cancer survival. However, treatment-related side effects, if left unmanaged, can complicate things. Side effects can compromise a person’s ability to get the nutrition they need and stay on course with their treatment. As a nutrition counselor, my job is to help you prevent and manage side effects that interfere with good nutrition during treatment.
Nausea and Vomiting
Managing nausea caused by radiation or chemotherapy requires a proactive approach. Some chemotherapy drugs are more likely to cause nausea and vomiting than others are. Moreover, your propensity for nausea may play a role in the extent of nausea and vomiting you experience. If you are prone to nausea, the use of prescription anti-emetics may be necessary to manage this side effect.
Smaller food portions are often easier to handle when you’re feeling queasy, and snacking throughout the day on dry cereal, pretzels, or other bland foods, like a baked potato, may help to dissipate nausea. Consuming ginger and ginger-infused products has been shown to provide relief as well. It’s important to stay well hydrated during treatment, so drinking water is always encouraged, but you may be able to better tolerate broth, lemonade, or ginger ale when you’re nauseated.
Smaller portions are often easier to handle when you’re feeling queasy.
Sometimes even the smell of food can trigger nausea. Keep a window open while cooking or baking, and wait for foods to cool down before eating them. You might want to consider sticking to cold foods, as they have less of an aroma. Nevertheless, even chilled liquid meal replacement drinks or shakes may be better tolerated when their scent is concealed in a travel mug.
Chemotherapy and radiation can sometimes cause you to experience heartburn, especially after overindulging or eating spicy foods. Heartburn may also result from constipation, another common side effect of cancer treatment. If you’re experiencing treatment-related heartburn, ask your doctor if you would benefit from taking a proton-pump inhibitor, a medicine that reduces the amount of stomach acid made by glands in the stomach lining. You also should limit your intake of caffeinated beverages and greasy, spicy, or acidic foods, such as tomatoes and citrus fruits, and you’ll want to avoid peppermint as it may increase heartburn as well.
Managing constipation can be as simple as eating high-fiber foods, drinking more fluids, and engaging in some physical activity. Many people find that adding flax meal to smoothies or oatmeal is a successful way to manage constipation. Some old-fashioned remedies, such as drinking hot water with lemon or eating stewed prunes, also can do the trick. However, if you’re taking opioids to control pain, you may need to talk with your doctor about taking stool softeners or laxatives to help with constipation as a side effect of those medications.
On the other hand, if you’re experiencing loose stools during treatment, try incorporating foods that contain stool-bulking soluble fiber, such as bananas, applesauce, white rice, and white toast, into your diet. Smooth nut butters, white pasta, tapioca, and, surprisingly, marshmallows can help by slowing down digestion. Drinking sports drinks containing electrolytes is also recommended. If you’re undergoing radiation to the lower abdomen or pelvis, or if you’re on certain chemotherapy drugs, it may be necessary to take anti-diarrheal medication and follow a low-fiber diet.
Sore mouth and taste changes can make eating difficult during treatment. It may be wise to avoid crunchy, salty, and acidic foods if you have mouth sores. It may also be helpful to drink through a straw.
If you’re struggling with taste aversions, this is a good time to experiment with dips, condiments, and different herbs and spices to enhance your food’s flavor. If you enjoy only the first few bites of a food, try fixing yourself a meal with small portions of a few different foods so you aren’t overwhelmed but won’t get bored while eating either. Rinsing your mouth with saltwater or baking soda solutions can help rid your mouth of bad tastes and heal mouth sores.
As you go through treatment, consider keeping a journal to track any side effects you experience. Then, work closely with your doctor and a registered dietitian (if one is available at your cancer center) to ensure that your side effects are well managed and you’re getting the nutrition you need.
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Carly Roop is a certified specialist in oncology nutrition at Abramson Cancer Center at Pennsylvania Hospital in Philadelphia, PA.
To find a certified oncology nutrition specialist in your area, visit OncologyNutrition.org.
This article was published in Coping® with Cancer magazine, May/June 2014.