Managing Eating Problems In Cancer Patients

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1 Managing Eating Problems In Cancer Patients Patient Information Nutrition and Dietetic Department Author ID: LB Leaflet Number: Diet 004 Version: 2 Name of Leaflet: Managing Eating Problems in Cancer Patients Date Produced: January 2015 Review Date: January 2017 Managing Eating Problems in Cancer Patients Page 1 of 7

2 Cancer and the side effects of its treatment may affect your ability to eat. These side effects include: Loss of appetite Changes in weight Sore mouth or throat Dry mouth Difficulty to swallow Dental and gum problems Changes in sense of taste or smell Nausea/vomiting Diarrhoea/Constipation Fatigue and/or depression You may or may not have any of these side effects. Many factors determine whether you will have any and how severe they will be. These factors include the type of cancer you have, the type and the length of treatment and the dose of treatment. Recommendations about food and eating for cancer patients can be very different from the usual suggestions for healthy eating. This is because they are designed to help build up your strength to help you withstand the effects of your cancer and its treatment. This diet sheet contains information to help make sure your food intake is as good as possible and to give you meal and snack ideas to use until you are feeling better. Difficulties in swallowing Difficulty in swallowing may be experienced for a number of reasons including the type of cancer or side effects of radiotherapy or chemotherapy treatment (dry mouth, sore throat). Some suggestions if experiencing swallowing difficulties are: Eat small and frequent meals Mince, blend, puree or chop your food, but try to make it look appetising on the plate Go for soft, nutritious foods such as thick and creamy milk yoghurts without fruit, soft scrambled eggs, thickened broths and cream soups Try pureed or mashed fruit and vegetables Ice-cream, custard, thickened juices and thick milk shakes Using a straw to drink may help Moisten foods with sauces and gravies to make them easier to swallow Take small bites and chew your food well If you have a sore mouth, try to avoid foods that can irritate your mouth. These include: - Citrus fruits and juices - Spicy/salty foods - Raw vegetables and dry foods - Commercial mouth washes that contain alcohol Managing Eating Problems in Cancer Patients Page 2 of 7

3 Loss of appetite Poor appetite is one of the most common problems that occur with cancer and its treatment. A small drink of wine or sherry before meals helps to increase the appetite, but check with your doctor first if you are on medication Try frequent small meals throughout the day Make meals as attractive as possible with garnishes, e.g. parsley or other fresh herbs, tomato, lemon as appropriate Nourishing drinks can be used to replace some meals (see page five) Make foods such as soup, mashed potato, sauces and milk puddings more nourishing by mixing in milk powder, cream, evaporated milk, grated cheese or butter/margarine If you are too tired to prepare a meal, have a ready meal instead If food has no taste, try highly seasoned or marinated food If you are unable to tolerate hot foods, eat food cooled to room temperature or when cold If you find cooking smells a problem, avoid the kitchen or use cool or microwaved foods Try not to drink fluids during meals as it may make you feel full Weight loss Little and often is the best way to increase your calories when you notice any signs of weight loss. Aim for three small meals and three snacks daily. You can also add high energy foods to your meals to increase calorie intake. Add margarine/butter or cream to mashed potatoes and vegetables Add extra sugar to drinks, cereals, desserts and fruit Add honey, syrup or jam to porridge and desserts Add grated cheese to potato, vegetables or soup Add mayonnaise to salads and sandwiches. Add cream to soups, sauces and desserts Include cream cheese on bread and biscuits Make fortified milk (four tablespoons of milk powder mixed into a pint of milk) and use this for your drinks and in cooking Feeling sick? Some types of chemotherapy or radiotherapy near the stomach can make you feel sick. This should be temporary, but is upsetting and can affect your ability to eat well. If you feel sick or are being sick, your doctor may prescribe you some anti sickness tablets (anti-emetics). It is important to eat when you are feeling sick, even though you don t feel like it! Eating may help to settle your stomach Try to eat little but often Give yourself plenty of time to eat and ensure you are sitting in an upright position Have something dry like a biscuit first thing in the morning Managing Eating Problems in Cancer Patients Page 3 of 7

4 Don t eat fatty or highly spiced foods Keep meals fairly dry and drink an hour or so after eating. If you are feeling sick in the morning or after a nap, try to have foods like toast, biscuits, crackers and crisp breads Try cold foods and drinks Acidic flavours like chilled tinned grapefruit are easier to take Try ice lollies or fizzy drinks such as lemonade, cola or Lucozade or fruit juice mixed with soda water or lemonade Drink plenty of fluids Try salty foods Ginger flavoured foods can also help to reduce nausea Drink through a straw Keep away from the smell of cooking Wear loose clothing Have plenty of fresh air in your room Try to go for a walk before meals Diarrhoea Some chemotherapy drugs, radiotherapy to the gut, pain relief medicines, antibiotics and anti-nausea drugs can affect the lining of the digestive system and cause diarrhoea. During diarrhoea, food passes quickly through the bowel before your body has a chance to absorb enough vitamins, minerals and water. This may cause dehydration. Drink plenty but not with meals; don t become dehydrated Avoid fatty foods Avoid high fibre foods for a while, e.g. bran, peas, beans Don t have very hot or cold foods and drinks Eat little and often If diarrhoea persists seek medical advice Constipation Some anti-cancer drugs and other drugs such as pain medication may cause constipation. This problem also can occur if your diet lacks enough fluid or fibre, or if you have been in bed for a long time. Try to eat regular meals Drink plenty of fluid at least six to eight glasses daily If wind is a problem, avoid carbonated soft drinks Eating more fibre may not be possible for everyone, if you find that it does not agree with you ask your dietitian for advice Try to be as active as you can If constipation persists seek medical advice Heartburn and reflux This side effect is also very common in cancer treatments. There are medications that may help the problem. Seek medical advice if the problem persists. Managing Eating Problems in Cancer Patients Page 4 of 7

5 Have small regular meals Don t drink immediately before eating, and wait 30 minutes after eating before you have a drink Chew your food well Sit upright when you eat and stay like that for a little while afterwards to help the food to go down Peppermint sweets and/or peppermint tea may help Avoid fatty or fried foods Don t eat within one hour of going to bed Drinking milk or eating yoghurt may help Changes in taste and smell Cancer and its treatments can cause changes in your senses of taste and smell. This can make your favourite foods taste or smell unappetising. Rinse your mouth frequently with water Use plastic cutlery to reduce the sense of metallic flavour Use fresh fruit and vegetables in meals instead of tinned Season foods with tart flavours such as lemon, vinegar, pickles, however, be cautious if you also have a sore mouth Use spices such as garlic, chilli, basil, oregano Serve foods cold or at room temperature If you cannot tolerate red meats, try other high protein foods such as poultry, fish, eggs or cheese Chew a few peppermint or spearmint leaves or drink a cup of peppermint tea to free the metallic taste after eating Nutritional supplements If you are struggling with your diet or your body needs more nutrition than your normal meals provide it may be necessary for you to take nutritional supplements. Your dietitian can recommend prescribable supplements and arrange these with your doctor. Remember there are lots of ways to drink these, and they can also be used in cooking. How to take your supplements Your dietitian will advise you on how many supplement drinks to take each day It is best to have these drinks after or in-between meals or in the evening. If you take it just before a meal you may find it reduces your appetite and you are unable to finish your meals Most of these drinks are best served chilled although they can also be heated gently. Remove from carton/bottle before microwaving Do not boil supplement drinks The drinks can be sipped through a straw from the bottle/carton or poured into a glass Managing Eating Problems in Cancer Patients Page 5 of 7

6 The drinks can be frozen into ice cubes or lollies if preferred Remember: these products are meant to supplement your diet and not replace ordinary food. How to store your drinks Check the best before date on the supplement drink before use Prior to use, supplement drinks should be stored in a cool dry place Once opened these drinks should be stored in the fridge and any unused portion discarded after 24 hours If the drink is left at room temperature it should be discarded after 4 hours To help meet your nutritional needs it is recommended that you take the following supplements: Supplement drink Daily quantity It is recommended that you should continue to take these for weeks/months. Your Dietitian is Contact details: Managing Eating Problems in Cancer Patients Page 6 of 7

7 Comments, Compliments or Complaints The Patient Relations/PALS Department provides confidential on the spot advice, information and support to patients, relatives, friends and carers. Contact Us Tel: (Monday to Friday 9am to 4pm) The Patient Relations/PALS Manager Wrightington, Wigan and Leigh NHS Foundation Trust Royal Albert Edward Infirmary Wigan Lane Wigan WN1 2NN In addition to the Patient Relations/PALS Service, you can contact HELPline on This leaflet is also available in audio, large print, Braille and other languages upon request. For more information call Wrightington, Wigan and Leigh NHS Foundation Trust All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright owner Managing Eating Problems in Cancer Patients Page 7 of 7