Taking Control of Nutrition After a Cancer Diagnosis

Receiving a cancer diagnosis is itself often overwhelming for patients. Then, throw nutrition into the mix and patients who may not understand what getting good nutrition requires will overlook an area that is critical to their treatment.

Being well-nourished before, during and after treatment is important because it helps with healing, immune function, keeps energy levels up and maintains muscle mass and weight.

According to Colleen Doyle, M.S., R.D., managing director of nutrition and physical activity at the American Cancer Society, many patients with cancer have access to a registered dietician at larger cancer centers, but patients who are seen in outpatient cancer centers do not. “Those nutrition services need to be a critical, important part of that care team for somebody that’s undergoing cancer treatment,” says Doyle.

Accessibility is not the only challenge for patients seeking proper nutrition, there are also hurdles to overcome when it comes to the side effects of cancer treatment. These can vary from nausea to fatigue, and both can impact a patient’s ability to eat. For example, a patient could develop mouth sores that may make eating difficult or another patient might not feel like eating at all.

When Chef Ryan Callahan’s mother was diagnosed with breast cancer and undergoing treatment, she quickly developed mouth sores, a loss of appetite and a strong metallic taste.

“The chemotherapy to fight her breast cancer was killing her sensory cells, diminishing her ability to smell and drastically reducing the sensory ability on her tongue,” recalled Callahan. He swore he would do whatever it took to make food taste good for her again and it wasn’t long before he developed two cooking techniques that helped his mother: roundness of flavor and palate cleansing. He put those techniques into recipes that are featured in his how-to cookbook, “Cooking for Chemo ...and After!”

Callahan’s experience isn’t an isolated one — many patients with cancer undergoing treatment will encounter changing taste buds and appetites, as well as food intolerances.

In a survey of 1,203 patients with cancer from seven different medical centers conducted by the Cancer Nutrition Consortium (CNC), results showed that eight out of ten patients avoided some types of foods, with approximately 57 percent avoiding foods that they used to eat due to intolerance and 47 percent due to medical advice.

According to the CNC survey, foods that patients with cancer found the most appealing fell into five main categories: sweets like ice cream, soft and creamy foods like applesauce, comfort foods like soups, carbohydrate-heavy foods like macaroni and cheese, and meats, fish, fruits and vegetables.

Experts advise that patients take notes of any changing eating habits or challenges while eating. In addition, if a patient notices they look thinner or that clothes are fitting differently — they should tell their health care team because those are all signs of poor nutrition.

“The most important thing is to communicate with family members and the medical team to avoid risk of reducing the efficacy of treatment,” Amanda Bontempo, M.S. R.D. C.D.N., said in a statement.

Sometimes the solution to better nutrition with cancer treatment can be as simple as thinking out of the box. For instance, changing the temperature of the food, preparing it in a different area to prevent smells that could trigger nausea or switching up the time of day in which you eat it could make a big difference.

Patience is also key, and that goes for patients and their caregivers. One day a patient might feel great and a specific food sounds really good, but by the time it’s ready, the urge has passed and they are no longer hungry. “Be as responsive as you can,” advised Doyle. “Don’t take it personally and be as supportive as possible.”

If eating solid foods doesn’t work, drinking may be a viable option. Liquids tend to be absorbed more quickly by the body versus solid food. This is due to components of whole foods, like fiber, that require more time to digest. Liquid nutritional supplements such as Nestle’s Boost® nutritional shakes or Hormel’s Vital Cuisine™ protein shakes could help for those who are unable to eat or just don’t feel like eating food.

"Most patients with cancer are too tired to make a meal, or even shop for it. Yet the importance of good, consistent nutrition can't be overstated," said Bruce Moskowitz, M.D., chairman of the CNC.

Both supplements, which are available to the public, can be quick and easy meals without sacrificing nutrition.

“I’m happy that we have an opportunity with some of these supplements that are out there to be able to provide some examples to patients who are undergoing treatment,” said Doyle. “So, when they leave, they get home and find out that it was really helpful to have a liquid supplement when they didn’t feel like eating.”

Doyle added, “There are just so many different needs depending on the individual, but also different cancer types. That’s why it’s critical to have nutrition expertise so that an individual can be assessed and evaluated, then have a specific plan that meets their needs based on their type of cancer, treatment and their response to that treatment.”

If you or a loved one has been diagnosed with cancer, the Academy of Nutrition and Dietetics website features a Find an Expert tool that can provide listings of registered dietitians based on area of expertise or location.

Additional resources for cooking and nutrition during and after cancer treatment, including tips for caregivers, can be found online at the American Cancer Society, the American Institute for Cancer Research and the Academy of Nutrition and Dietetics.