Nutritional management of treatment side effects

There is more to nutrition during cancer and cancer therapy than getting enough calories and protein. The foods you choose also help you cope with side effects, such as loss of appetite, nausea, vomiting, diarrhea, chewing and swallowing problems, and taste changes.

Each person is different, so is their reaction to treatment. Side effects may be severe or mild. Or you may not have any. Be sure to talk with your cancer care team about possible side effects before the treatment begins.

Nutritional management of nausea and vomiting

If you have nausea and vomiting, choose foods that are easy to chew, swallow, and digest, such as the following:

• Toast, crackers, and pretzels

• Yogurt

• Sherbet

• Angel food cake

• Cream of wheat, rice, oatmeal, or grits

• Boiled potatoes, rice, or noodles

• Skinned chicken that is baked or broiled, not fried

• Canned peaches or other soft, bland fruits and vegetables

• Clear liquids such as bouillon; clear carbonated drinks; apple, cranberry, or grape juice; sports drinks; plain gelatin; ice pops; tea; and water

• Ice chips

• Carbonated drinks

Try to not eat the following:

• Fatty, greasy, or fried foods

• Very sweet foods, such as candy or cookies, or cake with icing

• Spicy or hot foods

• Foods that have a strong odor

Also consider the following to reduce side effects:

• Talk with your healthcare provider about taking antinausea medicines at least an hour before eating.

• Eat small meals often throughout the day. An empty stomach may make nausea worse.

• Eat more of the foods that appeal to you.

• Eat in a place that is comfortable. Stay away from stuffy places that are too warm or have cooking odors.

• Drink a half hour before or after meals but not with your meals.

• Drink slowly or sip liquids throughout the day. Use a straw if necessary.

• Eat your food at room temperature or cooler, rather than hot.

• Don't force yourself to eat foods you normally like to eat because it may cause you to dislike them later when you feel better.

• Rest after you eat, but don't lie down. Stay upright for at least 1 hour after eating.

• For morning nausea, try eating crackers or toast before you get up. Keep crackers at your bedside.

• Wear loose-fitting clothes.

• If you feel nauseated during treatment, wait a couple of hours before eating.

• Keep a diary of when you feel nauseated, how long it lasted, what you ate, and where you were. Your healthcare provider may need the information to help you better manage your symptoms.

If you vomit, don't eat or drink anything more until the vomiting is under control. Then try small amounts of clear liquids. Start slowly with little sips.

Once you can drink clear liquids without vomiting, continue by switching to full-liquid or soft foods, such as fruit juices and nectars, milk, pudding, plain gelatin, cooked cereal, ice cream, custard, pureed soup, and vegetable juice.

Be sure to tell your healthcare provider or registered dietitian if you have nausea or vomiting. There are a number of different things they may advise for you.

It is important during cancer treatment to get enough calories, protein, and nutrients. This may be especially hard if you have nausea and vomiting. If you find you can't get enough calories in a day, your healthcare provider may advise commercially prepared liquid nutritional products for a short time until you feel better.