CANCER

Cancer care: Eating problems and how to manage them

Find out how the side effects of cancer can affect your appetite and what you can do to manage these eating problems.
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When you are healthy, eating enough food to get the nutrients and calories you need is not usually a problem. But when you are being treated for cancer, this is hard to achieve, especially if you’re suffering side effects such as nausea and a loss of appetite.


You might need to change your diet to help build up your strength and withstand the effects of your cancer and treatments such as chemotherapy. Read on for tips on how to improve your appetite, while getting the nutrition that you need.

Changes in your sense of taste or smell

One common side effect of cancer: a lingering chemical or metallic taste in the mouth1. Lemon drops, mint, sour plums or preserved orange peels may help you deal with this bitter taste. Rinse your mouth and brush your teeth frequently to help clear your tastebuds. Try eating with plastic or porcelain cutlery to minimise the metallic or bitter taste in your mouth.

You may also be sensitive to strong flavours during this period. Serve foods cold or at room temperature, as this can decrease the taste and smell of your meal and make it more tolerable.

If everything tastes bland, try seasoning foods with tart flavours (lemon, other citrus fruit, vinegar) or sweet flavours (sugar, honey, syrup). Adjust the amount of seasonings and spices used in cooking until you obtain the taste you desire.

Bloating

Try to regulate the amount of water that you take throughout day. For instance, you could take your beverages between meals, rather than during meals.

Limit your intake of foods and beverages which tend to cause gas. Examples include soft drinks, dairy products that contain lactose, as well as vegetables and fruits such as cabbage, cauliflower, beans, lentils and apples.

Avoid overeating and chew food thoroughly before swallowing. Take less fried or greasy foods – fat stays in the stomach longer and makes you feel full. You can also try to eat small frequent meals throughout the day.

Mild exercise after meals may also help to relieve stomach bloating. You could take a slow walk, for instance. As a safety precaution, consult your healthcare team on the types of exercises recommended for your condition, before you start on these activities.

Constipation

Stick to routine: eat at the same times each day, and try to be regular with your bowel movements by making regular trips to the toilet. To soothe your stomach, consume fibre-rich foods such as wholegrain products, vegetables, fruits, beans and lentils.

Make sure that you’re drinking at least 8 to 10 cups of fluids daily. These can include water, milk, juices, soups and other beverages. Cut down on caffeinated drinks like coffee and tea as these tend to dehydrate the body.

Light exercises such as walking may sometimes help stimulate bowel movements. Use laxatives only with your doctor’s advice. Check with your doctor if you haven’t had a bowel movement for three days or more.

Diarrhoea

Cut down on fibre-heavy foods as well as dishes that are greasy, spicy or very sweet. Avoid eating raw fruits and vegetables with skin or seeds and dried fruits too. Drink plenty of mild, clear liquids throughout the day to prevent dehydration and take these drinks at room temperature.

When diarrhoea is over, gradually introduce foods with more fibre in your diet. You can also continue to take lactose-free dairy products or nutritional supplements to ease your digestion. Limit sugar-free gum and candies with sorbitol, as these are difficult to digest. Inform your doctor if diarrhoea persists or increases, or if your stools have an unusual colour or odour.

Dry mouth

Stay hydrated by sipping on healthy drinks and water throughout the day. This can help moisten your mouth, which can help you swallow and talk. Do not drink beer, wine or any type of alcohol as these can make your mouth even drier.

Eat foods that are easy to swallow such as porridge, mashed potatoes and soupy noodles, as well as steamed or stewed dishes. Moisten food with sauces, gravy, or soups. Avoid mouthwash containing alcohol as it will further dry your mouth. You can also ask your doctor to prescribe an oral lubricant to relieve the discomfort.

Sore mouth or throat

Avoid tart, acidic or salty beverages and foods to alleviate a sore throat. You should also avoid foods with rough textures: this would include dry toast, crackers, granola and raw fruits and vegetables.

Skip irritating spices such as chilli powder, cloves, curry, hot sauces, nutmeg and pepper; season with herbs instead. Choose foods that are easy to chew such as porridge, scrambled eggs, steamed fish, ice cream and custard. You can also cut food into small pieces, and cook them until they are soft and tender.

To make it easier for you to take fluids, drink your beverages with a straw. Use a very small spoon (like a teaspoon for instance) to help you take smaller bites.

Nausea

Even if you do not feel hungry, you should still eat as an empty stomach can make you even more nauseous. Choose foods that don’t have a strong odour and are not overly sweet, spicy or greasy. Have foods and drinks that are not too hot and not too cold. Eat dry toast or crackers before getting out of bed if you have nausea in the morning.

Sip clear fluids like barley water, ginger tea and clear soups between meals. Small amounts of salty or sour foods like sour plums may help reduce nausea. You can also ask your doctor to prescribe anti-nausea or anti-vomiting medication, to help manage this side effect.

This article was adapted from the 'Eating Well During Cancer' booklet by Singapore Cancer Society and Abbott.

Cancer.net. Retrieved on September 2, 2015 from: http://www.cancer.net/navigating-cancer-care/side-effects/taste-changes.