Cancer treatment and getting the most from food

There are many treatment side effects that can affect your food intake and your appetite. A lot of time can be spent travelling to the hospital, waiting around for appointments and staying in temporary accommodation with limited cooking facilities. Having a range of quick and easy snacks that are suitable to eat when you are away from home, or when you don’t feel like preparing a meal is important to prevent weight loss and malnutrition.

If you are not able to eat your usual amount of food, or you need to gain or maintain your weight, it is helpful to take in more energy (kilojoules) without having to eat more. Try adding extras to your basic foods at mealtimes, such as protein, fats and sugar.

How to gain and maintain weight

Increasing the amount of energy or kilojoules (e.g. protein, fat and sugar) in your diet is usually a temporary measure to keep you eating well during and after treatment. It is important to understand that eating extra fat and sugar while you are underweight, or struggling to maintain your weight because of treatment side effects will not hurt you and is often only needed for a small period of time.

Speak with your doctor and dietitian about relaxing low–cholesterol or diabetes dietary restrictions that may prevent you from eating extra fat and sugar.

  • Treat food like medicine: something you have to have. Set times for meals and snacks.
  • Make sure your meal or drink is nourishing, for example drink milk rather than water and choose cheese and biscuits over lollies.
  • Aim to have a small snack and/or nourishing drink, such as a milkshake or smoothie, if you can’t manage larger quantities.
  • Use full cream milk and dairy products, or enrich milk with milk powder.
  • Add milk, cream, butter, margarine or yoghurt to porridge, sauces, desserts, mashed vegetables, egg dishes and soups.
  • Add cheese to sauces, soup, vegetables, casseroles, salads and sandwiches.
  • Fry or roast meat, chicken, seafood and vegetables in oil, butter or margarine.
  • Spread bread, toast, scones, muffins, biscuits or fruit buns with butter or margarine and add honey or jam for extra energy. You can also use avocado, hummus or lite cream cheese if you prefer a low fat option.
  • Use egg or mayonnaise, cheese, cold meats, canned salmon or tuna, peanut butter, banana, baked beans, avocado on bread, toast, crumpets or muffins.
  • Carry snacks such as hard boiled eggs, chocolate bars, muesli bars, sweet biscuits, cakes and slices. Look for those with fruits and nuts for added energy.
  • Ready-to-use drinks are handy for travel and are useful if preparation is difficult. Examples include Sustagen, Ensure and Resource Fruit Beverage.

Food-type nutritional supplements

If you cannot manage to eat a balanced and varied diet, or are experiencing unintentional weight loss, then it is recommended that you use nourishing fluids and/or nutritional supplements.

Nutritional supplements such as Sustagen Hospital Formula, Ensure and Resource contain energy, protein and other nutrients in a concentrated source. Glucose powder supplements can also provide energy, but they don’t provide protein, vitamins or minerals, so they have a particular function and shouldn’t be used as a meal replacement. You can sprinkle glucose powder on food or stir it through to give meals and snacks extra energy. Nutritional supplements and/or nourishing fluids should be taken in addition to eating your usual meals, for example try them as between meal snacks.

A dietitian can suggest the most appropriate supplement for you, and where it can be purchased. Your choice of supplement should be based on your nutritional needs, on availability and on the cost of the supplement.

If you have been assessed by a speech pathologist as having swallowing difficulties and need thickened fluids the nutritional supplements need to be thickened to the advised consistency. Discuss this with your speech pathologist.

Vitamin and mineral supplements

Vitamins and minerals are an essential part of a healthy diet and play an important role in the body’s immune system. If you are managing to eat a balanced diet through eating a variety of foods then the use of vitamin and mineral supplements is not usually necessary.

Some people believe that taking high–dose vitamin supplements will strengthen the body’s immune system, but there is little evidence to support this. In fact, many vitamins and herb compounds can be toxic at high levels, and may interfere with chemotherapy, radiotherapy and other medications. Therefore high doses of vitamin or mineral supplements are usually not recommended for use during treatment.

Dietary supplements cannot replace whole foods, which are still the best source of vitamins and minerals.

Many dietary supplements contain levels of antioxidants (such as vitamins C and E) that are much higher than the recommended Dietary Reference Intakes for optimal health. Whether antioxidants or other vitamin supplements are helpful or harmful during chemotherapy or radiation treatment is a major question without a clear science–based answer right now. Until more evidence is available, it’s best for people having these treatments to avoid dietary supplements, except to treat a known deficiency of a certain nutrient, and to avoid supplements that exceed the recommended daily intake.

Talking to your doctor, dietitian or cancer pharmacist before taking vitamin and mineral supplements or before starting treatment is encouraged.

This information was last reviewed in June 2013

This information has been reviewed by: Jenelle Loeliger, Head – Nutrition Department, Peter MacCallum Cancer Centre, VIC; Kate Aigner, Cancer Information Consultant, Cancer Council Helpline ACT; Ian Anderson, Consumer; Anna Boltong, PhD Candidate (Dietitian), Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, VIC; Clare Hughes, Nutrition Program Manager, Cancer Council NSW; Bridget Kehoe, Public Health Coordinator (Nutrition and Physical Activity), Cancer Council QLD; Steve Pratt, Nutrition and Physical Activity Manager, Cancer Council WA; and Roswitha Stegmann, Helpline Nurse, Cancer Council WA.

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