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Diet and Chemotherapy
 
 
What to eat during chemotherapy

There are no real do's and don'ts about diet and chemotherapy. Contrary to popular belief:

  • chemotherapy does not suppress your appetite

  • there are no foods or vitamins or herbs that reliably counteract the side-effects of chemotherapy, and if they did, they would probably be interfering with its effectiveness

  • there is no magic diet that "increases your immune system". This is rubbish.

  • there are no foods that interfere with the mode of action of chemotherapy.

Patients having chemotherapy will have some alteration in appetite. Often they will feel like eating more than usual, especially in the first week after treatment.This is partly due to the effects of some of the antinausea drugs, and also because the general unsettled feeling in the stomach gives people the "munchies". Certain women having 4-6 cycles of chemotherapy might add 10 kg to their weight if they are not very careful to curb their appetite for energy-rich carbohydrate-containing foods and snacks.
My general advice is:

  • Try to maintain your normal routine of meal times, and your normal eating habits

  • Have plenty of fresh fruit and vegetables. If you are not a fruit eater, have at least one large glass of fruit juice daily. Make your vegetables as varied as possible, and try to incude one large serving of leafy greens, minimally cooked.

  • Alcohol is fine in moderation. That means 2-3 standard drinks daily, with 2-3 rest days per week. Don't mix alcohol with anti-nausea medication, pain killers or sleeping tablets.





What about vitamins, antioxidants, selenium, and trace elements?

My advice to you is to avoid fad diets and to follow the sensible balanced diet set out below. If you do so, you will be obtaining a fully balanced supply of vitamins and antioxidants, minerals, and trace elements. It is probably important to get your vitamins and antioxidants in the balanced environment of fresh fruit and vegetables, rather than overwhelming the intestine and the liver with the excessive concentrations that are usually found in vitamin supplements. There is as yet very little reliable evidence that excessive amounts of vitamin supplements reduce the risk of cancer. In fact, there is some evidence that vitamin E and vitamin A may cause an increase in the incidence of certain cancers when taken in the quantities commonly found in vitamin supplements. Furthermore, large amounts of vitamins may interfere with the activity of chemotherapy drugs, and large doses of vitamin C (over 10 g/day) cause bladder irritation.



Tips on eating while on chemotherapy:

Vegetables.
Have at least one serving daily of leafy green vegetables minimally cooked. Salads are ideal. Other good choices include green beans, broccoli, brussels sprouts, and spinach. A good way to cook them is like this:
Be sure that you have a lot of variety in your other vegetables. There are no hard and fast rules here, but try to take vegetables from each of the broad colour groups at least once during the week. From the orange group you will be choosing carrots and pumpkin, for example, from the yellow group, corn and squashes, and from the red group, tomatoes and capsicums. Make it a habit to go to the greengrocer several times a week and choose the best and freshest vegetables that are in season.
Dress you salads with olive oil – based dressings.
Fruit.
Try to have three pieces of fresh fruit daily. Try to get as much variety as possible in the fruit you eat during the week. Buy the fruit that looks best and is in season and is fresh. Try to avoid fruit that has spent a long time in cold storage. If you're not a fruit eater, make it a habit to visit a shopping mall where there is a fruit juice kiosk, and tell them to prepare for you large freshly made juice from whatever fruit takes your fancy.
Prepare a fruit platter instead of desert for the evening meal, or a freshly made the fruit salad.
Meat
Have some meat on most days. Remove excess fat from the meat before cooking, and grill or roast the meat rather than frying it. Do not listen to people who tell you that meat is contraindicated for people on chemotherapy. This is nonsense. You need it for iron, protein and other nutrients.
Try to have at least one fish meal per week. Tinned salmon or smoked salmon are excellent choices for sandwiches. Again, when cooking fish try to grill it rather than fry it but if you must fry meat or fish always use olive oil.
Dairy products
You should have 1-2 servings of low-fat dairy products daily. There is no evidence that dairy foods cause breast cancer or its recurrence. See my article HERE
The munchies
Some people get the munchies while having chemotherapy. You need to watch this as some patients gain 5-10 kg while on treatment, partly because of the munchies, but possible also because chemotherapy alters the metabolic rate.
A low glycaemic index diet is good if you feel this way to avoid peeks and troughs in your blood glucose level. Avoid high carbohydrate snacks, like biscuits, soft drinks and potato chips. Go for nuts, but count them out first and limit it to about 10 cashews or 15 peanuts, preferably unsalted. Fruit is also great. Be careful with juices: they have as much sugar as soft drinks.
Eating when you’re nauseated
Don’t get in a panic about this. The nausea is brief and reversible and your body will compensate. The only vital thing is that you keep up your fluids – try to have 1 – 1.5 litres a day. If you cannot keep fluids down you need to be in hospital for intravenous fluids.
Go for bland foods like clear soups and rice cooked in clear stock, steamed chicken.
Sometimes you will feel as many women do in pregnancy: you will develop a fetish for certain foods, like prawns, or mango chicken or whatever! That’s fine – indulge yourself. It’s only temporary, and let your body guide you as to what it wants and needs.
Eating when to avoid constipation
Some anti-nausea and analgesic drugs cause constipation. This can make nausea worse, and is best countered with laxatives, like coloxyl and senna. You can help prevent it by using high bulk, high fibre foods, like fruit, prunes, and minimally-cooked vegetables.




FURTHER INFORMATION

See my article EATING TO BE CANCER=FREE





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Copyright © 2013, Professor Richard Kefford AM MB BS PhD FRACP. All rights reserved.