Eat Sensibly During Cancer Treatment

The Role of Nutrition During Cancer Treatment

The treatment of cancer may cause changes in how you eat and how your body reacts to food. Good nutrition during treatment is crucial for better outcomes but can be challenging to achieve, leading to malnutrition.

Download PDF

Malnutrition Among Cancer Patients

40 – 70% of patients have

MALNUTRITION

1 in 5 patients pass away due to malnutrition-related reasons

Common Nutritional Problems Among Cancer Patients

UNDERNOURISHED

WEIGHT LOSS

CACHEXIA

EFFECTS OF MALNUTRITION

Weight Loss
Increased risk of infection
Delayed treatment and recovery
Increased risk of complication
Shorter lifespan
Reduced quality of life
Reduced respnse towards therapy
Reduced treatment tolerance and compliance

BENEFITS OF GOOD NUTRITION

Easier to maintain a healthy weight.
Lower risk of infection.
Faster healing and recovery.
Optimised body defenses.
Increased energy and strength for treatment.
Improved response toward therapy.
Better treatment compliance.
Better tolerance towards side eects.

Obtain Enough Nutrition From These Food Groups to Maximise the Benefits:

Carbohydrates

Main Source of energy for the body

eg: rice, bread, pasta, cereal, potatoes

Proteins

Rebuild muscle, repair injured and damaged tissue and fight infestion

eg: chicken, fish, egg, tofu, lentils, lean meat

Fluids

For cell functions and to replace fluid loss due to treatment side effects

eg: water, juice, soup, milk

Fats (included in cooking)

Provide and store energy, insulate body and transport some vitamins

Limit saturated fats and avoid trans fats. Choose unsaturated fats

eg: nuts and plant oil

Vitamins and Minerals

Support body function and metabolism

eg: fruits, whole grains and vegetables

Quick Snack Options

Snacking

Include 1 to 2 snacks in between meals. Keep snacks available at all times

Bread with butter
Sandwich
Soft bread with cheese
Bun and roll
Biscuits with cream
Nuts and seeds
Hard boiled/ Scrambled egg/ Omelette

Plain cakes
Puddingand custards
Yogurt
Milk or soy drinks
Milkshakes
Cream soup
Stamed chicken bun/pau

Add extra energy and Protein into Your Food

Here are some ingredients that can add extra calories into your food

Soft margarine
Salad dressing and mayonnaise
Honey
Cheese
Milk powder

Jam or marmalade
Healthy cooking oils
Peanut butter
Banana/ Mango

Type of protein source	Preparation method
Cheese	Melt on sandwiches, bread, omelette, muns, hamburgers or eggs Grate and add to soup, sauce, casserole or vegetables
Milk or powdered milk	Mix with beverage/milkshake Add during the preparation of hot cereal, pudding, gravy or soup
Commercial nutritional supplement	Drink on its own, preferably 1 to 3 times a day depending on your appetite e.g. Ensure Gold/Nutren Fibre/ Supportan/Prosure
Fish, poultry and meat	Steamed fish/chicken, minced meat Add chopped, cooked meat or fish to soup, porridge or noodles (Avoid raw fish and undercooked meat/poultry. They may contain harmful bacteria and your treatment may increase your risk of infection.)
Eggs	Add chopped, hard-boiled eggs to soups, dishes or sandwiches (Avoid raw/undercooked eggs. They may contain harmful bacteria and your treatment may increase your risk of infection.)
Bean and legumes	Cook and use dried peas, beans or bean curd (tofu) in soups, porridge or noodles

Side Effects During Cancer Treatment

You may experience any of the side effects below while undergoing your treatment

Loss of Appetite

Nausea/Vomiting

Fatigue

Diarrhea/ Constipation

Change in taste or smell

Weak immune system

Dry/ Sore mouth or sore throat

Unintended weight loss

Tips to Overcome Side Effects from Treatments

Loss of Appetite

Loss of appetite is the feeling of not wanting to eat much. It can be due to the illness itself, medication, or feelings of stress and fear

Eat 5 - 6 small meals instead of 3 large meals
Drink when you don’t want to eat (e.g. smoothie, milkshake, fruit juice, milk, soy milk)
Consume easy-to-carry snacks Add extra calories and protein into your food
Do light exercises and be physically active to stimulate appetite
Eat your meal separately from your drinks

Nausea and Vomiting

Nausea happens when you feel uneasy or sick in your stomach, sometimes leading to vomiting. Certain food smells may also trigger nausea and vomiting.

Eat 5 - 6 small meals instead of 3 large meals
Eat soft, easy-to-digest and bland food
Chew food slowly
Suck on hard candies such as peppermints or lemon drops
Wear loose and comfortable clothes
Sit or lie with your head up for at least 1 hour after meals
Avoid spicy, greasy or fried food and food with strong smells
Avoid eating in a room that is too warm or has a strong smell
Do not drink right before or after meals
Do not skip meals and snacks

Constipation

Constipation happens when you have fewer bowel movements. The stool becomes hard, dry, and tough to pass, leading to pain, bloating, or nausea. Medication, insucient liquid intake, low fibre in your diet, or lack of physical activity may also cause constipation.

Drink at least 8 cups of liquid per day (hot drinks may work better) unless contraindicated
Eat more high-fibre food such as whole grains, vegetables and fruits
Do light exercises (e.g. walking, stretching, doing house chores) and be physically active

Diarrhoea

Nausea happens when you feel uneasy or sick in your stomach, sometimes leading to vomiting. Certain food smells may also trigger nausea and vomiting.

Eat 5 - 6 small meals instead of 3 large meals
Drink plenty of water throughout the day
Eat food or drink liquids at room temperature
Take high-sodium, high-potassium food and drinks, e.g. banana, electrolyte drink, soup
Limit milk and dairy products that may worsen the symptoms (choose lactose-free products)
Avoid high-fibre food
Avoid greasy, spicy and overly sweet food
Avoid overly sweet and caeinated beverages
Avoid carbonated drinks or foods that cause gas, e.g. legumes, broccoli and cauliflower

Change in Taste or Smell

Food might be tasteless, and some food could taste bitter or metallic. Your sense of smell might also change. While these issues cannot always be avoided, they often improve after the treatment is finished

Serve food at room temperature
Chew food longer for it to taste better
Season and marinate food using spices, lemon or vinegar
Use sugar-free lemon drops, peppermints or chewing gum
Rinse your mouth with alcohol-free mouthwash or salt water before meals to clear the taste buds
Use plastic utensils if you have a metallic taste in your mouth

Change in Digestive System

Some treatments may cause you to have an upset stomach. When this happens, you may want to:

Choose lactose-free or low-lactose product
Try milk substitutes, e.g. soy milk or almond milk
Eat non-dairy calcium options such as edamame, spinach or calcium-fortified products

Weak Immune System

Cancer and its treatments can impact the immune system, which is responsible for the body's defence. Individuals with cancer might face a higher risk of infections due to alterations in their immune system.

Eat food that is thoroughly cooked
Eat food served at room temperature within 2 hours
Thaw frozen food using a microwave or chiller
When eating canned food, make sure the can is in good condition (not dented or rusted)
Choose freshly cooked food if eating out
Practise personal hygiene, e.g. regular hand washing, bathing daily and rinsing your mouth
Avoid raw foo e.g. salad, ulam or raw Japanese food
Avoid half-cooked food such as runny eggs and medium-cooked meat

Sore Mouth/ Sore Throat

A sore mouth or throat occurs when the lining of your mouth, lips, or throat is inflamed and in pain. This discomfort can make eating dicult and potentially lead to unintentional weight loss.

Eat 5 - 6 small meals instead of 3 large meals
Eat soft, moist and easy-to-chew food
Cut food into small pieces
Eat moist food with sauces, gravy or soup
Cool hot food and drink liquids at room temperature
Add proteins and calories into food, e.g. prepare omelettes with milk and butter or mix soup with protein powder
Drink with straw
Gargle or rinse your mouth after every meal and before sleep with alcohol-free mouthwash
Avoid food that may hurt your mouth such as dry, hard, crunchy, salty, spicy, sour or hot food

Dry Mouth

Dry mouth happens when there is less saliva than usual, making it challenging to talk, chew, and swallow. Treatment and certain medications may contribute to dry mouth

Sip water throughout the day
Chew on chewing gums or suck on ice chips, hard candy, frozen fruits or popsicles to stimulate saliva production
Eat tangy food such as mango, starfruit or orange to stimulate the saliva in the mouth
Eat food that is soft and easy to swallow
Eat moist food with sauces, gravy or soup
Rinse your mouth regularly
Apply lip balm
Use a humidifier to moisten the air in your room
Avoid food that may hurt your mouth such as dry, hard, crunchy, salty, spicy or sour food
Avoid mouthwash that has alcoholAvoid mouthwash that has alcohol

Unintended Weight Loss

Weight loss can be caused either by cancer or the side e ects of treatment, e.g. nausea and vomiting or by stress and anxiety. It is common for individuals going through cancer treatment to have weight loss.

Maintain a consistent eating schedule
Eat 5 - 6 small meals instead of 3 large meals
Drink smoothies or milkshakes when you do not feel like eating
Add proteins and calories into food, e.g. prepare omelettes with milk and butter or mix soup with protein powder