Diet and Weight Changes

Healthy Food
Cancer treatment often produce side effects that can negatively impact appetite, taste, and digestion, and may affect body weight

Cancer treatment often causes a lack of appetite, changes in taste, and hinders digestion. These changes may affect your body weight. What you need in your diet can also change. You may need more calories, protein, and fiber. Once treatment ends, many of these changes subside. However it is important that during treatment you get the best nutrition. Healthy eating can boost your immune system, repair damaged tissue, and help you get through treatment. Suggestions for diet and weight changes during treatment are given below.

Changes in Eating Habits

Your needs or reactions to food may change from day to day. Food that tasted or smelled good one day may make you sick the next. Your taste may change as well. Some spices or foods may be more appealing during this time. Because swallowing may be difficult, adding sauces or gravy to some meals may help. Mouth sores and a sore throat also may be a challenge, requiring a less-acidic or less spicy menu. If nausea is an issue, mild flavored foods served cool or cold may make you feel less sick.

Help Caregivers Help You

Caregivers and loved ones want to help. Therefore, they need to know how you are truly feeling.

"Even though it may be difficult, it's important to 'speak up' to your family and friends," says Colleen Doyle, MS, RD, Director, Nutrition and Physical Activity with The American Cancer Society's National Home Office in Atlanta.

"The most important thing to remember is that they really do want to do what's best for you–and what's most helpful to you–and they won't know that unless you tell them, especially because you may experience different symptoms from day to day," Doyle says. "Especially because you may experience different symptoms from day to day."

It is also important to tell caregivers about any allergies, aversions, or dietary restrictions. For example, tell people if you keep kosher, are diabetic, or are lactose intolerant. Ask your treatment team for recipes that are for patients with cancer. Sharing these recipes with caregivers may relieve their stress and provide you with food that can be enjoyed.

Nancy J. Burke, RD, Senior Dietitian, Adult and Pediatric Oncology, at the University of Michigan Comprehensive Cancer Center in Ann Arbor, says mealtimes can be stressful. You may not feel like eating when offered food. So let caregivers know how you are feeling and that you will eat when ready. Ask them to make foods in meal-sized portions that can be frozen or that will stay fresh for longer periods in the refrigerator. Burke also suggests making a food schedule in advance. This can allow helpers to choose a day that is easy for them to help. "This can help relieve the stress with meal preparation, especially if you are too tired during treatment to cook," she says. Stating what foods you want and when you might want them will also make this schedule easier.

In addition to making meals, caregivers could also go shopping and buy easily prepared items. Such items include hot cereals, soups, yogurt, eggs, cheese, crackers, water, popsicles, or juices, Burke recommends. Liquid meal replacements, such as Ensure, are also a good to have on hand.

Tips for Weight Changes

Often people undergoing cancer treatment experience changes in body weight. Some lose weight while others gain weight. Suggestions on how to respond to weight changes are presented next.

Consult an Expert

If you have any concerns about weight changes, Mary-Eve Brown, RD, LDN, Clinical Dietitian Specialist, Oncology, at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, suggests meeting with an oncology dietitian to develop an individualized plan that can help you.

"This is an individual approach that would provide the greatest success," Brown says. "The dietitian will understand the reasons that you are either losing weight or gaining weight and can provide suggestions based on your nutritional difficulties."

If you are gaining weight during treatment, Joan L. Daniels, RD, Senior Dietitian, Adult and Pediatric Oncology, at the University of Michigan Comprehensive Cancer Center in Ann Arbor, says you should discuss it with a doctor or nurse to find the possible cause.

Weight gain may be caused by certain drugs that can cause the body to retain extra fluid. If this is the case, restricting sodium in your diet or taking a "water pill" (diuretic) can help. Weight gain can also result from increased appetite and decreased physical activity.

To avoid further weight gain, you can:

  • Limit portion sizes,
  • Reduce intake of sweets, such as desserts and juices,
  • Avoid drinking soda that has sugar. Eat more fruits and vegetables, whole grain breads, cereals, and beans ,
  • Ask your doctor if it would be safe to increase physical activity, such as walking,
  • Choose lean meats and low-fat dairy products,
  • Limit fats such as margarine, mayonnaise, and high-fat- sauces or dressings,
  • Avoid trans fats (anything made with partially hydrogenated oils or shortening),
  • Try broiling or steaming foods rather than frying them in oil or butter,
  • Drink lots of water, unless your doctor instructs you to limit fluid intake.

Avoid "Dieting"

Eating well during cancer treatment is vital to your overall health. "Restricting calories [during treatment] would not be the best time," Brown says.

"Cancer treatment increases your need for calories and protein," Brown continues. "The reason the body does this is because not only are tumor cells destroyed during treatment, but good cells are destroyed, as well. The body requires more calories and protein to build new healthy cells. If someone restricts calories and protein it might make it more difficult for the body to recover."

When Weight Loss is okay

There are times when some weight loss during cancer treatment can be tolerated. For people who are overweight or obese, Doyle says, no more than two pounds of weight loss per week can be encouraged during treatment, provided that the treating oncologists approve and the weight loss is monitored closely and doesn't interfere with treatment. Safe weight loss should be achieved by eating a well-balanced diet and increasing physical activity. Physical activity must be tailored to the patient and approved by the treating doctor.

Share Your Doctors' Recommendation

Tell caregivers what your doctor recommended for food. Tell them about foods that are okay and foods to avoid. This will give your helpers healthy guidelines to follow which may put them more at ease.

Dietary Issues While Hospitalized

If you are hospitalized, it is important to have a clear plan for how your diet needs will be conveyed and handled. Someone from the hospital's nutrition department will create a summary of your dietary needs. This summary should detail your food allergies, preferences, and restrictions.  "They can then provide alternatives to ensure that these nutritional needs are met given the individual nutritional restrictions," says Brown. If you have food allergies, these must be clearly documented in your medical records. "When hospitalized, let your dietitian, nurse, or food service worker know about your food allergies, vegetarian preferences, or special dietary needs so you can continue with your specific diet as much as possible," she says.