Cancer and its treatments can trigger a variety of changes within the body, such as changes in taste perception and loss of appetite. These side effects, if left untreated, can lead to malnutrition, compromising the body’s ability to combat the disease and recuperate effectively. In this article, we delve into the critical role of good nutrition in cancer treatment, explain the eating challenges people with cancer may face, and offer practical tips to help ensure a nourishing, well-rounded diet that facilitates cancer recovery.
Table of Contents
1. Why Is Eating Nutritious and Healthy Diet Important in Cancer Treatment?
Nutrition plays a crucial role in providing the body with the energy and nutrients necessary to support recovery from illness. In the case of cancer, the body requires an increased intake of essential nutrients, including proteins, vitamins and minerals to facilitate the repair and replacement of damaged cells, as well as to support overall bodily functions. A cancer patient's nutritional status is also linked to their quality of life, impacting not just their health, but also their social, psychosocial, and physical activities.
Here are some of the ways consuming a balanced and nutritious diet can support people with cancer during their treatment:
- Give the body more energy to repair and rebuild
- Improve the way a patient tolerates and responds to the treatment, such as chemotherapy, radiation therapy, surgery, etc.
- Rebuild and maintain the body’s store of nutrients, muscle mass and body weight
- Preserve immune function
- Reduce inflammation
- Help to ease the impact of side effects like fatigue, diarrhoea, or nausea
- Lower the risk of infection
- Shorten recovery time
2. Why is Eating a Challenge For Cancer Patients?
Cancer patients are often aware of the role of nutrition during their treatment journey, yet maintaining an adequate and balanced diet can be a struggle for them due to numerous reasons.
Firstly, cancer and its treatment can cause side effects, affecting appetite and the ability to eat. For instance, loss of appetite is reported in as many as 50% newly diagnosed cancer patients. Other common digestion-related side effects such as nausea, vomiting, taste changes, mouth sores, and diarrhoea can further impair the body's ability to absorb and utilise nutrients. Additionally, the stress and emotional strain associated with the diagnosis and treatment process can also disrupt eating habits, exacerbating the challenge of obtaining proper nutrition during this critical time
While there are common side effects and factors contributing to a patient's dietary challenge during cancer treatment, each person's experience is unique. As a cancer patient, caregiver or family member, it is important to keep in mind the complex interplay of factors involved, including the type of cancer, the cancer therapy you or loved one is undergoing, treatment side effects, and psychological impact.
3. The Prevalence of Malnutrition among Cancer Patients
Cancer-related malnutrition occurs when there is a lack of key nutrients consumed and/or absorbed due to cancer or cancer treatments. Worldwide, malnutrition affects a staggering number of cancer patients, up to 85% of patients with certain cancers such as pancreatic cancer. It is also estimated that 10-20% people with cancer die from malnutrition and not cancer itself.
Prolonged poor supply of nutrients is often linked to less effective treatment outcomes. When a cancer patient experiences malnutrition, their body becomes weaker and less effective in responding to therapies and fighting infections. The risk of malnutrition differs among people with cancer, depending on factors such as the tumour's location, the treatment plan, and the specific side effects experienced by the patient.
Location of the Cancer can Affect Nutrition
In general, a person is at higher risk of malnutrition if he/she has cancer of the upper gastrointestinal tract, or of the head and neck, which causes difficulties with swallowing and eating. If cancer is located in the areas of the liver, pancreas, intestine, it will also become difficult to maintain nutrition because of digestion and malabsorption issues.
Certain Types of Cancer Have Increased Malnutrition Risk
Cancer cells are known to be able to alter multiple metabolism processes in the body. The linkage is muti-faceted and still being further researched. For some cancer patients, these changes result in starvation and the loss of lean muscle mass. When this happens, they may experience weakness and weight loss and long-term loss of appetite. Both conditions lead to malnutrition in cancer patients. Stomach, pancreatic, ovarian and lung cancers are often associated with appetite loss.
Side Effects of Cancer Treatment can Impair Appetite and Nutrition
Cancer treatments like hormone therapy, radiation therapy, immunotherapy, and chemotherapy cause side effects in many patients, including loss of appetite, vomiting, digestive tract ulcers, and altered taste and smell. Certain treatments may have their specific adverse side effects on nutritional status. For example, treatments for breast and prostate cancers may cause reduction in calcium and vitamin D levels, resulting in bone loss. These side effects put a patient at increased risk of getting insufficient nutrients.
If you or a loved one experiences side effects during cancer treatment, you may want to check out our doctor's answers to commonly asked questions about cancer side effects here. However, as each patient's experience is different, it is important to consult your oncologist and cancer care team about your specific concern, especially if you or a loved one experiences severe side effects.
4. Top 8 Ways To Stimulate Appetite And Boost Nutrition During & After Cancer Treatment
There is no one-size-fits-all approach to addressing nutritional challenges during cancer treatment. The best strategies to ensure adequate nutrition need to be tailored to the specific needs and circumstances of the individual, taking into account their overall condition during cancer treatment, diet preferences, and in consultation with the cancer doctor and cancer care team when necessary.
Bear in mind that maintaining sufficient nutrition cannot be achieved simply by "stuffing" the person with cancer. It isn't helpful to tell a loved one going through cancer treatment to "just eat more". We need to find the right strategy to restore appetite and boost nutrient supply without making meals a chore.
The following are some useful tips to improve your nutrition intake during cancer treatment. You may need to experiment with different tactics to see what works for you or a loved one, and establish your personal diet plan from there.
4.1. Add Liquid Food
When cancer treatment causes sore mouths or difficulties with chewing and swallowing solid foods, you can try liquid foods. They are easier to swallow and digest, take less time to consume and can provide as much or even more calories than solid foods. Moreover, liquid foods keep the body hydrated. Remember, you should drink at least 8 to 12 cups of water a day even if you are resting for most parts of the day.
Replacing solid with liquid foods is very helpful on days when you cannot eat. If you are pressed for time and too tired to prepare liquid foods, opt for pre-made liquid meal replacement such as bouillon (condensed broth cube), protein drinks, sports drinks, or meal-replacement shakes. The following are some liquid foods to consume:
- Nutritious soup and broth
- Pureed and blenderised food
- Vegetable or fruit juice
- Caffeine-free tea
- Clear carbonated beverages
- Water
4.2. Soften Food
In addition to liquid food, soft food is another good option to enrich the menu. Some foods are harder to swallow, such as tough meat, dry biscuits, or nuts, further irritating the sensitive taste buds of cancer patients. Below are some tips to get enough calories and nutrients when trying soft foods:
- Soft foods to try: scrambled eggs with baked beans, yogurt, custard, jelly or pudding.
- Eat soft cereals, or porridge with minced meat or minced ingredients.
- Prepare moist and soft foods by adding milk, cream, or butter to the recipes.
- You can also use liquid food as dips to soften dry and harder foods when serving, for example, dipping bread in soup or cookies in milk.
4.3. Try Frozen Foods
When it is difficult for you to make your meals or you feel nauseous while making a meal, try quick frozen foods, such as frozen yogurt, smooth ice cream, popsicles, and canned fruits. These types of foods are high in calories and do not require chewing, both of which cancer patients need.
You can make your own nutritious ice cream from your favorite milkshake and freeze it. When consuming ice cream frequently, try to balance your diet with other healthier options such as soup, leafy green veggies and whole grains.
4.4. Eat 5-6 Meals A Day Instead Of 3 Meals
Another tip to get enough calories and nutrients according to your bodily needs is to aim for 5-6 smaller meals and snacks instead of 3 meals a day. It is because cancer patients often feel full after eating a small meal due to their loss of appetite and taste changes. So, whenever you get the urge to eat, you should eat even if it is not mealtime.
Having more frequent meals in smaller amounts helps you eat more types of food, consume more calories and nutrition.
4.5. Have More Snacks
Snacking may not be advisable to those who want to lose weight, but it is a useful tactic to add calories and protein to the diet of cancer patients. To eat more snacks, keep them nearby at home and take them with you every time you go out. Eating a bedtime snack can also help you get extra calories without affecting your appetite for the next meal.
Try these tips to incorporate snacks to your dietary routine:
- Munch on snacks throughout the day whenever you can.
- Eat protein-rich snacks that are easy to prepare and consume. These include sandwiches, crackers, a bowl of soup, cereal & milk, and yogurt.
- Ready-made snacks such as dried fruits, granola bars, and peanut butter are also good choices.
- Avoid snacks that worsen the side effects of cancer. For example, if you have diarrhoea, you should not eat food that triggers your tummy. If you have a sore mouth or throat, you should avoid eating dry or acidic snacks.
4.6. Consume More Protein-Dense Foods
To fight off cancer and strengthen your immunity, it is vital to increase your protein intake. During chemotherapy or radiation therapy, patients need extra protein to build and repair the damaged tissues, produce the necessary hormones and enzymes to restore the bodily functions. The body also needs protein to replenish its energy source which could be lowered during cancer recovery.
Insufficient protein intake is a prevalent issue among the general population over 50 years old, regardless of health status. In Singapore, one in two adults aged 50 and above doesn't meet the daily recommended protein intake of 1.2g per kg of body weight. Statistics are not publicly available for cancer patients, but we can guess that the matter is more serious.
Below are some food sources of protein you should incorporate in your diet:
- Lean meat
- Poultry
- Fish and seafood, such as salmon
- Seeds, nuts and nut butters
- Low-fat yogurt and dairy products
- Eggs
- Beans and lentils
- Soy, tofu and other soy products
Learn about protein needs by age and how to ensure adequate protein consumption here.
4.7. Add Calories To Your Drink
To get enough calories, try adding extra calories to your drinks. This has the benefit of boosting your calorie intake, while making 8 glasses of liquid a day more enjoyable to drink. For example, you can add fresh fruits to your milkshake. You can also make smoothies by adding fruits, veggies, or ice cream to the milk.
4.8. Other Tips To Boost Appetite During Cancer Treatment
When building your cancer-fighting diet, it is crucial to note that everyone is different. You may need to try a few different options to know what works best for you. Below are a few additional tips related to cancer diet.
- Make sure to eat the right foods for you. If you have nausea, constipation, or diarrhoea, you should avoid foods that trigger them even if they meet the requirements for protein and nutrients supply.
- Use herbs and spices moderately and adjust it to the cancer patient’s preference. Many people are sensitive and nauseous to strong flavours during cancer recovery.
- Exercise is linked to improvement in appetite for cancer patients: Try to be active throughout the day as your body allows.
- Side effects like depression and anxiety may happen during cancer treatment and can aggravate appetite and nutrition intake. Make sure to find emotional support from your parents and loved ones or support groups to overcome anxiety and depression.
- If you’re having severe nausea, diarrhoea, or sudden weight loss despite eating the foods recommended by your oncologist and cancer care team, you should seek immediate medical attention to resolve the issue.
- For certain types of cancers or therapies where nutrient deficiency is a common side effect, your doctor may prescribe vitamins and supplements, which you should take as required (for example, vitamin D and calcium supplements in breast and prostate cancers)
5. Takeaway Message
Sufficient nutrition is crucial in recovery from illnesses, more so during cancer treatment. Yet the various side effects from cancer treatment and cancer itself can make eating arduous for cancer patients. Eating plenty of nutritious foods, adding liquid replacements, consuming more protein and calories, exercising regularly, and snacking throughout the day can help you overcome cancer-related side effects and recover faster. When it comes to food types, the general guidance is to choose foods that are cooked, nutrient dense, easy on your stomach, and mild in flavour.
In the event these tips do not help, contact your cancer doctor or relevant healthcare providers for prompt intervention. Remember, loss of appetite could be a common side effect, but there are ways to manage it and you do not have to further suffer because of it.
