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Breast cancer survivor May Chan Mei-wah adjusted her eating habits during her treatment. Photo: K. Y. Cheng

What to eat during cancer chemotherapy to avoid weight loss from malnutrition – foods like bananas and miso soup that won’t cause nausea

  • Many cancer patients become malnourished during treatment because of poor appetite, nausea, dry and sore mouth and problems swallowing
  • Breast cancer survivor May Chan took a dietitian’s advice to stay healthy and strong as she has treatment, eating small meals and blending her food when needed
Wellness

After May Chan Mei-wah began chemotherapy and radiation treatment for Stage 2 breast cancer almost a year ago, she found it a challenge to eat.

“I had no appetite, experienced nausea, vomiting and bloating, and couldn’t taste my food,” says the 55-year-old from Hong Kong. “I also had trouble chewing because my gums were sore and I could barely move my jaw because my mouth felt paralysed.”

Such problems are not uncommon for cancer patients undergoing treatment. According to Sally Poon Shi-po, a dietitian at Maggie’s Cancer Caring Centre in Hong Kong, typical side effects of chemotherapy include a poor appetite, nausea and vomiting, taste changes, dry mouth, and issues with the tongue and throat such as sores and difficulty swallowing.

The severity of the side effects differs from person to person, and doctors may prescribe medication to prevent some of them.

Dietitian Sally Poon recommends screening for nutritional risks soon after a cancer diagnosis. Photo: Sally Poon

It’s not surprising, then, that many cancer patients undergoing therapy are malnourished – about 20 to 70 per cent, depending on their age, cancer type and cancer stage, says Poon. This leads to weight and muscle loss, higher risk of infection, psychological stress, reduced quality of life, treatment toxicity, and increased risk of death.

To help patients improve their nutrition, Poon recommends screening for nutritional risk soon after their diagnosis and regularly thereafter. This would ensure any cancer-related malnutrition is detected early and treated as soon as possible.

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Sometimes, patients may be given supplements to help ensure they are getting the nutrition they need.

Poon shares a few ideas for people who are having cancer treatment and find eating a challenge.

Those with a sore or dry mouth, for instance, should avoid spicy foods and opt for soft foods like mashed potatoes, steamed eggs and pasta. If your appetite is poor or you’re feeling nauseous, eat small meals frequently throughout the day and avoid drinking water or soup before a meal.

Don’t be afraid to sweeten food to make it more appealing; calories are more important than perfect nutrition during chemotherapy. Photo: Getty Images

For hydration, drink fluids between meals. To help with taste changes, Poon recommends using a moderate amount of oil and condiments when cooking to adjust the flavour of the dish. If something tastes bitter, adding sugar, a sweet sauce or some fruit will balance out the taste.

Dr Shireen Kassam, a consultant haematologist at King’s College Hospital in London, shares another tip. “Avoid foods that trigger your nausea and instead eat foods that can help alleviate that sickly feeling, like bananas, grapes, icy-cold smoothies, oatmeal, chia pudding, plain crackers, toast with nut butter, miso soup, veggie broth, plain unsalted nuts, and peppermint and ginger tea.”

Kassam is also a visiting professor in plant-based nutrition at the University of Winchester and the founder of Plant-Based Health Professionals UK, a non-profit organisation that provides evidence-based education on plant-based nutrition.

Foods like miso soup can relieve feelings of nausea. Photo: Getty Images

Poon says that a balanced diet, with sufficient calories, carbohydrates, protein and fat will prevent weight loss and help you regain strength and rebuild healthy tissues during cancer treatment. Foods high in vitamins and minerals are also essential to support your immune system.

Be mindful about food safety, too. Chemotherapy can weaken your immune system by affecting the white blood cells that protect you from pathogens.

“Ensure your meals – even vegetables – are fully cooked, and, if you’re dining out, the food should be hot when served,” Poon continues. “If eating raw veggies, wash them thoroughly under running water using a vegetable brush.

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“Avoid items with raw eggs, like home-made mayonnaise and hollandaise sauce; raw vegetable sprouts; soft-serve ice cream, to prevent listeria infection; and raw honey or honeycomb – select a commercial, grade-A, heat-treated honey instead.

“Choose vacuum-sealed nuts and shelf-stable nut butters and avoid raw nuts and fresh nut butters.”

It’s OK to eat something rich and sugary if your appetite is poor and you can’t stomach the unappealingly bland meal in front of you. The food may not be considered healthy, but Poon says it can give you much-needed calories when you can’t eat anything else.

Soft non-spicy food is easier to eat for those with a sore or dry mouth, and plant-based foods can help patients stay in remission longer than foods with animal-based ingredients. Photo: Getty Images

Kassam points out that recovery from cancer requires nutrient-rich foods that are packed with antioxidants and anti-inflammatory compounds. These include whole plant-based foods such as fruits, vegetables, whole grains, beans, nuts and seeds.

Plant sources of protein, such as tofu and tempeh, are generally healthier than animal sources because they are low in saturated fat, have no cholesterol and are packed with vitamins and minerals.

“Studies show that patients who eat a plant-based diet stay in remission longer after their cancer treatment than those who don’t. This may be due in part to their healthier gut microbiome,” Kassam says.

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Soy is a much better choice than dairy for people with breast or prostate cancer. Dairy from cows contains growth hormones like oestrogen and insulin-like growth factor, which might explain why dairy consumption is associated with an increased risk of prostate cancer and may increase the risk of breast cancer.

“In contrast, soy reduces the risk of these cancers and also improves remission duration after treatment of breast cancer.”

Chan says that attending Poon’s nutrition workshops and taking the dietitian’s advice taught her how to work around some of the side effects of chemotherapy so she could enjoy her meals.

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“I love to eat and couldn’t imagine giving up my favourite foods, so I learned how to scale back my portions and eat more frequently. When it hurts to chew on one side of my mouth, I switch to the other side, and I blend or cut my food into smaller pieces to make it easier to chew and swallow,” Chan says.

“Thanks to Sally, my diet hasn’t changed much because I can still eat what I like, as long as it’s fully cooked. I haven’t lost weight and feel nourished, healthy and strong as I continue my treatment.”

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