Nutrition for Chemotherapy Side Effects

Chemotherapies are powerful, cell-killing medicines used to treat cancer. In cancer, atypical cells are growing at very fast rates, often forming tumors. Chemotherapies target cells that are reproducing, like tumor cells. Unfortunately, our bodies also have healthy cells that are constantly reproducing, and chemotherapies kill these cells as well. The digestive, or gastro-intestinal tract, the bone marrow, and the liver are all places where cells need to reproduce. When chemotherapies are introduced, these areas can be compromised. Most forms of chemotherapy result in at least some eating problems, and these problems can interfere with proper nutrition and health.

Nutritional Problems Related to Chemotherapy

There are many significant chemotherapy side effects that can create nutritional problems for those undergoing treatment, including:

Loss of appetite: This is one of the most common side effects of chemotherapy, and likely has several causes, including other side effects, like nausea, and emotional stress, in addition to the chemotherapies themselves. Loss of appetite generally leads to eating less, which can result in serious caloric and nutritional deficiencies. Several strategies have been proposed, including eating high-protein/high-carbohydrate meals and snacks, and taking advantage of times when you are most hungry (which is in the morning for many people). Eating smaller meals more frequently can also help. Liquid or powder meal replacements can also help maintain proper levels of nutrients. Proper hydration is important – patients should strive to have eight cups of fluids each day. Only sip fluids during meals and snacks to avoid feeling too full during eating times.

Nausea: Nausea, with or without vomiting, is also a common side effect of chemotherapy. For patients dealing with nausea, foods that are easy on the stomach are best. These include toast, crackers, oatmeal, boiled potatoes, rice, yogurt, soft and bland fruits, and chicken. Foods to avoid when nauseous include fatty foods, spicy foods, and very sweet foods. When experiencing nausea, eat slowly, eat small amounts, and eat foods at room temperature. Resting in a sitting position after eating is also beneficial.

Diarrhea: Diarrhea is produced when foods move too quickly through the digestive tract. This rapid movement does not give the body enough time to extract vital nutrients and water from food; therefore, diarrhea can lead to dehydration and nutritional deficiencies. Chemotherapy patients experiencing diarrhea should drink more fluids to replace those being lost. Smaller, more frequent meals are recommended. Diarrhea can also cause imbalances in potassium and sodium, so intake of these nutrients should be increased, from a food source if possible rather than supplements. Good food sources of these nutrients include bananas, peaches, apricot nectar, cream of wheat, rice, noodles, yogurt, cheese, eggs, chicken, well-cooked vegetables, and potatoes. Vegetables high in fiber, like broccoli, corn, and peas, should be avoided. Many sports drinks contain additional sodium and potassium, and can be sipped throughout the day.

Constipation: Constipation is the opposite of diarrhea. When constipated, it can be very difficult to pass stool, and stool can be very dry and hard. Fluid intake is vital in helping reduce constipation. Bowel movements can be stimulated by having a hot drink about one half hour prior to your usual time for bowel movement. If your doctor consents, increasing the fiber in your diet can also help. Foods high in good fiber include whole grains, cereals, bran, dried fruit, and some fresh fruits and vegetables. Fiber supplements are also available, but discuss any changes in fiber intake with your doctor, because high-fiber diets are not recommended with certain types of cancer. Regular exercise can also help with constipation.

Alternative Medicine for Chemotherapy Side Effects

Several alternative nutritional treatments are also beneficial to manage chemotherapy side effects, including:

Nausea: THC, the active ingredient in marijuana, has been effective in treating nausea. A synthetic form is available by prescription, and in some States, food products containing the plant are available from dispensaries with a prescription. Caraway seed tea and ginger are also often recommended to manage nausea.

Constipation: Enzyme formulations like Beano can be helpful. Also potentially helpful are probiotic products, like yogurt and kefir, that can help reintroduce good intestinal flora into the gut to encourage proper intestinal health.

What Does Good Nutrition Involve?

The Dietary Guidelines for Americans, produced through collaboration between the U.S. Department of Agriculture and the Department of Health and Human Services, is a set of recommendations reflecting the most current scientific knowledge about diet and health. The Department of Agriculture also develops diet plans for the general public in order to increase health and fitness and reduce the risk of disease. The Guidelines are produced every five years; the next set will be released in 2010.

The most recent guidelines, published in 2005, offer the following recommendations on six food groups:

Fruits and vegetables: Two cups of fruit and two and a half cups of vegetables are recommended daily. Variation within fruits and vegetables is encouraged. For example, the Guidelines suggest a balance between five vegetable groups: starchy, dark green, orange, legumes, and other vegetables.

Whole grains:Three or more ounces of whole grains should be consumed each day. At least 50 percent of all grains consumed should be whole grains.

Dairy:Daily intake of three cups of low or non-fat milk, or equivalent milk products is recommended.

Fats: Less than 10 percent of the daily-recommended 2,000 calories should come from saturated fats. No more than 300 mg/day of cholesterol should be consumed. Trans fats should be eliminated or kept as low as possible. Total fat intake should not exceed 20 percent to 35 percent of total caloric intake. Good fats include those in fish, nuts, and vegetable oils.

Carbohydrates: Focus on fiber-rich foods. Avoid foods and beverages with added sugars.

Sodium and Potassium: Consume less than one teaspoon of salt per day. Choose potassium-rich foods – many fruits and vegetables contain potassium.

Additional Resources

National Cancer Institute
The Department of Health and Human Services
The Cancer Cure Foundation
The American Cancer Society