Side Effect Management – Nutrition and Exercise

Good nutrition and physical activity are important for cancer patients. Not only can they improve your quality of life and long-term survival, but these cancer treatment tips can also help you reduce your chance of cancer recurrence and better manage side effects that are associated with certain cancer treatments.


Nutrition & Side Effect Management During Cancer Treatment

Getting enough calories and protein, as well as making wise food choices, are both important aspects of nutrition during cancer treatment. However, because everyone is different, there is no way to know if you will have difficulty eating, and if so, how bad it will be.

Changes in nutritional needs vary among patients. Sometimes, it’s due to the cancer itself. Other times, it’s because of side effects (e.g. nausea, loss of appetite) from treatment. Regardless, changes like these can make it both challenging to eat and to eat enough.

Consuming a healthy and well-balanced diet during cancer treatment can help you feel better and stay stronger. A healthy diet includes eating and drinking enough to maintain the nutrients the body needs including vitamins, minerals, protein, carbohydrates, and fat. Plus it’s important to stay hydrated. For most people, this includes a diet that consists of:

  • Lots of vegetables, fruits, whole-grains, beans, legumes, nuts and seeds
  • Modest amounts of meat and milk products
  • Small amounts of added sugars, deep fried/very fatty foods, alcohol, and salt

Because the illness and the treatment can affect your appetite as well as your body's ability to tolerate certain foods and use nutrients, you may need more or less of certain foods than usual. When you have cancer, you may need to increase your calorie and protein intake. This means you will need to choose high-calorie, high-protein foods as often as possible in order to compensate for any nutritional loss.

Keep in mind that calorie needs during cancer are not the same for everyone. Factors such as your weight, height, the presence of side effects, and type(s) of cancer treatment must be taken into consideration when deciding what and when to eat.

Nutrition therapy is often used to help cancer patients keep a healthy body weight, maintain strength, keep body tissue healthy, and decrease side effects both during and after treatment. A registered dietitian (or nutritionist) is an important part of the health care team and can work with patients, their families, and the rest of the cancer care team to help the patient manage their nutritional needs during and after cancer treatment. If you start to have eating problems such as loss of appetite, dry or sore mouth, nausea, vomiting, difficulty swallowing, weight loss or weight gain, constipation, or diarrhea, tell your cancer care team right away so.

Some ways cancer patients can get the most nutrients out of your foods and drinks, as recommended by the National Cancer Institute, might include:

  • Eating several small meals and snacks throughout the day, rather than three large meals, focusing on items that are high-calorie and high-protein.
  • Eating your biggest meal when you are the most hungry.
  • Focus on eating foods that sound good until you are able to eat a bigger variety, even if it’s the same thing again and again. You might also drink a liquid meal replacement for extra nutrition.
  • Drink plenty of liquids. Aim to drink 8 to 12 cups of liquid a day. Liquids may include drinks such as water, clear apple juice, clear carbonated beverages, or weak, caffeine-free tea.

Many cancer treatments or the cancer itself can cause nutrition-related side effects. If you are experiencing specific difficulties, there are many strategies that can be used to help get around specific challenges. Here are some examples of nutrition struggles people have going through treatment. Click the link to learn more about overcoming these nutrition barriers:

Below are links with additional information on managing nutrition-related side effects during cancer treatment:

For additional information regarding common food problems triggered by cancer treatment, how to deal with them, and recipes that can help you meet your nutritional needs, download the National Cancer Institute’s booklet 
Eating Hints: Before, During, and After Cancer Treatment
Eating Hints: Before, During, and After Cancer Treatment (Spanish)

Food Safety

In addition to paying attention to what to eat and how much to eat, cancer patients must also pay attention to how food is handled and prepared. Cancer patients are at a greater risk of suffering a foodborne illness because of their weakened immune systems. Because of the higher risk, it is important that additional food safety practices are used at all times.

Be careful to:

  • Wash your hands and surfaces before handling food.
  • Keep foods at their required temperatures (keep hot foods hot, keep cold foods cold).
  • Refrigerate leftovers immediately after eating.
  • Separate raw meat and poultry from ready-to-eat foods.
  • Cook food to safe temperatures.
  • Scrub all raw fruits and vegetables with a brush and water before eating. Unwashed fresh vegetables, including lettuce (salads), can put you at a higher risk for infection, as they are more likely to contain harmful bacteria or viruses.
  • Foods that are not easily scrubbed (e.g. berries) should be soaked in water, then rinsed.
  • Foods with rough outer surfaces and peels should be scrubbed with a brush and water prior to cutting them.
  • Avoid raw honey, raw milk, and unpasteurized fruit juice, and choose pasteurized versions instead.
  • When eating out, avoid salad bars; raw sushi; and raw or undercooked meat, fish (including shellfish), poultry, and eggs—these foods are more likely to contain harmful bacteria.

Be sure to consult with your provider or dietician or dietary if you have any questions about the safety of particular foods. When uncertain, the U.S. Food & Drug Administration (FDA) recommends to “throw it out when in doubt.”

Nutrition during Head and Neck Cancer Treatment

People undergoing treatment for head and neck cancer may have significantly more difficulties maintaining optimal nutrition.  It is critically important that people receiving radiation to the head and neck keep up adequate calorie and protein intake to maintain their weight during treatment.  Below are several websites with helpful information on tips for eating well during this difficult treatment.

Nutrition & Exercise After Cancer

We have all heard that eating a well-balanced diet and being physically active are two of the most important things you can do for both your physical and mental health. This is especially true for cancer survivors.

Importance of Achieving and Maintaining a Healthy Weight

Gaining Weight After Cancer Treatment

Many patients lose a significant amount of weight while they’re being treated for cancer, most often as a side effect of cancer treatment. Patients who received chemotherapy and/or radiation therapy often experienced nausea, a loss of appetite, or dry mouth which makes it hard to swallow food. The taste and smell of food may have also changed, making foods that you normally liked seem unappetizing. These things can all lead to less food intake and ultimately weight loss during cancer treatment.

Losing Weight After Cancer Treatment

While some patients need to regain weight after cancer treatment, others may need to focus on losing weight. Some medications cause patients to gain weight. Eating to cope with stress is a common reaction which can lead to weight gain. Or you may have been physically active before treatment but then stopped exercising during treatments resulting in weight gain and/or loss of muscle tone.

If your cancer treatment left you overweight or underweight, it’s important to take steps to return to a weight that’s in the normal range for you.

Diet & Exercise Affect Your Weight, and Much More

Foods For Cancer Survivors

It’s true: “You are what you eat.” As a cancer survivor, now is the ideal time to evaluate your diet and exercise habits so you can stay on a healthy path. What are your pantry and refrigerator stocked with? Is there an abundance of processed foods? Is there hardly any food because you rely on dining out? If so, it may be time to re-evaluate your habits. Consider asking your cancer care team to recommend a dietitian to help you get on track. Take it in small steps so that you don’t change everything at once. But work towards eating a balanced diet that is not filled with convenience or over processed foods.

For more more information on healthy eating for cancer survivorship, check out the following links: