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Cancer and nutrition: Dietary Tips for Cancer Patients

What Causes Cancer

Nutrition and Cancer

What Food

Side-Effects

Food Safety

Physical Activity

Cancer is only going to be a chapter in your life, not the whole story.

Embrace yourself well for a fight, a fight that you can win.

Are you someone diagnosed with cancer or know someone diagnosed with cancer?

A lot of questions surfaced your mind when you first heard about your or your loved one’s diagnosis. You will be getting some answers to your questions through this blog.

This blog will discuss the importance of nutrition, some myth and facts about cancer and nutrition, food safety and recommendations for a healthier life.

What causes cancer?

Cancer is not caused by a single factor. There are several factors, combined that may cause cancer. Genetics, lifestyle and environmental exposures are all factors that may cause cancer.

Cancer has four stages :-

  • Stage 1, cancer is small and has not spread.
  • Stage 2, cancer has grown and may have spread to the lymph nodes but has not spread to other body parts.
  • Stage 3, cancer has grown and possibly has spread to other tissues.and DHA.
  • Stage 4, cancer has spread to other areas/organs in your body.
Cancer has four grades :-
  • Grade 1, Cells slightly abnormal and well differentiated
  • Grade 2, Cells more abnormal and moderately differentiated
  • Grade 3, Cells very abnormal and poorly differentiated
  • Grade 4, Cells immature and undifferentiated

Nutrition and Cancer

Your food choices and eating habits when you are undergoing treatment will be different from that you used to eat prior to cancer.

Fueling your body during or after your treatment is very important in order to keep your weight within healthy normal ranges, prevent malnutrition, prevent nutrient deficiencies, increase your energy and strength, have lower risk of infections, and better tolerate the side-effects of your treatment (chemotherapy, radiation, immunotherapy, hormonal therapy, and surgery).

What Food to Choose?

Enhancers and Inhibitors of cancer

Certain foods enhance cancer and other are inhibitors of cancer.

Inhibitors of cancer

  • Antioxidants and phytochemicals which are found in fruits and vegetables

The consumption of fruits and vegetables daily is highly encouraged due to their health benefits.

Fresh fruits and vegetables are usually the most nutritious, while canned have sometimes added sugar, syrups and canned vegetables might have added sodium to them as preservative).

  • Coffee and tea (preferably green) are also good drinks to consume.
  • Folate, food sources are dark green leafy vegetables (broccoli, spinach…), beans, whole grains, fruits, peanuts
  • Calcium and Vitamin D are also good sources to consume, such as dairy (always pasteurised), yogurt, edamame, almonds, fortified cereals and orange juice.

Enhancers of cancer

  • Fat in red meat
  • Polycyclic aromatic hydrocarbons which is formed when meat is grilled at high heat
  • Heterocyclic amines, which is formed when your meat is charred/burnt
  • N-nitroso compounds which is found in processed meats, smoked salted and pickled food, gives luncheon and hot dogs their pink colour

The macronutrients (Protein, Carbohydrates and Fat) guidelines are similar to normal guidelines

Inadequate protein intake during your treatment will lower your resistance to infections and lengthen your hospital stays/treatment. Patients diagnosed with cancer will need more protein to help them heal and fight off infections. Food sources of protein are either animal based (fish, poultry, eggs, low fat dairy product, lean meat) or plant-based (dried beans, peas, lentils, nuts, seeds)

There are several ways to increase protein in your meal:
  • Add powdered milk to puddings, potatoes, soups, ground meat, cooked cereal, milkshakes, yogurt
  • Use eggs to make pancakes, omelettes, veggies casseroles
  • Add cheese to salads, sandwiches, potatoes, soup
  • Add peanut butter to toast, crackers, bananas, apples
  • Add greek yogurt to oatmeal, salad dressings or smoothies.
There are several ways to increase protein in your meal :-
  • Focus on monounsaturated fats (almonds, cashews, hazelnuts, peanuts, pecans, olives, olive oil, pistachios).
  • Focus on polyunsaturated fats (walnuts, pine nuts, pumpkin seeds, sesame seeds, sunflower seeds).
  • Limit the consumption of saturated fats which is found in animal sources like meat, whole-fat milk, and (butter, cream, palm oil, shortening)
  • If you or your loved one are craving a piece of cake or a cookie, it is best to cook them at home using healthy ingredients.

Fluid (Water and Alcohol)

It is very important to stay hydrated especially if you are experiencing diarrhea or vomiting as side-effects. Try to drink 8 glasses of water per day.

Other examples of fluids are water, soup, milk and even ice cream (anything that turns liquid at room temperature).

Cancer survivors and current cancer patients are advised to stop or limit their alcohol consumption. There are no beneficial aspects to drinking alcohol and it can interfere with your medications and worsen your treatment’s side-effects.

Side-Effects

Cancer treatments result in unfavorable side-effects. But here are the common side-effects and tips to help with them!

Before you start searching for Omega 3 supplements, it is important to talk with your doctor or your dietitian to check for any contraindications. For example, if you use anticoagulant medicines like warfarin, it may increase the risk of bleeding.

Loss of Appetite

  • Divide your meals into 6-8 small portions per day rather than having 3 big ones. By dividing your meals you will be able to consume a good amount of food without feeling discomfort.
  • Do not drink fluids while eating your meals. Take sips of water after you finish eating.
  • Eat in a relaxing environment; you could eat with your family or friends, put on some music, or do anything that keeps you calm.

Always keep energy-dense food with you:

  • A toast with peanut-butter and fruits
  • A smoothie made up of your favourite fruits
  • Milk or rice pudding
  • Raw nuts and fruits

As a caregiver, do not force or blame the patient if he/she did not eat, try to offer them the meal again after 1-2 hours.

Nausea and Vomiting

  • Do not skip your meal, an empty stomach can make nausea worse.
  • After eating your meal, stay seated for 1 hour.
  • Always wear comfortable clothes to avoid any pressure on your stomach.
  • If you have nausea, do not eat your favourite food to avoid finding them unappealing later.
  • Avoid strong aromas like perfumes, detergents, hot food, such smell can make you more nauseous.
  • To avoid dehydration, always have few sips of water.
  • Eat food that are at room temperature or cold, they will have less smell.
  • Avoid foods that are greasy, spicy and are high in fat.
  • Consume food that are bland (pasta, rice, apples, biscuit, cooked or grilled vegetables, grilled or baked chicken, fish).
  • Avoid alcoholic and caffeinated drinks.
  • Limit the intake of food that might cause gases (cabbage, onions, broccoli, corn, milk, whole grains, legumes, garlic) – only when you are nauseous or vomiting.

Altered taste and smell

  • Use plastic utensils instead of metal utensils.
  • Flavour your meal with spices (onion, garlic, basil, oregano, rosemary, mustard, mint).
  • If you are experiencing a salty taste, counter it with added sweetener.
  • If you are experiencing a sweet taste, counter it with added lemon juice and salt.
  • If you are experiencing a bitter taste, counter it with added sweeteners.
  • Always brush your teeth to keep your mouth clean which will ease the bad taste.
  • Rinse your mouth with salt, baking soda and water mouthwash before you eat which will help foods taste better. (You need to mix 1 teaspoon salt, 1 teaspoon baking soda in 4 cups water, shake it well, swish and then spit it out).
  • Consume your meal at room temperature or cold which will decrease the meal’s smell and taste.
  • Consume fresh vegetables; they are better tolerated than canned or frozen​.
  • To make meat tender, marinate them.
  • Make fresh yogurt or shakes by blending your fruits.
  • Your environment should not be warm, always choose a room you are relaxed in while eating.

Xerostomia (Mouth Dryness or Thick Saliva)

  • Avoid alcohol, caffeine, sugar (candy, soft drinks..).
  • Sip liquid throughout your day to keep your mouth moist (very important).
  • Eat your meals moist by adding gravy, sauce, milk, yogurt.
  • You can have ice-chips, sugar free candies, or sugarless gum.
  • Avoid food that are hot, spicy, or acidic.
  • Avoid food that are salty (pretzels, chips, popcorn, salted nuts).
  • Avoid mouthwash that contains alcohol​.

Sore mouth or throat

  • Drink using a straw to avoid any mouth ulcers.
  • Do not smoke, this will compromise your healing process.
  • Do not consume alcoholic beverages, acidic drinks (lemon, orange, kiwi, tomatoes, pineapple), caffeine (coffee, tea, cola, chocolate), vinegar, and hot spices.
  • Do not consume food that can scratch/irritate (nuts, biscuits, seeds, chips, popcorn, toast, rice cakes, dried fruits and vegetables).
  • Do not consume spicy herbs such as basil or thyme.
  • Experiment and find out what food temperature best suits you (warm, cold, room temperature, icy)​.

Diarrhea

  • Avoid milk, it can make diarrhea worse, you can consume cheese or yogurt.
  • Avoid fried food, oil, butter, and greasy food.
  • Avoid whole grain, replace brown grains with white grains, white paste, white bread.
  • Increase your consumption of soluble fiber which are peeled apples (no skin), banana, oats.
  • Avoid sweeteners (mannitol, xylitol, sorbitol).
  • Avoid alcohol, caffeine, chocolate, soft drinks, nuts.
  • Increase the consumption of food high in potassium (banana, potatoes, apricots)​. Potassium is an important mineral that is lost due to diarrhea.
  • Drink 6 to 8 cups of fluid per day. Water, juice diluted with water, broth, jello, herbal tea.
  • Consume in moderation food containing salt such as soups, broths, crackers (to replenish mineral sodium).
  • You can buy oral rehydration solution.
  • Some fiber food will make diarrhea worse, and those are: nuts, seeds, whole grain, legumes (peas and beans).
  • Avoid raw fruits and vegetables, you can cook them and eat them.
Examples of food that you can consume (when you have diarrhoea)
  • Starch: boiled potato, boiled rice, boiled noodles, white bread, white toast, oats without skin, cornflakes without fiber.
  • Meat: boiled or grilled meat, chicken, fish, boiled eggs and turkey.
  • Fruits: banana, only apple and pear but without skin and made compote.
  • Vegetable: boiled vegetables, especially carrots.
  • Dairy: white cheese and yogurt.
  • Decaffeinated drinks.

Constipation

  • Consume fiber-rich food such as whole grain, raw fruits and vegetables with skin, beans, peas, and nuts.
  • Drinks up to 2 litre of fluid daily.
  • Try to walk and exercise.
  • Avoid using a straw and food that might cause gas such as beans, peas, chewing gum, cabbage, broccoli, milk, onion, eggs, and carbonated drinks).
  • Consume yogurt, parmesan cheese, Swiss cheese, pickles and olives (probiotic-containing food)​.

Swallowing Problems

  • Use a straw for liquid and soft foods
  • Thicker liquid (fruits blended to get a pureed texture or liquid with added thickeners) are easier to swallow than thin liquid.
  • Consume frequent meals throughout the day (do not consume 3 big main meals).
  • Foods such as meats, cereals and fresh fruits are better if mashed or pureed, a texture similar to baby food (You might need to add liquid to dry food if you want to blend them).
  • Avoid alcohol and hot spices.
  • Avoid acidic food, citrus fruit and soft drinks.
  • Avoid hard food, crackers, chips, nuts, pretzels.
  • Refrigerate your food, the cold helps to numb the pain, if your pain gets worse with cold food, try at room temperature.
  • Sit upright when and after you eat​

Thickeners make food easier to swallow, here are some examples:

  1. Gelatin: 1 tablespoon of unflavored gelatin mixed in two cups of hot liquid, mix well to dissolve and pour over your food.
  2. Tapioca, flour, cornstarch: Cook them before using.
  3. Commercial thickeners: Follow the label instructions
  4. Pureed vegetables and instant potatoes: You can use them in soup; however, they change the flavour of food.
  5. Baby rice cereals

Losing Weight

There are several oral supplemental drinks that you can drink, however you should always drink them after your meal.Consult your dietitian/ doctor regarding the type and amount of oral nutrition support that you can drink.

Foods to have and avoid when your blood cell count is low “Neutropenia” 

Food: Meat, poultry, fish, tofu, nuts

Food Recommended:

  • Meat, poultry, fish should be cooked well.

  • Use a food thermometer.

  • Tofu from the fridge should be cut into 1inch cubes and boiled for 5 minutes in the water/broth before you eat it.

  • Always buy vacuum sealed nuts.

Food to Avoid:

  • Avoid raw or undercooked meat, fish.

  • Avoid raw nuts.

 

Food: Eggs

Food Recommended:

  • Cook the egg well, until you see the yolk and white become solid.
  • Always buy pasteurized eggs.

Food to Avoid:

  • Avoid raw or soft-cooked eggs (poached, soft boiled, sunny side up).
  • Some food contains raw eggs such as (Caesar salad dressing, smoothies, raw cookie dough, homemade mayonnaise, eggnog).

 

Food: Milk and dairy Products

Food Recommended:

  • Buy only pasteurized milk, yogurt, cheese

Food to Avoid: 

  • Avoid soft, mold ripened or blue cheese (Brie, Blue cheese, camembert, Roquefort, stilton).
  • Avoid the Mexican styled cheese like queso blanco fresco (unpasteurized milk is used to make them).

 

Food: Bread, cereal, Pasta, Rice

Food Recommended:

  • Breads, cereal, potatoes, bagels, rolls, muffin, noodles, pasta, crackers, rice are all safe to eat, but always buy them wrapped, pre packed and not in self-service bins.

Food to Avoid: 

  • Avoid buying bulk bin sources of grains.

 

Food: Fruits and Vegetables

Food Recommended:

  • Wash raw fruits and vegetables well.

Food to Avoid: 

  • Avoid fresh salad and fresh salad dressing found in the fridge of the market. (it is better to choose shelf stable dressing).

Food Safety

Cancer patients are prone to infections, this is why handling and cooking food is crucial to avoid infections.

Food Handling Tips:

  • Wash your hands using warm water and soap for 20 seconds before preparing food.
  • Refrigerator should be at or below 4-degree Celsius / 40-degree Fahrenheit.
  • Hot food should have a temperature of 60-degree Celsius or 140-degree Fahrenheit
  • When you defrost food, eat right away and do not refreeze them
  • Never thaw meat, poultry, fish at room temperature. Use microwave or refrigerator.
  • Perishable food should be put in the refrigerator within 2 hours after buying them or preparing them. Food such as egg dishes, cream and mayonnaise-based food are not to be left unrefrigerated for more than 1 hour.
  • Wash fruits and vegetables well before peeling them. You can use vinegar or salt to wash them.
  • Do not buy food products that were already cut at the market store (such as melon or cabbage or watermelon)
  • Wash the cans with water and soap before opening them
  • Do not consumed eggs that have broken or cracked shells
  • Throw out food that smell strange or look strange, do not taste them.

Cross Contamination:

  • Clean knives should be used when cutting different food.
  • Meat should be stored away from ready to eat food in the refrigerator. It is advised to store meat at the bottom of the refrigerator and not above food, to avoid any dripping that might occur from the meat.
  • A different cutting board should be used for different food (raw and cooked).

Cook Food Well:

  • Put a thermometer into the boiling water and have it read as 212-degree Fahrenheit or 100-degree Celsius
  • Cook meat until no pink color is visible anymore. Meat should be cooked at 160-degree Fahrenheit or 71-degree Celsius and poultry should be cooked at 180-degree Fahrenheit or 82-degree Celsius.

Grocery Shopping:

  • Always read “sell by” and “use by” before buying the food product. Never buy food products that are out of date/expired.
  • Do not buy swollen, rusted, damaged cans.
  • Do not buy food that are sold in bulk containers or self-served containers. Always buy products that are sealed.
  • Buy unblemished fruits and vegetables (check the color. Are there spots or stains present?)

Dining Out:

  • Do not eat from salad bars, buffets, any place with high-risk food sources.
  • Do not eat raw fruits and vegetables.
  • Always ask for pasteurized products, even fruit juice. Never consume “freshly squeezed juice” when in a restaurant.

Physical Activity

Exercise has a lot of benefits, especially for a cancer patient.

The recommendation for adults is 150 to 300 minutes per week of moderate intensity or 75-150 minutes per week of vigorous intensity exercise.

The recommendation for children is active to moderate vigorous intensity for 1 hour per day.

This can be challenging if you are experiencing fatigue and pain. But when you feel good and are able to exercise, go ahead and do.

Physical activity can vary from home activities to sports to leisure.

You can mow your lawn or play volleyball, tennis, basketball, dance, yoga, jogging, swimming.

Try using the stairs instead of an elevator, try to park your car a small distance from your office and walk to work.

Avoid a sedentary lifestyle; try limiting sitting down. Watch television/ play on your laptops for 1 hour per day.

Always consult your doctor and take their advice on what type of exercise is permitted and suitable for you.

FAQs (Frequently asked questions) 

There are a lot of questions that cancer patients and caregivers ask.

Here are some:

1. Does sugar feed cancer?

According to American Institute for Cancer Research, No, sugar does not feed cancer.

It is not suggested to consume sugar on a daily basis because it has no nutritional value, and excess intake of sugar will lead to weight gain, and an un-healthy weight does add a risk of cancer.

If you are on chemotherapy, sugar is advised to be limited due to the medications.

But the statement “sugar feeds cancer” is not true. There are no human studies proving this claim so far.

2. Should I follow a ketogenic diet?

Ketogenic diet consists of high fat, moderate protein and low carbohydrate food.

This diet does not reduce your risk of cancer or aid in your treatment.

Currently, there has not been a study able to explain and prove the effectiveness of ketogenic diet for cancer patients.

A diet you that you should focus on is that of the healthy guidelines explained above, carbohydrate, protein and fat intake are all important for you to have.

3. Should I take supplements?

Do not take any supplement before taking approval from your doctor.

The best way to get your nutrients is from food, but if you believe you need supplements, consult your doctor and ask about the right dosage, the right time to take the supplement and what you should avoid.

Always consults a specialist before taking any pill.

4. Are Organic food recommended for cancer patients/survivors?

According to American Cancer Society, there are no studies proving that consuming organic food will decrease the risk of cancer, decrease the risk of cancer worsening, or decrease the re-occurrence of cancer.

5. Do Genetically Modified Food cause cancer?

According to American Institute for Cancer Research, there are no known evidence that genetically modified food affect cancer risk.

6. If I heat my food in the microwave, does this increase the risk of cancer?

No, this does not increase the risk of cancer.

Microwave radiation will not affect your food.

Cover your food with the lid when placed in the microwave.

7. Does a vegetarian diet reduce the risk of cancer re-occurrence?

According to American Cancer Society, no link has been proven that vegetarian diet reduces the risk of cancer.

A diet you should aim to follow is on rich in fruits, vegetables, whole grain, legumes with small amounts of meat and fish.

Avoid/limit processed food and processed meat, sugary food and refined grains.

8. Do alternative sweeteners cause cancer?

The FDA approved alternative sweeteners which are “aspartame, acesulfame potassium, monk fruit extract, neotame, saccharine, stevia, sucralose and advantame” and claim that they are safe to consume.

According to national cancer institute, no evidence was found to link artificial sweeteners to cancer.

They are safe, within limited quantities.

 

The food choices you consume are very important to help you recover and strengthen your body to endure the treatment that is planned for you. 

Stay healthy,

Wellbene, your wellness companion

Written By :

Mirabelle

October 15, 2022

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