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First of all; please note that you CANNOT starve cancer. The tumor will always take all the nutrition it requires whether you nourish your body or not. If you deprive yourself of adequate nutrition, you will reduce your body’s ability to withstand treatment and fight off the cancer, your healthy cells will become more starved because the tumor will take what it need regardless of what you put in your body. Second; sugar does not ‘grow’ cancer cells. Cancer cells will derive the sugar they need from your blood whether or not you choose to eat a healthy portion of carbohydrates. Eating moderate sugar in your diet will not reduce our body’s ability to recover. The bottom line is this: eat a healthy balanced diet. This will give your healthy cells the nourishment they need.

Neutropenia

When people receive cancer therapy, their doctors monitor a type of white blood cell called a neutrophil. When neutrophil levels are abnormally low, it’s called neutropenia. If you have neutropenia, you have a higher risk of infection, so it’s very important to follow safe food handling and cooking practices to minimize infection risk

  • Wash your hands for a full 20 seconds with plain soap and running water immediately after handling raw meat, poultry, seafood, eggs, and unwashed produce. Wash surfaces, cutting boards and utensils after each use.
  • Never use the same cutting board and knives for uncooked meat, poultry, and seafood and produce. Separate these foods in the refrigerator in clean, sealable bags. Store ready-to-eat foods on shelves above raw meat, poultry, and seafood so nothing drips onto other foods.
  • Cook all food to the proper temperature to kill bacteria. Beef, pork, lamb, and veal should be cooked till fully done.
  • Refrigerate perishable foods within 1 hour. Always thaw frozen food on a plate or pan in the refrigerator and never on the counter.

If you have neutropenia (or a low white cell count), avoid the following foods:

  • raw or undercooked meat, poultry, seafood, and eggs
  • raw or unpasteurized milk
  • unwashed fresh produce i.e. fruit and vegetable
  • raw milk/unpasteurized cheeses

Some types of produce, such as lettuce, raw green leafy vegetables, strawberries, and raspberries, are difficult to clean well. You may need to avoid these foods if you have neutropenia.

Interaction with medication

  • Grapefruit is unusual in that it has the potential to interact with many common drugs, from cancer therapy to medicines used to treat heart disease. So, it’s best to avoid grapefruit and grapefruit juice until cancer therapy is completed.
  • Green tea is generally considered safe if not consumed excessively — one or two cups per day is okay, unless a person is being treated with Velcade (Bortezomib), which is used to treat certain types of blood cancer (Multiple Melanoma). Studies suggest even small amounts of green tea may reduce the effectiveness of Velcade. It’s important to know that taking green tea supplements is considered unsafe.

Supplements

In general, you should limit the use of most dietary supplements during cancer therapy to minimize the risk of the nutrients interacting with the cancer therapy medicine(s). Avoid any supplement that contains unusually highly concentrated forms of a food or beverage during cancer therapy. These higher amounts of food components have the potential to interact with cancer therapy. If you are interested in taking supplements during cancer therapy treatment, talk to your oncologist BEFORE you take anything.

Nausea

Nausea is a very common side effect of treatment.

The following tips can help you cope with cancer therapy-associated nausea:

  • Take any anti-nausea medicines exactly as prescribed. Many people make the mistake of waiting until they are nauseous to take these medicines. Nausea is much easier to prevent than to stop once it starts. Food and nutrition can help with nausea, but medicines are your first line of defense.
  • Stick to small, frequent meals. Avoid eating or drinking too much at once. Feeling overly full will make nausea more intense.
  • Try dry and bland foods, such as soft or water crackers, toast, oatmeal, and plain yogurt.
  • Sip cold, clear liquids, such as ginger ale, iced tea, or sparkling water. Sip ginger tea.
  • Avoid oily, or very sweet foods if they trigger or worsen your nausea.
  • Suck on ginger sweets, mints or lemon drops.
  • Suck on frozen fruit such as frozen grapes, watermelon, or cherries.
  • Note: Avoid citrus flavors if you have mouth sores

Constipation and diarrhea

Constipation and diarrhea are two other common side effects.

Fiber is key to managing both constipation and diarrhea. There are two types of fiber: soluble and insoluble. Soluble fiber becomes “sticky” when it gets wet e.g. Oats. Insoluble fiber does not absorb much water, so it doesn’t change when liquid is added to it e.g. Cabbage.

  • Drink plenty of liquid to help move things through your digestive tract more quickly and easily. This can ease constipation. You may also try fruits such as watermelon, mangoes and soursop.
  • For diarrhea, you want to eat soluble fiber. Think of foods that absorb water and have a sticky quality after preparation or cooking. Examples include oats, barley, and white rice.

Beans and peas contain significant amounts of both soluble and insoluble fiber.

Mouth sores

The following tips can help you cope with cancer therapy-associated mouth sores:

  • Eat your foods at room temperature or cold. Avoid very hot/very cold/spicy foods. Avoid citrus, spicy, and strong minty flavors such as lemons, limes, tomato sauce, oranges, and orange juice.
  • Try using baby-soft toothbrush as well as toothpaste.
  • Avoid dry and sharp foods such as toast, crackers, and chips.
  • Suck on ice chips, popsicles, or frozen fruit. Some cancer therapy medications cause cold intolerance, so avoid this if you have been told to skip very cold foods.
  • Do not use alcohol or tobacco. Avoid fizzy and carbonated beverages.
  • Try moist, bland foods such as oatmeal, pudding, and custards.
  • Do not use commercial mouthwashes that contain alcohol.

Altered taste

Altered sense of taste is a common complaint among people receiving cancer therapy. If food tastes truly terrible and you notice white patches in your mouth, tell your doctor. This can be a sign of infection in the mouth and it requires prompt treatment.

For most people, some adjustments in the types and flavors of food can help when food doesn’t taste right.

The following tips can help you cope with cancer therapy-associated changes in taste:

  • If food tastes metallic, try using plastic or wooden utensils. Avoid canned fruit, sauces, and vegetables. Opt for fresh or frozen instead.
  • Practice good oral hygiene. Lightly brush your tongue and gums to eliminate bad tastes.
  • Ask your medical team if they recommend specific mouth rinses or toothpastes to combat odd tastes.
  • Experiment with different or new spices and flavors. Try fruit sauce on meats or lemon juice and butter drizzled on vegetables or beans.
  • Eat nutrient-dense, lower-flavor foods, such as unsalted nuts and nut butters.
  • Serve foods at room temperature or cooler (but make sure they are cooked thoroughly for food safety first) to lessen strong flavors.
  • Try simmering potatoes and meat in broth or coconut milk.

Lack of appetite

Lack of appetite and feeling full after only a few bites are common challenges for people receiving cancer therapy. If you are struggling with this issue, focus on eating good sources of protein and nutrient-dense foods.

The following tips can help you cope with cancer therapy-associated lack of appetite:

  • Eat five or six small meals and snacks rather than two or three larger meals.
  • Bring food with you when you leave the house. If hunger strikes, you can take advantage of it immediately. Pack granola bars, nuts, dried fruit, an apple, or a banana in your purse, bag or backpack.
  • Eat by the clock. Don’t wait to feel hungry. Instead, make it a priority to have a few bites of food every hour or so.
  • Avoid water, tea, coffee, diet soda, or other non-caloric beverages with meals. They can fill you up and replace the food your body truly needs.
  • Include protein foods, such as eggs, nuts or nut butter, tuna, or chicken with every meal and snack.
  • Add cheese to soups, stews, and casseroles.
  • Enjoy custard and pudding made with whole milk for dessert.
  • Drizzle olive oil over vegetables.
  • Add avocado, nuts, and nut butters to salads.

Treat food like medicine. While it’s not fun to eat when you have no appetite, your body needs fuel in the form of calories and protein. Eating well can help you recover from treatment and rebuild your immune system.

Dehydration

Staying well hydrated is an important part of cancer therapy. Your kidneys need plenty of fluid to process and excrete the cancer therapy medicines. If you aren’t urinating regularly or your urine is a dark color, call your doctor right away. In addition to drinking plenty of fluids, eat water-rich vegetables and fruit, such as carrots, cucumbers, celery, berries, apples, plums, pears, peaches, nectarines, and oranges. Sip soups and broth, and enjoy smoothies made with milk or non-dairy options. Along with these foods, minimize the risk of dehydration with the following tips:

  • Carry a water bottle with you at all times. Sip from it frequently.
  • Try flavored or sparkling water if plain doesn’t taste good.
  • Try a squeeze of lemon or lime in your water to make it more appealing.
  • Try non-caffeinated and herbal teas, such as chamomile, hibiscus, or other flavors for variety in your fluids.
  • If water tastes funny, mix half water and half fruit juice for a different flavor.
  • Add cucumber slices to water for a fresh taste.

Juicing

Juicing can be a great way to get more vitamins, minerals, and plant-based nutrients into your diet. It can be used to add fruit and vegetables to an already-healthy diet. Before you try juicing, focus on eating five servings of whole vegetables and fruit daily. Once you meet this goal, juicing can be added into your nutrition plan. You also may want to consider blending your vegetables and fruits to make healthy smoothies. Unlike juicing, blending foods into a smoothie means you get some fiber. If you do want to try juicing, the following tips will help you make the most of these beverages without overdoing it on the sugar.

  • Focus on vegetables. For the healthiest juices, include more vegetables than fruits. One fruit can sweeten up your mixture but make the other ingredients vegetables.
  • Drink juice with protein, and a little healthy fat. Protein and fat balance out the carbohydrates in the juice. Mix fruits with Greek yogurt, nuts and seeds, half an avocado, etc. Or have your juice with scrambled or hard-boiled eggs, or toast and peanut butter.
  • Avoid overdoing it on the same foods and nutrients. By mixing it up, you get the greatest variety of nutrients possible. You can even juice items you might throw away, such as a small broccoli stem.
  • Vary how you’re consuming the same vegetables and fruit. We absorb different nutrients from the same food, depending on how it’s prepared. What you absorb from a cooked carrot is different from what you absorb from a raw carrot. Don’t rely on juicing for all of your servings of any one particular food, or you miss out on vital nutrition.

DO NOT REPLACE REGULAR SOLID FOODS WITH A JUICE-ONLY DIET!
The American Cancer Society recommends eating extra protein after cancer therapy to help heal tissues and fight infection. During cancer treatment, aim for at least 0.5g of protein per kilogram of body weight per day. For example, if you weigh 80kg, aim for at least 40 grams of protein every day.

If you have other medical issues, such as kidney or liver disease, you may need less protein. Ask your doctor or dietitian for guidance on meeting protein needs if you have chronic conditions that may affect protein needs.

Vegetarians and vegans can meet protein needs with plant foods. Plant protein shakes are one good option. These products can fill in the protein gaps for people who do not eat meat, chicken, fish, dairy or eggs. Greek yogurt and eggs are good protein sources for vegetarians. Vegans should focus on beans, lentils, chickpeas, nuts, and seeds.

Alcohol

Cancer therapy can be taxing on the liver. Alcohol is processed by the liver. For this reason, we recommend completely avoiding alcohol during treatment.