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CANCER TREATMENT: Nutritional Management of Side Effects Lynn Goldstein, M.S., R.D., C.D.N. Nutritionist The Jay Monahan Center for Gastrointestinal Health We Will Talk About : What to do when you are feeling well Nausea Vomiting Constipation Diarrhea Loss of appetite

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cancer treatment nutritional management of side effects

CANCER TREATMENT: Nutritional Management of Side Effects

Lynn Goldstein, M.S., R.D., C.D.N.


The Jay Monahan Center for Gastrointestinal Health

we will talk about
We Will Talk About:
  • What to do when you are feeling well
  • Nausea
  • Vomiting
  • Constipation
  • Diarrhea
  • Loss of appetite
we will talk about3
We Will Talk About:
  • Taste changes
  • Mouth sores
  • Dry mouth
  • Weight loss/increasing calories & protein
  • Iron deficiency anemia
  • Safe food handling
when you are feeling well
When You Are Feeling Well
  • Maintain a balanced healthy diet
  • Eat plant-based foods
  • Get plenty of fruits and vegetables
  • Choose lean meats, fish and poultry
  • Avoid saturated and transfatty acids
  • Avoid refined, processed foods
  • Get plenty of water
  • Eat 5-6 small meals – avoid an empty stomach
  • Eat bland and easy-to-digest foods
  • Eat cold foods
  • Suck on frozen ice pops or fruits, such as watermelon and grapes
  • Try sour foods, such as granny smith apples
  • Suck on hard candy – ginger root
  • Try easy foods with low odor, such as canned peaches, pears, or fruit cocktail
  • Avoid foods with strong odors and hot foods
  • Avoid drinking large quantities of fluids w/ meals
  • Limit gas-producing foods, such as bean, cabbage, and broccoli
  • Avoid sweet, fatty, fried, or spicy foods
  • Avoid your favorite foods to limit food aversions
  • Avoid warm/stuffy rooms
  • Do not eat or drink until vomiting is under control
  • Drink small amounts of clear liquids
  • Once liquids are tolerated, try a soft diet with bland foods such as mashed potatoes, rice, pureed fruit, and yogurts
  • Eat potassium, magnesium-rich foods, such as bananas, potatoes, OJ, and tomatoes
  • Have fiber with all meals
  • Try kidney beans, chickpeas, lentils, fruits, vegetables, oatmeal, and high-fiber cereal
  • Try dried fruit
  • Try 2 tbsp flaxseed
  • Drink plenty of fluids
  • Avoid binding foods, such as cheese and chocolate
  • Add exercise to your daily routine
fiber recipe for constipation
Fiber Recipe for Constipation
  • 3 parts wheat bran cereal
  • 2 parts applesauce
  • 1 part prune juice
  • Mash mixture together
  • Eat 3 times per day as needed
  • Works well on toast
  • Drink plenty of fluid to prevent dehydration
  • Drink fluid with electrolytes: Pedialyte
  • Consume potassium-rich foods, such as orange juice, bananas, tomatoes, and potatoes
  • Think BRATT:

Bananas, Rice, Applesauce, Tea, and Toast

  • Try canned fruits, plain pasta, noodles, cream of rice cereal, eggs, potatoes, lean meats
  • Avoid high-sugar beverages and snacks
  • Avoid “sugar-free” candies and gum
  • Avoid spicy, greasy foods
  • Avoid dairy products if they are not tolerated
  • Avoid insoluble fiber foods, such as raw fruit/vegetables, whole grains, nuts, seeds, popcorn, beans, lentils, and brown rice
  • Avoid snack foods with Olestra (WOW)
rice congee recipe for diarrhea
Rice Congee Recipe for Diarrhea
  • 1 cup long-cooking white rice
  • Combine with 6-7 cups of water and one tbsp salt
  • Cook for about 40 minutes
  • This is a sticky/soupy mixture that really helps diarrhea
loss of appetite
Loss of Appetite
  • Eat by the clock rather than hunger
  • Choose high-calorie/protein snacks
  • Bring snacks with you when you go out
  • Have your favorite foods on hand
  • Have a friend or family member assist with meal preparation
  • Make foods visually appealing and avoid unpleasant odors
loss of appetite14
Loss of Appetite
  • Drink high-calorie/protein shakes
  • Avoid liquids with meals to keep from getting full quickly
  • Try a small amount of sherry or wine
  • Get some fresh air
  • Avoid stressful and unpleasant conversation during meal time
  • Avoid warm, stuffy environments
mouth sores mucositis
Mouth Sores (Mucositis)
  • Eat soft, bland, cool foods
  • Puree and liquify foods in a blender
  • Drink through a straw
  • Suck on frozen fruit – avoid citrus, tomato
  • Avoid irritating spices and seasonings
  • Avoid rough, dry, course foods
  • Avoid alcohol or tobacco
  • Rinse mouth often with mild mouthwash
taste changes
Taste Changes
  • Season foods with tart flavors
  • Chew lemon drops, mints, gum
  • Flavor foods with onion, garlic, chili powder, basil, oregano, rosemary, BBQ sauce, mustard, or catsup
  • Marinate foods in sweet juices
  • Drink flavored instead of plain water
taste changes17
Taste Changes
  • Serve food cold
  • Rinse mouth w/ tea, ginger ale, salted water w/ baking soda before eating
  • Eat frozen fruits, such as cantaloupe, grapes, oranges, or watermelon
  • Select fresh instead of frozen/canned vegetables
  • Use plastic utensils instead of metal
dry mouth
Dry Mouth
  • Sip fluid every few minutes
  • Try very sweet or tart foods & beverages
  • Suck on hard candies, Popsicles, gum
  • Eat foods with sauces, gravies, dressings
  • Puree foods
  • Use lip balm
weight loss increasing calories and protein
Weight Loss/Increasing Calories and Protein
  • Eat several small meals a day
  • Eat favorite foods any time of the day
  • Eat every few hours; eat on a schedule
  • Keep easy-to-grab snacks on hand at all times, such as granola bars, fruit, nuts, single serving- size tuna cans, trail mix, puddings, and yogurt
  • Focus on high-calorie foods
  • Take advantage of your most energetic time
weight loss increasing calories and protein20
Weight Loss/Increasing Calories and Protein
  • Exercise lightly to increase appetite
  • Drink nutritional supplements
  • Drink caloric fluids between meals
  • Add fat, such as olive or sesame oil
  • Add chopped nuts/seeds to meals
  • Avoid low-fat or “diet” foods
  • Add protein powders
iron deficiency anemia
Iron Deficiency Anemia
  • Animal (heme) products are best source; the darker the meat, the higher the iron amount
  • Dark green vegetables (non-heme) and dried fruit
  • Iron-fortified grains/nuts/seeds
  • Vitamin C to boost absorption of non-heme iron
  • Calcium decreases iron absorption
  • Coffee/tea/cola decrease iron absorption
  • Cook acidic foods (tomato sauce) in cast iron pots and pans
safe food handling
Safe Food Handling
  • Wash hands well with warm soapy water before preparing and eating food
  • Do not use same cutting surface for meat and vegetables. Sanitize cutting surface before each use
  • Keep hot foods hot and cold foods cold
  • Never thaw foods at room temperature
  • Eat only well cooked foods
safe food handling23
Safe Food Handling
  • Avoid raw egg products
  • Avoid unpasteurized products
  • Avoid salad bars
  • Avoid fresh squeezed juices unless made at home
  • Avoid raw fish
helpful websites
Helpful Websites
  • Jay Monahan Center
  • American Cancer Society
  • American Institute for Cancer Research
  • National Cancer Institute