Nutritional and Dietary Management
During cancer treatment
Nutritional management
Nutritional management for patients undergoing cancer chemotherapy should be tailored to the individual patient's characteristics, and patients with nutritional issues should consult with a dietitian regularly. Dietary adjustments should be made based on the patient's loss of appetite, changes in taste, early satiety, nausea, weight loss, and a series of treatments.
Diet
Sterile diet is typically used for infection prevention in patients with blood tumors, and it is handled as follows:
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Adhere to dietary guidelines for infection prevention.
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The range of permissible and restricted foods may change according to the chemotherapy regimen, and the timing of loosening food restrictions should be discussed with your primary physician.
However, even when food restrictions are lifted, alcohol, cigarettes, street food, junk food, medicinal mushrooms, herbal medicines, and raw fish continue to be restricted.
▲ Alcohol, tobacco, street food, bad food, medicinal mushrooms, herbal medicine, sashimi restrictions
Strategies for Dealing with Side Effects During Treatment
This is one of the most common issues, with many factors such as nausea, vomiting, discomfort, and feelings of discouragement due to the illness affecting appetite. Patients experiencing these symptoms, whether mental or physical, tend to have less interest in eating. Therefore, the following strategies are utilized at home.
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Ensure not to rush during meal times.
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Encourage participation in normal activities as much as possible. Staying active can help to maintain strength and improve overall well-being.
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Consider changing the setting of meal times, such as the location or atmosphere. Listening to music, adding flowers to the table, or eating with friends can make meal times more enjoyable and appetizing.
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Provide a variety of menu options.
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Don't be bound by traditional meal times. Eat whenever it's possible and when you feel hungry.
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Supplement your diet with high-calorie, high-protein, and easily digestible snacks. Nutritional drinks like Ensure or Boost can also help to maintain nutrient intake.
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Identify the causes of loss of appetite, such as pain, nausea, or constipation, and work towards resolving these issues. Addressing the root cause can help to improve appetite and ensure proper nutrition.
Pain, swelling in the mouth, weakened gums, and throat or esophageal pain can occur due to radiation therapy, chemotherapy, or infections. During these times, avoid foods that may irritate the weakened mouth or are hard to chew and swallow. Protect your mouth well and make eating easier to maintain nutritional intake.
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Try foods that are easy to chew and swallow. (Porridge, rice soup, broth, mashed potatoes, macaroni, boiled eggs, scrambled eggs, mashed vegetables, bananas, and other soft fruits.)
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Use a blender to puree your food or try using minced food.
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Mix your food with substances like butter, clear meat broth, or sauces to make it easier to swallow.
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If your mouth is sore, consider using a straw.
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Avoid hot foods as they can irritate your mouth and throat. Opt for room temperature or slightly cold food instead.
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Rinse your mouth frequently to remove food particles and bacteria.
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Anesthetics can be used to temporarily alleviate pain in the mouth and throat during meals.
An abnormality in taste can lead to decreased sensitivity to sweet and salty flavors, while there may be an increased sensitivity to bitter flavors.
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Prepare food that is visually appealing and smells good.
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If you dislike the taste of meat, you can substitute it with fish, eggs, tofu, and dairy products.
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When preparing meat, marinate it in fruit juice, wine, dressing, or sauce to enhance the flavor.
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Using plastic utensils and dishes instead of metal ones can help lessen the perception of a bitter taste.
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Serve food at room temperature.
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Discontinue foods that cause an unpleasant taste.
Chemotherapy and radiation treatments around the head and neck can reduce saliva production, leading to a dry mouth.
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Encourage frequent sips of water.
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Margarine, sauces, and other additives are used to make the food tender.
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It prepare the food with broth to make it easier to swallow.
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Sweet or sour foods are used to help produce more saliva.
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Lip balm and similar products are applied to keep the lips moist.
Nausea and vomiting can be side effects of chemotherapy, radiotherapy, and immunotherapy. Since nausea can make it hard to get the nutrients you need, keep these tips in mind:
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Choose dry foods.
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Stay away from foods that are too sweet, greasy, spicy, hot, or have strong flavors.
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Eat slowly and have small portions more often.
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Drink cold or iced beverages.
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Wait until you have control over vomiting symptoms before trying to eat or drink.
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After eating, avoid moving too quickly, and try resting with your head raised a bit.
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Limit how much you drink during meals. (Sip small amounts with a straw and prefer cold drinks, but not during meals)
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Avoid eating in places that are hot, poorly ventilated, or have bad smells.
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If you're undergoing radiotherapy or chemotherapy, don't eat 1-2 hours before your treatment.
| Safe Foods to Eat When Vomiting | Foods to Avoid When Vomiting |
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Diarrhea can have many causes, including chemotherapy treatment, abdominal radiation treatment, infection, food sensitivity, and emotional distress. During diarrhea, food passes through the intestines too quickly for the body to absorb sufficient vitamins, minerals, and water. This can lead to dehydration and increase the risk of infection.
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Replenish adequate fluids
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Encourage frequent, small meals.
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Avoid greasy foods and foods that produce gas.
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Avoid foods and beverages containing caffeine.
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Encourage the consumption of clear liquids for 12 to 14 hours after acute diarrhea. This can give the intestines a rest and help replenish fluids lost due to diarrhea.
| Foods allowed during diarrhea | Foods not allowed during diarrhea |
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Some anticancer drugs and antiemetics can cause constipation. It can also result from inadequate intake of food or fluids, and lack of exercise.
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Increase fluid intake and ensure adequate food consumption.
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Encourage the consumption of high-fiber foods (such as whole grains, vegetables, fruits, and seaweed)
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Encourage regular moderate exercise, such as walking.
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If bedridden, gently massage the abdomen to aid bowel movement.
Lactose intolerance can occur due to antibiotic treatment or radiation treatment affecting the abdomen or digestion. During treatment, the intestines' ability to break down lactose may be incomplete. Symptoms such as gas, cramping, and diarrhea may disappear weeks or months after treatment, but in some patients, these symptoms may persist, requiring changes in dietary habits. In these cases, encourage the use of soy milk products instead of dairy.
Diet Management After Treatment
* Since anticancer drugs are metabolized in the liver, it is best to avoid folk remedies with unknown ingredients or substances that can increase liver enzyme levels, such as ginseng, red ginseng, herbal medicine, tonic, medicinal mushrooms, herbs, and yeast extract formulations.
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The range of foods allowed and restricted may vary depending on your chemotherapy regimen, and this information is provided during nutritional counseling.
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Purchase food that has been stored at appropriate temperatures, and strictly adhere to the storage methods and times indicated on the product.
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Ensure that the area where you prepare and cook food is cleaned before use, and use plastic cutting boards and stainless steel containers.
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Check the expiration date of all food items before use, including dairy products and canned goods.
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Prepare food in single servings to avoid leftovers. However, any leftover food can be stored in the refrigerator for up to 24 hours and must be reheated before consumption. When reheating, first bring the food to a boil, stir thoroughly, and then continue to boil for an additional 5 minutes.
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Use individually packaged foods. This can reduce the chance of contamination that can occur from handling the food multiple times.
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Drink boiled water or commercially available bottled water in small volumes.
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Consume bakery items that are individually wrapped, sealed, and without filling.
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Meat, fish, eggs, and tofu should be fully cooked before consumption, and eggs with cracked shells should not be used.
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Fresh fruits and vegetables should be thoroughly washed before consumption, and uncooked fish and meat should be consumed only after consulting with your physician.
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Check the expiration date and inspect for any contamination due to mold or foreign substances.
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Keep utensils clean and avoid leaving food at room temperature or within the danger zone. (5-60°C)