People with cancer often need to follow diets that are different from
what you think of as healthy. For most people, a healthy diet includes
the following:
Î lots of fruits, vegetables, and whole grain breads and cereals
Î modest amounts of lean protein and dairy products
Î small amounts of sugar, alcohol, salt, and saturated and trans fats (such as those found in
butter, meat, dairy, fast food, and fried foods)
When you have cancer, though, you need to eat to keep your strength up in order to deal
with the side effects of treatment. When you are healthy, eating enough food is often not a
problem. But when you are dealing with cancer and treatment, this can be a real challenge.
When you have cancer, you may need extra protein and calories. At times, your diet may
need to include extra meat, fish, eggs, dairy, and plant-based proteins. If you have trouble
chewing and swallowing, you may need to add sauces and gravies. Sometimes, you may
need to eat low-fiber foods instead of high-fiber ones. A dietitian can help you with any diet
changes you may need to make.
Side effects from cancer treatment can lead to eating problems
Cancer treatments are designed to kill cancer cells. But these treatments can also damage
healthy cells. Damage to healthy cells can cause side effects that lead to eating problems.
See the list on page 9 to see the types of eating problems that cancer treatment may cause.
Common eating problems during cancer treatment include
appetite loss
changes in sense of taste or smell
constipation
diarrhea
dry mouth
Î lactose intolerance
nausea
sore mouth
sore throat and trouble swallowing
vomiting
weight gain
weight loss
You may have a poor appetite or nausea because you are stressed about cancer and
treatment. But once you know what to expect, you may feel better.

Getting ready for cancer treatment
Î Talk with your doctor or nurse about eating problems to watch for. Until treatment starts,
you will not know what, if any, side effects or eating problems you may have. If you do
have problems, they may be mild. Many side effects can be controlled and many problems
go away when cancer treatment ends.
Î Eat a healthy diet and maintain your weight before treatment starts. Eating a healthy
diet and maintaining weight before treatment helps you stay strong, lower your risk for
infection, cope with side effects, and have a greater chance of receiving treatment without
unplanned breaks.
Î Go to the dentist. It is important to have a healthy
mouth before you start cancer treatment.
Ask your doctor, nurse, or dietitian about medicine
that can help with eating problems.
Discuss your fears and worries with your doctor,
nurse, social worker, counselor, or psychologist.
They can discuss ways to manage and cope with
these feelings.
Learn about your cancer and its treatment. Many people feel better when they know what
to expect.
Ways you can get ready to eat well
Fill the refrigerator, cupboard, and freezer with healthy foods. Make sure to include items
you can eat even when you feel sick.
Stock up on foods that need little or no cooking, such as healthy frozen dinners and
ready-to-eat cooked foods.
Cook foods ahead of time and freeze in meal-sized portions.
Ask friends or family to help you shop and cook during treatment. Maybe a friend can
set up a schedule of the tasks that need to be done and the people who will do them.
Create a grocery list of items you usually buy so that it is easy for friends and family to
shop for you.
Talk with your doctor, nurse, or dietitian about what to expect

Everyone is different
Because everyone is different, there is no way to know if you will have problems with eating
and, if so, how bad they will be. You may have just a few problems or none at all. In part, this
depends on the type of cancer you have, where it is in your body, what kind of treatment
you have, how long treatment lasts, and the doses of treatment you receive.
During treatment, there are many helpful medicines and other ways to manage eating
problems. Your doctor, nurse, or dietitian can tell you more about the types of issues you
might expect and ways to manage them. If you start to have problems with eating, tell your
doctor or nurse right away.

During treatment, you may have good days and bad days when it comes to what you are able
to eat. Here are some ways to manage:
Î Eat plenty of protein and calories when you can. This helps you keep up your strength
and helps rebuild tissues harmed by cancer treatment.
Î Eat when you have the biggest appetite. You may want to eat a bigger meal when you are
feeling your best and drink liquid meal replacements when your appetite is low.
Î It’s okay if you feel like you can’t eat a lot of different foods. Eat the foods that sound good
until you are able to eat more, even if it’s the same thing again and again. You might also
drink protein shakes for extra nutrition.
Î Do not worry if you cannot eat at all some days. Spend this time finding other ways to
feel better and start eating when you can. Tell your doctor if you cannot eat for more than
2 days.
Î Drink plenty of liquids. It is even more important to get plenty to drink on days when
you cannot eat. Drinking a lot helps your body get the liquid it needs. Most adults should
drink 8 to 12 cups of liquid a day. You may find this easier to do if you keep a water bottle
nearby. Also, try some of the clear liquids.

Some cancer treatments can make you prone to foodborne illness. When this happens, you
need to take special care in the way you handle and prepare food.
Keep hot foods hot and cold foods cold.
Put leftovers in the refrigerator as soon as you have finished eating.
Scrub all raw fruits and vegetables with
a brush and water before you eat them.
Scrub fruits and vegetables that have
rough surfaces and peels, such as
melons, oranges, and avocados, with
a brush and water before you cut or
peel them.
Soak frozen fruits and vegetables in
water and rinse if you are not going
to cook them (for a smoothie, for
instance). If cooking, you do not need
to wash frozen fruits and vegetables.

Wash your hands, knives, and countertops before and after you prepare food.
This step is most important when preparing raw meat, chicken, turkey, and fish.
Wash your hands each time you touch raw meat, chicken, turkey, or fish.
Use one cutting board for meat and another one for fruits and vegetables.
Thaw meat, chicken, turkey, and fish in the refrigerator or defrost them in the
microwave. Cook meat, chicken, turkey, and eggs thoroughly. Eggs should be
hard, not runny. Meats should not have any pink inside. To be sure meat, chicken,
turkey, and fish is safe, use a meat thermometer and cook to the safe temperature.

Make sure your juices, egg, and milk products are pasteurized.
Eat shelled and roasted nuts.
Eat only freshly cooked rice.

Do not
Eat produce that is not easily scrubbed in water, such as berries and grapes.
Eat raw fish or shellfish, such as sushi and uncooked oysters.
Eat raw nuts.
Use foods, condiments, or drinks that are past their freshness date.
Buy foods from bulk bins.
Eat at buffets, salad bars, or self-service restaurants.
Eat foods that show signs of mold, including moldy cheeses such as bleu cheese and
Roquefort.
Eat any perishable foods that have been sitting at room temperature longer than 2 hours.
Eat leftovers that have been in the refrigerator longer than 3 days.
Leave meat, chicken, turkey, or fish sitting out to thaw.
Eat leftover rice or leftovers that contain rice.

Many people want to know how they can
fight cancer by eating certain foods or taking
vitamins or supplements. But there are no
studies that prove that any special diet, food,
vitamin, mineral, dietary supplement, herb, or
combination of these can slow cancer, cure it,
or keep it from coming back. In fact, some of
these products can cause other problems by
changing how your cancer treatment works.
Tell your doctor, nurse, or dietitian about any vitamin, mineral, dietary supplements,
or herbs you are already taking or plan to take. Also, talk with them before going on a
special diet.

Special note for caregivers
Do not be surprised or upset if your loved one’s food preferences change from day to day.
There may be days when they do not want a favorite food or say it now tastes bad.
Keep food within easy reach. This way, your loved one can have a snack whenever they are
ready to eat. Put a snack pack of applesauce or diced fruit along with a spoon on the bedside
table. Keep roasted nuts on the counter. Or try keeping cut-up fruits and vegetables in the
refrigerator. Eat fruits and vegetables with dips for extra calories and protein. Carrots go well
with hummus and apples can be dipped in peanut butter.
Offer gentle support rather than pushing your loved one to eat. Suggest that they drink
plenty of clear and full liquids when they have no appetite. For ideas on clear liquids,
see page 41, and for full liquids, see page 42.
Talk with your loved one about ways to manage eating problems. Ask the doctor for a
referral to a dietitian and meet with them together. Talking it through and seeking other
advice can help you both feel more in control.

During cancer treatment, you may feel
depressed
anxious
afraid
angry
helpless
alone
It is normal to have these feelings. Although these are not eating problems, strong feelings
like these can affect your interest in food, shopping, and cooking. Fatigue can also make it
harder to cope.

There are many things you can do to cope with your feelings during treatment so they do
not ruin your appetite. Here are some ideas that have worked for other people.
Î Learn about eating problems and other side effects before treatment starts. Many people
feel more in control when they know what to expect and how to manage problems that
may occur.
Î Eat your favorite foods on days you feel well. This way,
you can enjoy the foods, but they won’t remind you of
feeling poorly.
Relax, meditate, or pray. Activities like these help many
people feel calm and less stressed.
Exercise each day. Studies show that physical activity
helps people with cancer feel better. Talk with your doctor
or nurse about how much exercise to do while having
cancer treatment.
Talk with someone you trust about your feelings. You may
want to talk with a close friend, family member, religious or spiritual leader, nurse, social
worker, counselor, or psychologist. You may also find it helpful to talk with someone who
has gone through cancer treatment.
Join a cancer support group. This can be a way to meet others dealing with problems like
yours. In support group meetings, you can talk about your feelings and listen to other
people talk about theirs. You can also learn how others cope with cancer, treatment side
effects, and eating problems. Ask your doctor, nurse, or social worker about support
group meetings near you. You may also want to know about support groups that meet
over the internet. These can be very helpful if you cannot travel or there is no group that
meets close by.

Get enough rest. Make sure you get at least 7 to 8 hours of sleep each night. During the
day, spend time doing quiet activities such as reading or watching a movie.
Do not push yourself to do too much or more than you can manage. Look for easier
ways to do your daily tasks. Many people feel better when they ask for or accept help
from others.
Be active each day. Studies show that many people feel better when they take short
walks or do light exercise each day. Being active like this can also help improve
your appetite.
Talk with your doctor or nurse about medicine if you find it very hard to cope with
your feelings.