Some women find themselves hungrier than usual during chemotherapy treatment for breast cancer; but for most, fatigue, fear, and side effects combine to act as an appetite suppressant, often leading to poor diet.
Chemo’s side effects range from the obvious (hair loss) to much more subtle shifts. You’re tired at the end of the day, and cooking dinner feels like a monumental task. Perhaps your sense of smell is suppressed; just-baked bread and roast chicken don’t have their usual allure. And oh, that sore throat… “Why don’t I just skip the meal and go right to bed?”
Unlike normal times, when food tastes good and meals are anticipated and enjoyed, eating during chemotherapy can become a chore. And that’s why it’s important to plan what you eat, and when; if you don’t make a plan and stick to it, you may find yourself going entire days without anything more than hard candies and ice chips passing your lips – and that’s simply not healthy.
Starting with your first chemo treatment, keep a daily diary of how you feel. Depending on your particular drug protocol (AC, CMF, etc.), you may feel worse the first 24 hours, then increasingly better; or it may be a day or two before the side effects really kick in. So write down how you feel – every couple of hours at first, then daily, as your initial symptoms abate.
Once you’ve tracked an entire 2- to 3-week chemo cycle, it’ll be easier to plan your diet. Which foods should you eat – and which should you avoid? Should you eat three meals a day, or just snack? What if you don’t feel like eating anything at all? Let’s check out some strategies for healthy eating during chemo.
First, take the drugs
If your oncologist recommends anti-nausea medication, take it. And take it on the recommended schedule, which almost always means popping those pills BEFORE you feel bad. It’s much easier to control nausea before it begins than once it starts.
If, despite the drugs, you experience severe nausea and/or vomiting, consult your oncologist or his/her nurse. There are other drugs to try, and s/he can also recommend specifics around eating – for instance, you may want to subsist on juice and broth for 24 hours, if that’s what it takes to get you over an initial reaction.
The BRAT diet
Remember your kids’ pediatrician telling you about the BRAT diet for upset tummies? Bananas, Rice, Applesauce, and Toast. What do all these foods have in common? They’re easy on the digestive system: low fat, no assertive spices, low fiber.
This diet is just as appropriate for chemo’s potential mild nausea as it is for any other kind of upset stomach. If chemo kills your appetite, yet you know you have to eat, try some sliced banana; rice pudding; a piece of toast, cut in small squares, or a small bowl of applesauce.
Notice the theme here: small portions, small bites. One of the keys to nourishment when your stomach is tied in knots is treating it gently; don’t challenge yourself with a big meal when you can have a bite of toast (or a couple of crackers) now, a few spoonfuls of applesauce in half an hour, and perhaps a banana an hour after that.
Forget what we Americans consider “normal” meals on a 3-meal-a-day schedule; instead, eat like a Scandinavian: 5 small “meals” a day, often consisting of nothing more than what you’d normally consider a snack.
Adding protein and calories
The BRAT diet may help you feel better – but long-term, it doesn’t offer you the nutrition you need. Once you’re past the worst of your nausea, stick to the “small portions, more frequent meals” schedule, but add some protein.
Eggs, preferably scrambled, poached, or hardboiled, are a great source of protein, and easy to digest. Milkshakes and fruit/yogurt smoothies are easy to sip slowly, and provide critical calories: fatigue during chemo is often the result of simply not getting enough calories every day.
Low-fat cheese and yogurt, and skinless chicken or turkey breast are also good choices when you’re looking to increase protein and calories.
So, how about a small slice of barbecued chicken pizza with low-fat mozzarella?
Not good; barbecue sauce tends to be spicy, and spicy foods are an absolute no-no during chemo: they’re hard on your mouth and throat, where you’re prone to develop sores; and they’re tough on your stomach, too.
Ditto very hot or very cold foods. Skip the scalding cup of coffee, or gulping down a diet soda loaded with ice; you’ll be much better off sipping cool juice or warm broth. Yes, it’s boring; but your stomach will thank you.
How to eat
We’ve mentioned small portions and more frequent meals. It’s also important to eat slowly; to avoid drinks with meals; and to move around a bit after you eat. Lying down after eating delays digestion, making you more prone to nausea.
And, while it may seem obvious, wear loose-fitting clothing; snug jeans may feed your self-esteem, but they don’t help your stomach!
You may be tempted, when you’re feeling better, to enjoy one of your favorite foods: salted nuts, perhaps, or a tuna sandwich. And, while these foods may help you in the short term, beware: they run a good chance of never again being your favorite foods, as you’ll forever associate them with chemo. Better to eat foods you don’t particularly care about than to risk losing your favorites!
One final note: Be sure to ask your oncologist about any foods that may interact with the particular chemo drugs you’re getting. Chemotherapy is a highly advanced type of drug treatment and, as such, has little room for error of any kind: your doctor wants the EXACT recommended dosage to reach your bloodstream, and your cancer. If for whatever reason a certain food might affect your chemo drugs, you need to avoid it.
Ditto over-the-counter supplements. While a supplement may say “all natural,” that doesn’t mean it’s good for you during chemotherapy.
Bottom line: before you start chemo, ask your oncologist to approve/disapprove anything you’re taking, from your cholesterol medication to the St. John’s wort you’ve been using for depression.
Published On: July 22, 2011