Managing Cancer Side Effects

Managing Side Effects During Cancer Treatment

You may experience side effects during your cancer treatment. Our nutrition team offers advice on how to help you manage them and minimize their impact on your quality of life.

Nausea

Tips for minimizing nausea:

Sometimes just thinking about treatment may make you nauseous. This is called anticipatory nausea, which you can decrease with relaxation techniques.

Dana-Farber’s Zakim Center for Integrative Therapies offers services which may help decrease your nausea, such as Reiki and acupuncture. Additionally, your care provider can prescribe medication that will help minimize nausea.

• Eat six to eight small meals a day, instead of three large meals.
• Try bland, soft, easy-to-digest foods. It may be best not to eat your favorite foods when you are nauseated.
• Keep up with your fluid intake. Sip clear liquids such as ginger tea, ginger ale, or lemonade frequently to prevent dehydration.
• Try using ginger, lemon, or peppermint in foods and fluids.

Lack of Appetite

Tips for helping lack of appetite:

• Eat small meals and snacks every couple of hours throughout the day.
• Use a small plate instead of a full-size dinner plate.
• Add calories to foods by adding healthy oils, nuts, seeds, avocados, and olives.
• Bring high-calorie snacks like nuts when away from home (especially doctors' appointments).
• Keep fluids to a minimum at mealtimes, but don't forget to drink between meals.
• Eat well during times when your appetite is better.
• Eat with others. The social aspect of eating is important and can help you get back on track.

Unintentional Weight Loss

Cancer treatment can leave you with lack of appetite. Decreased interest in food can be due different factors including: nausea, fatigue, taste changes, mouth sores, difficulty swallowing, and fatigue. Any of these symptoms can lead to undesired weight loss. During treatment, it's especially important that you eat as well as possible to help your body heal and keep your immune system strong.

Tips for increasing calories from healthful foods:

• Eat small meals and snacks every couple of hours throughout the day.
• Use avocado when stir frying or olive oil as a dip for bread. Drizzle  olive oil atop whole wheat pasta, brown rice, soups or in bread mixes.
• Add calories to fruits by baking them in layers with granola; dipping them in nut butters; or baking them in pies and turnovers. You can also add them to homemade smoothies or commercial nutritional supplements.
• Sip on higher-calorie fluids such as smoothies, 100% fruit/vegetable juices and protein-enriched nutritional supplements.
• Eat nuts and seeds for snacks. Add chopped or ground nuts to bread, baked goods, salads, pancakes, and cereal.
• Use peanut, almond, or cashew butter on grains, baked goods, fruit, or veggies.
• Use bean dips or hummus as a veggie dip. Add beans to nachos or baked sweet potatoes, or in dips for pita bread or tortilla chips.

Undesired Weight Gain

Fatigue, decreased physical activity, eating to cope with nausea, and stress can all contribute to unintentional weight gain. However, you can lose weight during and after cancer treatment in a healthy way while still meeting your nutritional needs.

Tips for promoting healthy weight loss:

• Keep it slow and steady. A safe amount of weight to lose is 1 to 2 pounds per week. Losing weight gradually is the best way to shed fat without losing muscle. You can do this by eating 500 fewer calories a day, burning 500 more calories per day, or doing a combination of both.
• Fill up on nourishing, lower-calorie foods. Trim portions of "unfriendly fats" found in foods like pastries, red meat, fried foods, and full-fat dairy foods. At the same time, boost your intake of lower-calorie foods like fruits, vegetables, and whole grains, which are rich in anti-cancer phytonutrients.
• Adjust your portions. Use a smaller plate, which will make a smaller portion look bigger. After you serve yourself, put any leftovers in the fridge right away to avoid the temptation to get seconds. Ask your restaurant server for a box so you can take half of your meal home.
• Balance your plate. Aim for generous portions of vegetables to fill your plate with fiber and phytonutrients. Pair protein sources with whole grain carbs for long-lasting energy. "Friendly fats," such as nuts, avocado, olive oil and hummus, are heart-healthy addition in small amounts.
• Add physical activity as you are able. Aim for 30 minutes of moderate physical activity, such as walking, six days per week, if your doctor permits it.
• Keep your dietitian and doctor in the loop. If you are struggling to lose weight, your dietitian can help you adjust your meal and exercise plan. If you are gaining or losing more than 2 pounds per week unintentionally, let your doctor know.
• Eat mindfully. Mindful eating is being present for the sensations of tasting, swallowing, and breathing while eating. Scientists are evaluating the complex role of the mind-body connection in eating behavior. Multitasking (watching TV, reading email) while eating can interfere with critical signals from the digestive system to the brain, leading to overeating.

Safe, Smart Swaps to Reduce Your Calorie Intake

These are just a few ways to trim calories. Mix and match and choose what works best for you:

Bowel Irregularities

Tips for reducing constipation:

• Drink warm prune juice or tea.
• Get plenty of water and fluids. Aim for at least eight to 10 glasses per day.
• Eat regular meals at same time daily.
• Increase fiber intake by choosing whole-grain crackers, cereals and breads, oatmeal, legumes (beans), fresh or frozen fruits and vegetables.

Tips for minimizing risk of diarrhea:

• Eat small meals or snacks that are bland and low in fat.
• Drink plenty of fluids such as broths and fruit juices diluted 1:1 with water.
• Drink fluids between meals rather than with meals. Choose non-carbonated, non-caffeinated, and clear fluids such as sports drinks, unsweetened coconut water and teas.
• Limit milk and milk products, as they can worsen diarrhea symptoms. Substitute with Lactaid, soy milk, rice milk, almond milk or other dairy substitutes.
• Avoid very hot or very cold food items; eat foods at room temperature.

Other common side effects include lack of energy, difficulty swallowing, and sleep disturbances. Dana-Farber nutritionists are experienced in treating these issues and can help tailor a plan to manage them for you.