Hands up if you think it is normal or expected to lose weight during treatment? My hand is high in the air. At least it was when I was having my treatment and shedding weight like a melting ice cube. It’s not normal or expected to lose weight during treatment of most cancers. Who knew, right?
Hundreds of studies worldwide have been conducted on the effects of not being able to maintain nutrition during treatment and the effect that has on treatment outcomes and quality of life. I’m going to throw a random word in here and it’s a word we generally don’t associate with developed countries. It’s malnutrition. A summary of the studies mentioned say up to 80%* of people will have some form of malnutrition during their cancer treatment.
Maintaining our bodies nutritional needs and weight has been found to have positive effects on treatment outcomes and quality of life. It has also been found that it can reduce the severity of side-effects and hospital stays. Pretty important stuff. Yet, lack of proper nutrition and treatment- related malnutrition are ever present.
Why do so many people become malnourished? Mostly it is due to the side-effects from treatment limiting the ability to eat and take in food. My arch-nemeses were mouth sores, nausea and vomiting. Taste changes, dry mouth and throat, constipation, lack of energy, difficulty swallowing and many more affect how we eat, what we eat and our enjoyment of food. I couldn’t find a way past eating fresh soft white bread and jam - the only combination of food that agreed with my side-effects.
When we lose our enjoyment of food, we lose our connection with family and friends because we can no longer participate in the sharing of a meal together. Food is the same as love and joy - we use food to celebrate and to console. Without it, there is loneliness and isolation. Let’s not go there.
Since looking into this issue, having had personal experience with it and making it my life’s work, I have seen a pattern. So many of us are grieving the loss of a normal life and are overwhelmed. The roller coaster that comes with a diagnosis can make it impossible to find a way through eating difficulties as well. I was there! Pain and fatigue (physical and emotional) are like wearing blinkers.
But there is always hope and help. Let’s get into this…
Eating through the difficulties of side-effects comes down to adapting, modifying and changing the consistency of food so it agrees with the side-effect. Following are some common treatment side-effects and general tips to consider:
Ginger is traditionally a nausea settling food. It can be added to meals or can be found in lollies. Bland, dry foods like dry toast, crackers and pretzels are commonly used when nausea is a problem. Bananas, rice, noodles and clear broths also fall into this bland category. Food smells and odours may trigger nausea so eat foods when they have cooled a little to lessen the smells coming from them. Try to eat something every 1 to 2 hours. This seems counter-intuitive when you feel unwell but try to eat. The feelings of nausea can worsen when you have an empty tummy.
Soft foods are the best option here along with bland foods. Avoid acidic, tart and salty foods that may sting or cause pain along with dry and rough foods. Food can be softened with sauces and gravy and creamy foods may be easier in the mouth. Consider canned vegetables which are generally soft and canned fruit (if this can be tolerated). Drinking through a straw may by-pass mouth sores. Seek advice from a doctor about medications to help.
Difficulty Swallowing and Dry Mouth & Throat:
As with a sore mouth, food needs to be moist and soft to allow it to go down easier. Slow cooked foods are softer and meals like casseroles can always be blended to become a tasty soup. Spicy, acidic foods, dry and rough foods, and foods that need excess chewing such as nuts are best left for another day.
- Bland Taste - Try foods with strong flavours such as tart foods like citrus or berries. Adding fresh herbs, spices marinades and sauces can add extra flavour. Consider stronger tasting versions of foods you already enjoy. For example, try a smoky flavoured cheese over a blander tasting cheese.
- Metallic or Bitter Taste - Try swapping white meat for red meat which can have a metallic taste to it. A lot of bitterness lies under the skin of carrots so peel these and use sweeter baby carrots if available. Sucking on moist fruits or berries or hard lollies can disguise or cover unpleasant tastes in the mouth. It could be worth retrying foods from time to time as taste changes alter over time.
- Too Sweet - Many foods come in a range of flavour versions. If everything is tasting too sweet, stick with the plain version. Go for foods without added sweeteners such as honey and breads and cereals without added fruits. If your mouth allows, adding salt or lemon juice can cut down sweetness in food. If you are using pre-prepared nutritional supplement drinks, adding buttermilk can reduce the sweet taste of these.
- Too Salty - Choose a low sodium version of food products you previously enjoyed. Cured and processed meats can have a higher salt content. The swap-out here would be freshly cooked meat. Processed cheese slices, tasty and hard cheeses can be salty tasting. Swap these for white cheeses like cream cheeses or mozzarella which are less salty tasting.
- Cannot tolerate food smells - Most of the tips here involving either removing yourself from the smell or doing things to lessen the smell. If you cannot tolerate the smell of cooking food, perhaps ask someone to prepare food for you as an interim measure. Cooking outdoors is a great option as food smells disperse easier outdoors but if you are restricted to indoors, use pot covers and lids to contain smells. Eating food at room temperature can lessen odours coming from it and ensuring nausea is under control can make tolerating food smells easier.
A final tip is to ask for help.
Ask to see a dietitian or doctor, you have that right. They are the best source of expert help and give Dr. Google the sack. If you have been given a specific diet to follow, keep in mind the tips above and modify the consistency of those foods so are still able to stick to your prescribed diet.
One last word from me…
I could lament on having had breast cancer and what that has taken from me but I’m not going to. I won’t even say cancer has given to me greater appreciation for life. What I will say is that cancer has given me insight into how I can give to others - and for that, I wouldn’t change a thing.
This article was written by Alyx Stewart, Cancer survivor
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