Cancer diet: Don’t just survive cancer; thrive at the table

Are you thriving at the dinner table during your cancer journey? Or just surviving? Food is not only important for the nutrition it provides, it’s also a source of comfort and pleasure. However, that may change during your cancer treatment. You can lose your taste for food, or perhaps more accurately, food loses its taste for you. If nothing tastes good, you struggle with your cancer diet.

The American Cancer Society stresses the importance of good nutrition during this time. Both the illness itself and the treatments can change the way you eat and how your body tolerates certain foods. The way your body uses food’s nutrients can also change. Your Sanford Health cancer care team is an important part of helping you identify and maintain nutrition goals. Eating right can help you feel better overall, specifically helping:

• Maintain energy and strength
• Sustain weight and nutrient storage
• Tolerate treatment side effects better
• Lower the risk of infection
• Heal and recover faster

These are good reasons to pay attention to what you eat and seek solutions when nothing tastes good or you’re not eating when you know you should. If eating becomes a matter of just surviving, you’re not thriving.

Jay Forney’s journey

When Jay Forney began his aggressive treatment for his neck cancer in the fall of 2015, he weighed 194 pounds. Today, Forney tips the scale at a mere 136 pounds and doesn’t expect much of that lost weight to ever return.

“It’s a challenge for me to eat 2,000 calories in a day,” Forney said. “The inability to really enjoy a variety of food is one of the things I miss the most.”

Helping Forney add a few pounds, enhance his taste buds and increase his energy level is Sanford dietitian Heather Knutson.

“Nutrients play a role in almost every metabolic process. Everything your body does is impacted by the food you eat,” Knutson said. “Everything in the body is a series of steps, and the nutrients you consume are part of those steps.”

Because a patient with head and neck cancer faces unique challenges when it comes to consuming food, Forney needed a gastrostomy tube (G-tube), or feeding tube, during his treatment. That helped ensure he would receive the fluids and calories his body needed.

“I like to think of the G-tube as the life preserver during treatment,” Knutson said. “With head and neck cancer patients, we work pretty much on a weekly basis to modify the foods they need to take orally, and balance that with what they need to take through the tube.”

“Heather was patient with me,” Forney said of his consumption balancing act. “I was still losing weight, but we were able to slow the weight loss. But we were most concerned about my energy levels.”

A customized plan

Because each cancer and each patient is unique, Knutson develops customized treatment plans for each patient she helps.

“No two cancers or diagnoses are the same, so treatment has to be individualized to fit the patient,” Knutson added. “It is incredibly inspiring to see what people can do when faced with extreme challenges. And it is a blessing to be able to witness the process.”

Just like the cancer itself, the way patients experience taste change is also different from person to person.

“There are different tricks and tips we use to help make food taste better and help the patient navigate through the side effects such as dry mouth and trouble swallowing,” Knutson said. “There are many dietary challenges of survivorship, including incorporating foods that help reduce risk of cancer reoccurrence.”

The power of food

In many cancer instances, including Forney’s situation, a switch to a plant-based diet seems to be the most effective dietary option.

“Roots, vegetables, whole grains, seeds and nuts are all helpful when you are faced with the side effects of treatment,” said Knutson, who works in Bemidji. “Adding these foods may be a challenge, but the goal is to navigate through them and resume life with a new way of eating.”

And a new plan for regaining weight and strength.

“The side effects of treatment can be very long lasting. Fatigue and muscle mass loss can be very difficult side effects during treatment and can result from a combination of inactivity, inadequate intake of food and nutrients, plus the physical demands of cancer treatment. Some fatigue is inevitable, but we try to use a combination of nutrition and physical activity to combat the fatigue. The trick is to make sure the patient has enough intake to provide the strength for the physical activity,” Knutson said.

“We match the patient with a nutrition plan that fits the patient and the family,” Knutson said. “Our objective is to meet them where they are at and help them to meet the goals they have set for themselves.”

Here are some ideas for overcoming obstacles to eating challenges when going through cancer treatments.

Problem: Eating isn’t appealing and even repulses me

If this is the case, try the following tips for a more appealing cancer diet:

• Clean your mouth often with a rinse consisting of 1 teaspoon baking soda and 1 teaspoon salt mixed well into 1 quart of room temperature water. Before eating, swish the rinse in your mouth and spit it out. Brushing your teeth also helps reduce bad tastes.
• Try sugar-free lemon drops, gum and mints.
• Change the terminology. Don’t associate breakfast and dinner with particular foods. Simply eat the foods you tolerate better. Many people find breakfast foods go down better. Thus, cereals, fresh fruits, pancakes and eggs become their go-to foods any time of the day.
• If food odors bother you, avoid the kitchen when food is being prepared. Instead of frying or baking, use a microwave for preparation. Cover beverages and drink through a straw. Consider eating foods that don’t need to be cooked; cold and room temperature foods have fewer odors. Freeze fruits and eat them as frozen treats. Fruits — like fresh berries, lemon or lime slices — added to water can improve water’s taste and the taste of other foods. Be aware that if you have a sore mouth or throat, tart flavors may cause irritation.
• Avoid eating in overly warm or stuffy rooms. Open a window for fresh air.

FASS Fixes

Tiny tweaks can make a big difference, says nutrition specialist Rebecca Katz, developer of the FASS Fixes for Troubled Taste Buds system, which uses fat, acid, salt and sweet. She is the author of “The Cancer-Fighting Kitchen.”

FASS is designed to fight the following issues with fixes provided:

Foods taste too sweet

• Start by adding six drops of lemon or lime juice.
• Keep adding it in small increments until the sweet taste is muted.

Foods taste too salty

• Add ¼ teaspoon of lemon juice.

Foods taste too bitter

• Add a little sweetener, like maple syrup or agave nectar.

Foods taste like cardboard

• Add sea salt until the flavor of the dish moves toward the front of the mouth.
• A spritz of fresh lemon juice also helps.

Problem: Foods taste metallic

Here are some solutions to try if foods leave a metallic taste in your mouth:

• Use plastic utensils and glass cookware.
• Experiment to find appealing flavors and tastes. Tenderize meat with marinades of sauces, wines or dressings. Try different herbs and spices. Cover up bitter, unappealing flavors with condiments such as ketchup and mustard. Season with tart flavors like lemon, vinegar and pickled foods, keeping in mind to take caution if you have a sore mouth or throat. This may also make meats — especially beef, pork and other red meats — taste less metallic.
• Try other protein sources such as beans, tofu, yogurt, poultry, eggs, nuts or seeds.
• Try these FASS Fixes: Add a little sweetener, like maple syrup or agave nectar. Add a squeeze of lemon. Or try incorporating fat, such as nut cream or butter.

Problem: I can’t think of what to eat

Johns Hopkins Medicine recommends stocking your pantry and refrigerator for a cancer diet with more palatable room temperature or cold foods, including: tuna salad, egg salad, chicken salad, pasta salad, deviled eggs, ice cream, milkshakes, pudding, custard, cheese, cottage cheese and yogurt.

If foods taste bitter, try mild options such as: vanilla pudding, perogies, hot cereal, rice, milk, plain crackers, mashed potatoes and plain noodles.

If you find red meat difficult to eat or digest, try to increase protein intake with: yogurt, cheese, milk, milkshakes, quiche, cottage cheese, hummus, deviled eggs, egg salad, chicken, turkey, fish, beans, peanut butter, custard and pudding.

Problem: I’m having trouble swallowing or dealing with mouth sores

Food choices in a cancer diet can help prevent secondary bacterial infection of mouth lesions during treatment.

• Eat soft, bland foods such as creamed soups, cooked cereals, yogurt, pudding, mashed potatoes, eggs, custards, casseroles, smoothies and shakes.
• Drink liquids and semi-soft solids through a straw to bypass mouth areas with sores and lesions.
• Blend or moisten foods with yogurt; tofu; pudding; soft cereals such as oatmeal, cream of wheat and malt-omeal; warm water; juice; milk; soy milk; rice milk; etc.
• Eat blended or pureed foods such as blended soups, smoothies and granitas.
• Add fat, such as nut cream, to your food.
• Try non-acidic juices such as apple, apricot, peach, pear nectar or grape juice. (Do not use grape juice if diarrhea is present.)
• Avoid tart, acidic or salty beverages and foods such as citrus. Avoid pickled items, tomato-based foods, alcohol, caffeine and tobacco.
• Choose soft, probiotic-containing foods such as yogurt.
• Avoid ginger, curry, red pepper flakes and other strong spices.

Problem: I’m having trouble maintaining weight

Getting through cancer treatment can be even more difficult if you or the person you’re caring for is losing weight. Most patients are urged not to lose weight — specifically body mass — during treatment. Many factors can go into weight loss: side effects from treatment like feeling very full after having just a small amount of food, diminished overall appetite or food tasting poor.

Weight loss can also take a psychological toll. Our culture is focused on weight loss. Accepting that weight loss is not good during this time can be difficult for some. It is important to maintain proper nutrition to keep the body strong during treatment. Good nutrition helps the body tolerate treatment better, lowers hospitalization rates and leads to better overall quality of life.

To help maintain proper nutrition in your cancer diet, try these tips:

• Drink more between meals than during meals to avoid filling up with liquids at mealtime.
• Eat more often and based on time of day instead of waiting for hunger signals.
• Increase calories in the foods you are already eating.
• Add nuts, seeds, granola and dried fruits to ice cream and yogurt.
• Consume full-fat foods instead of their low-fat counterparts.
• Try avocado in smoothies, salads and sandwiches.
• Use high-calorie condiments.
• Lightly exercise before meals to build an appetite.
• Dine in a peaceful environment.
• Obtain calories from less-filling liquids like shakes or smoothies.
• Use oncology dietitians as great resources for information and recipes.

Stay energized with ‘super shakes’

These “super shake” recipes, designed to help in those times when chewing, swallowing or just eating become difficult, add calories and protein to a cancer diet.  Use the recipes as a guide, feeling free to add ingredients you may have on hand.

Vanilla or strawberry shake

Ingredients:

• 2 cups vanilla ice cream
• 1 teaspoon vanilla extract
• 3 tablespoons sugar
• 1/4 cup heavy whipping cream
• 1/4 cup milk
• Add 3 large strawberries for strawberry flavor
• 1 scoop protein powder (with at least 20 grams protein per scoop)

Yields: 2 servings; 690 calories and 22 grams protein per serving

Orange dreamcicle shake

Ingredients:

• 1 cup vanilla ice cream
• 1 cup orange sherbet
• 1/4 cup orange juice
• 1/4 cup heavy whipping cream
• 1 scoop protein powder (with at least 20 grams protein per scoop)

Yields: 2 servings; 560 calories and 18 grams protein per serving

Chocolate peanut butter shake

Ingredients:

• 1 1/2 cups chocolate ice cream
• 3 tablespoons creamy peanut butter
• 3 tablespoons chocolate syrup
• 1/4 cup heavy whipping cream
• 1 scoop protein powder

Yields: 2 servings; 600 calories and 24 grams protein per serving

Roasted vegetable medley

Roasting vegetables will bring out many interesting flavors. This recipe is a great way to easily add in vegetables at a meal. They can be pureed if needed for those who have difficulty chewing, or they’re great just the way they are.

Tools:

• Cutting board
• Knife
• Vegetable peeler
• Potato masher
• Measuring cups and spoons
• Zip-top bag
• Bowl
• Cookie sheet or baking pan
• Food processor
• Oven

Ingredients:

• Fresh vegetable of your choice such as 1 pound of carrots, 2 potatoes or 2 sweet potatoes
• Olive oil to drizzle on vegetables
• Cottage cheese or Greek yogurt
• Whipping cream – 1 cup

Procedure:

1. Heat oven to 400 degrees.
2. Wash, peel and chop vegetables.
3. Place in zip-top bag and drizzle with olive oil.
4. Season with salt and pepper if desired.
5. Place vegetables on baking pan and roast in oven for 30 minutes or until tender.
6. Remove from oven.
7. Place about 1 cup of roasted vegetables in food processor.
8. Add ½ cup cottage cheese or 6 ounces of Greek yogurt.
9. Add 1-2 tablespoons whipping cream if desired.
10. Pulse several times in food processor and add more cream or milk if a thinner liquid is desired.

Nutritional information:

• 1 cup potatoes prepared = 400 calories and 14-20 grams protein
• 1 cup carrots prepared = 200 calories and 18 grams protein
• Additional cream will add 60 calories per tablespoon

Home-style cream of chicken soup

This recipe is great for those who have difficulty swallowing and need nutrients and high-caloric foods.

Ingredients:

• 1 quart chicken stock
• 12 ounces skinless boneless chicken breast
• 1/4 pound baby carrots
• 2 stalks celery
• 1/2 onion
• 3 medium potatoes
• 1 cup whipping cream

Procedure:

1. Pour chicken stock into saucepan and place on stove. Add chicken breast and bring to a boil.
2. Reduce heat to medium and cook for 20 minutes.
3. While that is cooking, chop the carrots, celery, onion and potatoes and place into a bowl.
4. Add the chopped vegetables to the saucepan and cook an additional 20 minutes until the vegetables are very tender.
5. Remove the chicken from the broth. Using 2 forks shred the chicken into small pieces and return to the saucepan with the stock and vegetables.
6. Cook an additional 10 minutes.
7. Add the cream to the saucepan and simmer for about 10 minutes.
8. Remove small amounts of the soup at a time and place in food processor and process until smooth consistency.
9. Additional cream, milk or broth can be added to make the soup thinner if desired.

Yield: 5 cups; 320 calories and 14 grams protein per cup

Turkish red lentil and bulgur soup

Lentils are a great source of protein, fiber, vitamins and minerals — a real power food for cancer patients.

Ingredients:

• 2 T. butter
• 6 scallions, thinly sliced
• ½ cup red lentils
• ½ cup bulgur
• 1 ½ cup vegetable broth
• 1 bay leaf
• 2 tablespoons minced dill fronds
• 1½ tablespoons tomato paste
• 1 teaspoon dried thyme
• ½ teaspoon black pepper
• ½ teaspoon salt

Procedure:

1. Melt butter in pot. Add scallions and cook 1 minute. Add the lentils and bulgur and heat for another minute.
2. Add everything else and bring to a full simmer.
3. Cover, reduce heat to low and simmer for about 40 minutes. Remove bay leaf before serving.

More on nutrition after cancer treatments end

https://news.sanfordhealth.org/cancer/eating-healthy-cancer-nutrition-tips-survivors/

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Posted In Cancer, Cancer Treatments, Health Information, Symptom Management

SHN Staff

Sanford Health News is your site for health news from the experts at Sanford Health. SHN staff is a team of Midwest-Emmy-winning journalists bringing you trustworthy information on healthy living, health care, scientific research, health conditions and medical innovation.