Starting Chemotherapy: What to Expect | Dana-Farber Cancer Institute
How to Get a Chemo Patient to Eat
One of the most common side effects of chemotherapy is loss of appetite and weight loss. This may be secondary to nausea and vomiting, mouth ulcers that prevent eating or swallowing, depression, changes in taste and/or dry mouth. It is vital that a patient receiving chemotherapy remain hydrated and eat nutrient-dense foods during treatment. Scroll down to Step 1 below to help the patient stay as healthy as possible while receiving chemotherapy.
Encouraging Their Appetite
Find high-calorie foods that appeal to the patient.Cravings are often the body’s subliminal attempt to signal a person to eat substances and nutrients in which they are deficient. What does he or she particularly enjoy? Keep the foods they crave around the house and easily accessible.
- Some examples of calorie and protein dense foods are milk shakes, cheese, smoothies, pudding, chicken, eggs, lean red meat, fish, yogurt, ice cream, peanut butter, almond butter, whole grain toast, lentils, spinach and garlic.
Keep snacks around to munch on throughout the day.Examples of high-calorie and protein snacks include:
- Half a cup of nuts and a fruit
- 2 graham crackers or a slice of whole grain bread with natural peanut or almond butter
- A mix of carrots, cherry tomatoes, cucumber or celery sticks with canola or olive oil based dressing
- Popcorn trail mix consisting of 1 cup of popcorn made with canola oil and missed with quarter cup of nuts and 2 tablespoons of raisins
- Low-fat yogurt with 2-3 tablespoons chopped nuts
- 1 cup of whole grain cereal with skim milk
- Fruit smoothie consisting of 6 ounces of low fat vanilla yogurt, half a cup of skim milk, a cup of berries
Drink plenty of fluids that are not caffeinated or alcohol based.A major symptom of chemotherapy is having a dry mouth (xerostomia). Aside from it being important to hydrate, constantly drinking healthy fluids combats this symptom, too.
- Water, flavored water, coconut water, smoothies, liquid nutrition supplements, ice cream, sorbet, sherbet, pudding, fruit based popsicles, crushed ice, herbal teas, decaffeinated coffee and teas are all good examples of non-caffeinated beverages.
- Nutritional supplements such as Ensure and Boost are good as well.
Surround them with foods that smell good.Most of taste is actually smell. If you surround the patient with foods thatsmellgood, you may be able to spike their appetite. The scent could entice them to at least try the food, or entertain the notion of eating.
- What foods do they like? Mint, cinnamon, coconut, apple? Studies show that any connection an individual has between scent and food can get the appetite going and increase salivation.
Get appetite-increasing medications.Prescription medications such as steroid hormones may be used to increase the patient’s appetite. A commonly prescribed steroid hormone is Megace (megestrol acetate) which is a lemon-lime flavored oral suspension taken by mouth (usual dose is 480 to 600 mg/day).
- The dosage may vary depending on the patients’ needs and should be determined by his/her doctor.
Do the shopping or food preparation for them.Eliminating or minimizing logistical barriers may encourage a patient receiving chemotherapy to eat. Grocery shopping or cooking meals may be difficult for a patient on chemotherapy due to fatigue. Offer to help out in any way you can to ensure they're eating properly.
- Ask friends, family and neighbors to grocery shop for the patient.
- Buy pre-cooked meals ahead of time and freeze them.
Set scheduled mealtimes so that the patient will remember to eat even if they are not hungry.If they know you are concerned and they know that it's best for them to eat (even when they're not hungry), they may eat -- as long as it fits into their schedule. Give them a routine that includes healthy meals several times a day. If you can eat with them, that's even better!
- Have them eat 5-6 small meals a day, rather than large meals. This keeps their body functioning at 100% and to reduce chemo complications.
Ask for a referral to a dietician that specializes in working with oncology patients.A dietician can help you plan meals and snacks that will provide adequate nutrition to gain or maintain weight. A dietician will work with the patient to identify foods they like to eat to create a personalized “healthy eating plate."
Minimizing the Side Effects of Chemo
Minimize their nausea.A common side effect that interferes with intake of nutrition is nausea and vomiting. Nausea may be minimized by selecting bland, soft foods, maintaining fluid intake to avoid dehydration, eating six to eight small meals a day, and using anti-nausea medications.There are several anti-nausea medicines and the patient may have to try different ones to determine the one that works best for him/her. Commonly used medications include:
- Ondansetron (Zofran), 8 mg SL every 8 hours, prior to meals by mouth.
- Granisetron (Kytril), 2 mg once per day or 1 mg twice per day by mouth.
- Palonosetron (Aloxi) 0.25 mg over 30 seconds intravenously.
- Dosages listed are the most commonly prescribed and may not be suitable for all patients. The patient’s physician should determine dosing.
Treat diarrhea and constipation.These are the common symptoms encountered after administration of chemotherapy drugs. These have significant effects on the lifestyle of the patient. A patient may diminish food intake fearing these symptoms.
- To combat diarrhea, eat a low-fiber diet. Reduce intake of food containing high fiber such as coarse grains, vegetable and fruits. Eat food like apples, bananas and lentils which are low in fiber. And be sure to drink plenty of fluids.
- To combat constipation, eat a high-fiber diet. Enhance intake of food containing high amounts of fiber such as fresh fruits, coarse grains and vegetables.
Lower the effects of dry mouth.Dry mouth is the side effect of chemotherapy drugs. It is called xerostomia.This can have a significant effect on the eating pattern and diet of the patient.
- Make sure the patient maintains good oral care. Use half to a full teaspoon of baking soda mixed in water to wash out the mouth. Don’t use commercial mouth washes having alcohol; the alcohol will enhance drying of the mouth.
Fight taste changes.Intake of some of chemotherapy drugs will alter the taste buds. This, obviously, will make the patient want to eat less. However, it's incredibly important that nutrition intake isn't diminished. To combat this:
- Replace your metallic utensils with plastic utensils.
- Suck on lemon-flavored candy. This will keep your mouth fresh.
- Add mint (or other spice or herb) to the food to change the flavor.
Treat the mouth sores.Most of chemotherapy drugs have an irritating effect on the mucosa of the mouth. This will cause the development of mouth sores that are very painful. This pain decrease urges to eat. Again, adequate, healthy nutrition is necessary, so this must be fought.
- Have them eat soft food which requires less chewing. This will reduce the time the food is in contact with mouth mucosa, reducing pain.
- Avoid foods containing acids like oranges and lemons. Citrusflavoris fine, but the fruits themselves are highly acidic.
Adjust for difficulty in swallowing.Difficulty in swallowing is called dysphagia. It is generally caused by the effect of chemotherapy drugs on digestive system. Soft food should be eaten to help to improve the dysphagia.
- Soft foods pass easily through the throat and food pipe. Food may be crushed or watered down to make it soft.
Encourage a healthy diet.During chemotherapy, nutrition needs to increase. Yet due to the decrease of appetite, intake of food decreases. This has a devastating effect on health. To counter this, encourage the patient to eat healthy food, ensuring that every bite counts.
- Focus on energy-concentrated food. Food should contain plenty of energy per bite. These foods include foods like butter-added snacks and milkshakes fortified with crushed dry fruits.
- Try some new food other than your routine meals. This can help you stimulate appetite.
Lay stress on the safety of food.While on chemotherapy, the power of your body to fight infections is lowered. Due to this, it's important to pay more attention to food safety. Contaminated food will make you sick.
- Wash the fruits and vegetables thoroughly before you eat. Keep them submerged for an hour in water before eating.
- Don’t eat stale food. Throw spoiled food away.
- Always try to eat freshly cooked food. Keep perishable food refrigerated until cooked.
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