When you are faced with a cancer diagnosis, nutrition can be an important part of your journey. Eating a well-balanced diet before, during, and after cancer treatment can help you feel better, maintain your strength, and speed your recovery. Use these registered dieticians' tips about nutrition written by registered dietitians.
How do I make the best food choices throughout cancer treatment?
When you are faced with a breast cancer diagnosis, nutrition can be an important part of your journey. Eating a well-balanced diet before, during, and after cancer treatment can help you feel better, maintain your strength, and speed your recovery.
- Maintain a healthy weight. Depending on what breast cancer treatment you undergo, you may experience weight gain or weight loss. Aim to maintain a healthy weight during treatment, avoiding excess gain or loss. Strict dieting during treatment is not recommended. Many breast cancer patients gain weight as a result of treatment as well.
- Eat small, frequent meals throughout the day. Eating frequent small meals will ensure your body is getting enough calories, protein, and nutrients to tolerate treatment. Smaller meals may also help to reduce treatment-related side effects such as nausea. Try eating 5- 6 small meals or “mini” meals about every three hours.
- Choose protein-rich foods. Protein helps the body to repair cells and tissue. It also helps your immune system recover from illness. Include a source of lean protein at all meals and snacks. Good sources of lean protein include:
- Lean meats such as chicken, fish, or turkey
- Low fat dairy products such as milk, yogurt, and cheese or dairy substitutes
- Nuts and nut butters
- Soy foods
- Include whole grain foods. Whole grain foods provide a good source of carbohydrate and fiber, which help keep your energy levels up. Good sources of whole grain foods include:
- Whole wheat breads
- Brown rice
- Whole grain pastas
- Eat a variety of fruits and vegetables every day. Fruits and vegetables offer the body antioxidants, which can help fight against cancer. Choose a variety of colorful fruits and vegetables to get the greatest benefit. Aim to eat a minimum of 5 servings of whole fruits and vegetables daily.
Fresh fruits and vegetables should be cooked for patients in treatment with a weakened immune system.
- Choose sources of healthy fat. Avoid fried, greasy, and fatty foods. Choose baked, broiled, or grilled foods instead. Healthy fats include:
- Olive oil
- Limit sweets and added sugar. Foods high in added sugars like desserts and sweets provide little nutritional benefit and often take the place of other foods that are better for you.
- Stay hydrated. Drinking enough fluids during cancer treatment is important for preventing dehydration. Aim to drink 64 ounces of fluid daily. Avoid drinking large amounts of caffeinated beverages. Too much caffeine can lead to dehydration.
- Use good mouth care. Chemotherapy and radiation to the head or chest can irritate the lining of the mouth, throat, and esophagus. This irritation can make eating and swallowing difficult. Good mouth care is very important if you have mouth soreness. Brush teeth with gentle toothpaste after eating and floss daily.
- Practice good food safety. Wash your hands often while preparing food. Use different knives and cutting boards for raw meat and raw vegetables. Be sure to cook all foods to their proper temperature and refrigerate leftovers right away.
- Talk to your healthcare team before taking any vitamins or supplements. Some medications and cancer treatments may interact with vitamins and supplements. Always choose food first as the main source for nutrients.
- Drink alcohol in moderation, if at all. Alcohol may contribute to dehydration, can lower the abilities of your immune system, and provides no beneficial nutrients.
- Most importantly, know that your cancer journey is unique to you and your treatment. You may experience side effects that affect your ability to follow these suggestions. If you are struggling with any side effects, such as loss of appetite, nausea, diarrhea, vomiting, or any other nutrition concerns, your needs may be different. A registered dietitian can suggest nutrition guidelines that will be appropriate for your cancer journey.
The outcomes of a surgery are directly related to nutrition status prior to and after surgery. It is very important to eat a well-balanced diet prior to surgery including fruits, vegetables, whole grains, and an adequate amount of protein. Vitamins, minerals, and protein are vital to the healing process. A single nutrient deficiency can impair the immune system causing significant delays in the healing process and a decrease in ability for the body to fight an infection. Follow these guidelines beginning at least three weeks prior to surgery or as long as possible prior to surgery to optimize your nutrition for a faster recovery:
Eat 3-5 servings of fruits and vegetables every day. Choose a wide variety of colors.
One serving of fruit is one piece of fruit (such as a medium orange or apple) or ½ cup of canned or frozen fruit. One serving of vegetables is ½ cup cooked or 1 cup raw. Fruits and vegetables are excellent sources of B vitamins as well as antioxidants (vitamins A, C, and E). The vitamins in fruits and vegetables support the body's immune system before, during, and after surgery. Frozen vegetables and fruit are good to have available when shopping frequently is not possible.
Eat 6-11 servings of whole grain foods every day.
One serving is considered one slice of 100% whole wheat bread, ½ cup cooked brown rice, ½ cup whole wheat pasta, or ½ cup of whole grain cereal. Whole grains also contain B vitamins essential to building the immune system and aids the healing process.
Eat a variety of protein containing foods at meals and snacks.
Protein contains essential amino acids that are vital to the healing process. The body's protein status prior to surgery also influences the recovery time. Good sources of protein include meat, fish, eggs, cheese, beans, nuts, tofu, and dairy products.
Use fats, oils, and sweets sparingly.
Choose healthier fats such as canola and olive oil. Avoid fried foods. Excess fat and sugar contain empty calories that do not provide the body with any nutrients. Too many empty calories and not enough nutritious food may have an effect on the immune system.
Drink plenty of water in the 3 weeks prior to surgery.
Staying well hydrated will help in the recovery process. It will also help during the period of time right before surgery that water is not allowed. A general goal for daily water consumption is eight to ten 8-ounce glasses per day.
Establish consistent eating habits.
Eat a good breakfast everyday including a good source of protein like eggs, peanut butter, or Greek style yogurt. Lunch should include a protein source, whole grains, vegetables, and fruit. The evening meal should be similar to lunch. Remember to include healthy snacks like fruit, trail mix, hummus and carrot sticks or whole grain crackers with cheese or peanut butter.
Goes grocery shopping the week before surgery.
If you are not able to go to the grocery store yourself, send someone with a list to shop for you. Shopping for healthy foods right before surgery will allow you to keep up your healthy eating plan after surgery during the recovery period. Focus more on shelf-stable items, and buy fewer perishable items. Shelf-stable items such as peanut butter, canned fruit in its own juice, and low-sodium canned soups are good to have available when you return home from the hospital.
Get some exercise.
Walking is not only good for the body it is also good for the brain. Exercise may help in “clearing your head” when you begin to get anxious. It will also help you to maintain lean body mass (muscle). Muscle loss may occur after surgery due to physical inactivity. It is important to try to get back to doing some exercise as soon as possible after recovering. Your surgeon can advise you as to when it is safe for you to resume or begin exercising.
Tell your doctor about any vitamins, minerals, herbs, or other over-the-counter products and medications you take.
Some of these may be harmful during surgery and it is best to stop taking them prior to surgery. Examples of herbal supplements to discontinue as soon as your surgery is scheduled are: echinacea, ephedra, garlic, ginger, ginkgo biloba, ginseng, kava, licorice, saw palmetto, St. John's wort, and valerian root.
Follow the pre-surgery instructions given by your doctor.
The pre-surgery instructions given by your doctor are meant to help minimize complications before and after surgery. Follow these instructions carefully. Most likely there will be some restrictions on food and beverage intake as the surgery date approaches.
Talk to a registered dietitian if you have lost weight or have any eating problems that are keeping you from eating healthy.
A registered dietitian will assess you and make recommendations for you to optimize your nutrition prior to surgery. Sometimes a liquid nutrition supplement may be beneficial.
The immune system is weakened during all types of cancer treatment. Unfortunately, chemotherapy medications are not able to tell the difference between healthy cells and cancer cells. For this reason, perfectly healthy red and white blood cells are damaged or killed during treatment and shortly thereafter. The result of this is that body is not as good at fighting illness and infection. A common term used to refer to a very low neutrophil (white blood cell) count is neutropenia. Paying special attention to food safety during cancer treatment to reduce the risk of exposure to food borne illness may also be referred to a neutropenic diet. The following are some simple tips to reduce exposure and avoid unnecessary infection and/or illness during the time the immune system is compromised.
Keep EVERYTHING Clean
- Wash hands often and thoroughly especially before handling any food as well as af Be sure to wash hands with warm water and soap for at least 20 seconds. Pay special attention to finger nails and the backs of the hands.
- Keep raw and cooked foods separated Do not reuse any utensils, cutting boards, plates, dishes, etc. once they have been touched by raw meat or eggs. Utensils, cutting boards, plates, dishes, etc. that have been used for preparing raw meats or eggs should be washed in hot, soapy water. It is best to keep a separate cutting board for meat and fruits/vegetables. Have an extra clean cutting board available for additional preparation as well.
- When shopping for and storing raw meats, keep them away from other foods and cover the packages with extra plastic wrap or use plastic bag This will prevent any liquids from leaking onto other foods or surfaces. Store meats and eggs toward the bottom of the refrigerator to prevent any dripping on other foods below.
Cook Food Thoroughly
- Avoid raw meat such as sushi, undercooked eggs (make sure eggs are at least “over easy” and not “sunny side up”), and other meats that have not been cooked to a proper internal temperature.
- Cook all eggs until both the white and the yolk are firm.
- Use a meat thermometer to make sure that all meats are cooked to the proper internal temperature prior to eating.
Foods to Avoid During Chemotherapy
- Raw or undercooked meats
- Unpasteurized milk and juices
- Soft cheeses made with unpasteurized milk such as feta, blue cheese, Roquefort, Stilton, brie, or farmer's cheese
- Processed meats such as luncheon meats as well as anything else from a deli counter
- Refrigerated meat spreads or paté
- Smoked fish or precooked shrimp or crab meat
- Sprouts such as bean sprouts, alfalfa sprouts, or broccoli sprouts
- Pre-cut fresh fruit and veg Buy them whole, wash, and cut them yourself using proper sanitary techniques as outlined above.
- Unwashed fresh fruits and vegetables
- Unroasted or raw nuts and seeds
- Raw tofu or tempeh
- Food from salad bars of buffets
- “Fresh” salad dressings, salsas, sauces, e sold in the refrigerated section of the grocery store.
- Raw apple cider
- Raw honey
- Unrefrigerated cream-filled pastries
The guidelines above were created with those who have severely weakened immune systems in mind. Consult your physician or healthcare team for regular updates on your blood counts and the status of your immune system.