How do I make the best food choices throughout cancer treatment?
When you are faced with a lung 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. Unintentional weight loss is common during lung cancer. This can be due to lung cancer treatments or the cancer itself. Monitor your weight closely. If you are losing more than 1-2 pounds per week consistently, discuss with your healthcare team how you can increase your calorie intake.
- 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 tissues. 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. Try to eat a minimum of 5 servings of whole fruits and vegetables daily.
- 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 sugars. 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. 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.
Cancer and its treatment can cause your body to use energy very quickly. When your body uses large amounts of energy, you may lose weight or have difficulty gaining weight. Your oncologist or registered dietitian may suggest that you follow a high-calorie diet to help keep you at a healthy weight.
If you are struggling with eating enough calories due to the side effects of your cancer or treatment, the following tips can help you increase your calorie intake:
- Try consuming several small meals throughout the day, spaced 2-3 hours apart.
- Eat more when your appetite is best.
- Use condiments to add calories to your food, such as adding extra butter, sour cream, oils, cheese, whole milk, whipped cream, mayonnaise, salad dressing, jelly, jam, syrup, and honey.
- Avoid drinking beverages with meals. These take up room in your stomach, making you feel full faster. Save them for in-between meals.
- Avoid foods labeled “lite” or “diet”.
The sample menu below provides 3,000 calories a day. Check with your healthcare team or registered dietitian to see how many calories you need in a day.
High-Calorie Sample Menu: Day 1
1 large scrambled egg 1 medium biscuit
2 Tbsp. butter
2 Tbsp. jelly
1 cup grape juice
1 cup 2% or whole milk
Biscuits, butter, whole milk, and juice are high in calories.
1 cup celery stalks
2 Tbsp. peanut butter 2 Tbsp. raisins
For variety, try almond, hazelnut, or soy nut butters.
Dried fruits are high in calories.
grilled chicken sandwich with 4 oz. chicken
1 leaf lettuce
1 slice tomato
1 oz. cheese
Double the cheese or mayonnaise for even more calories at lunch.
1 Tbsp. mayonnaise
1 cup applesauce
1 oz. pretzels
Orange Pineapple Smoothie*
1 cup spaghetti with
¾ cup tomato sauce and 3 oz. cooked ground beef 1 medium breadstick
1 Tbsp. butter
Large serving of spaghetti noodles and butter help to increase calories.
½ cup chocolate ice cream
High-Calorie Sample Menu: Day 2
1 cup Cheerios with
1 cup 2% or whole milk and
½ cup dried blueberries 1 English muffin with
2 Tbsp. peanut butter
Dried fruits and nuts are calorie boosters.
6 oz. fruit yogurt 6 vanilla wafers
Use regular yogurt and skip the light or low-fat yogurt.
1.5 cups Turkey Pot Pie with Cornbread Crust*
1 cup green beans with 1 Tbsp. butter and
1 oz. almonds
1 cup cranberry juice
Large servings of casseroles and combination dishes like pot pies help to add calories.
Add a handful of nuts or dried fruits as dessert.
High-calorie liquid nutrition supplement
Look for the words “plus” or “high- calorie” on the liquid nutrition drinks.
3 oz. pork loin
¾ cup glazed carrots
Stir in extra butter, whole milk, cheese, and sour cream to increase calories in
¾ cup mashed potatoes made with milk and butter
1 medium dinner roll 2 Tbsp. butter
1 serving Pear Crisp*
Baked desserts can add calories even in small servings.
High-Calorie Sample Menu: Day 3
2 medium waffles
1 Tbsp. butter
¼ cup maple syrup
½ cup vanilla yogurt 1 cup grapes
Large servings of butter, syrup, and waffles help to add calories.
4 squares graham crackers 1 cup 2% milk
Swap the 2% milk with whole milk or a milkshake to add calories.
Curried Chicken Salad Sandwich*
2 slices white bread
1 cup carrot sticks with 2 Tbsp. ranch dressing 1 cup canned pears
Extra salad dressing and fruit servings help to increase calories.
6 cheese crackers
4 oz baked salmon
¾ cup rice with 1 Tbsp. butter
¾ cup steamed broccoli with 1 oz. melted cheese
1 medium dinner roll with 1 Tbsp. butter
Sprinkle cheese and butter on rice and broccoli to boost calories.
3 medium gingersnap cookies 1 cup 2% or whole milk
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 after. 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 separate. 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 bags. 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
- 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 vegetables. 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, etc. 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 health care team for regular updates on your blood counts and the status of your immune system.