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The side effects of common cancer therapies vary according to the treatment and the area of the body undergoing treatment. The following are some side effects and some helpful suggestions. They do not replace, rather complement medication that may be used to alleviate these symptoms.

CHEWING AND SWALLOWING DIFFICULTY
Thick consistency liquids such as milkshakes or semi-solid foods like mashed potatoes and gravy may be easier to swallow and will help prevent aspiration.

PAIN, NAUSEA, VOMITING, DIARRHEA
Eating a meal immediately before or after the administration of the treatment may alleviate these symptoms.
The patient's position while eating may also contribute to these symptoms.

TASTE ALTERATIONS AND AVERSIONS

Give bland foods. Avoid strong flavors like spices, acidic foods, and sour tasting foods.

Provide cold foods; avoid hot or warm foods.

Avoid giving foods with strong odors.

If a person is experiencing severe nausea, avoid offering a person their "favorite food" unless they request it. Eating a food during severe bouts of nausea may cause them to develop an aversion to it.

BODY WEIGHT LOSS AND MUSCLE WASTING

Increase protein and calories in the diet.
Eat smaller, but more frequent meals.
Add powdered milk to foods and beverages.
Drink mainly calorie-containing beverages such as juices, milk, or sweetened drinks.
Add extra eggs or egg whites to foods. Never use raw eggs as they may contain salmonella which would further compromise a person who is immune suppressed. Raw eggs also contain a vitamin binder.
Add diced meat or cheese to sauces, vegetables, soups and casseroles.
Snack throughout the day on calorically dense foods such as nuts, hard candy, and dried fruits.
Consider using commercially available nutrition supplements. You can make your own high calorie shake by using an instant breakfast drink mix with milk, fruit, cookies, peanut butter, or other favorite mixers.
Increasing fats in the diet is an excellent way to increase energy consumption, if you are tolerating fats. Add margarine or butter to breads and vegetables. Add gravies and sauces to foods in liberal amounts.
If you are unable to digest fat, consult with your physician or dietitian for alternative fat sources. Supplements containing medium-chain triglycerides are often recommended for this purpose.

LACTOSE INTOLERANCE
Some cancer patients become unable to digest dairy products (lactose intolerance). Symptoms include bloating, gas, and diarrhea immediately after ingesting lactose-containing foods. People with lactose intolerance have trouble digesting the sugar in milk. Lactose intolerance is due to an inability to produce lactase, the enzyme that digests milk. The wall of the gastrointestinal tract produces this enzyme. Fortunately, lactase can be synthetically produced, purchased over-the-counter, or can be taken orally with milk. You can also buy "lactose-free" milk at most grocery stores. Cultured dairy products such as yogurt, cheeses, and buttermilk will have less lactose as the active cultures help to digest it. You may be able tolerate small amounts of lactose occasionally. You may have to restrict lactose entirely from the diet until you have fully recovered from your cancer therapy.

DUMPING SYNDROME
Some cancer treatments cause "dumping syndrome". If you have dumping syndrome, food is "dumped" 10 or 15 minutes after being swallowed into the jejunum. Ordinarily food is partially digested in the stomach, then released gradually in small amounts into the digestive tract. The presence of undigested food in the jejunum leads to abdominal fullness, nausea and crampy abdominal pain. Other symptoms include feeling warm, dizzy, and faint. You may also experience rapid pulse and cold sweats immediately after eating.

Recommendations for dumping syndrome are:

eat smaller, more frequent meals
lie down immediately after eating
restrict refined carbohydrates and increase protein and fat in the diet
restrict fluids to 30 minutes before a meal and 30-60 minutes after a meal

LOSS OF APPETITE (ANOREXIA)
If you are experiencing anorexia, adjust the diet to include any foods that appeal to you. Consult with your physician for consideration of appetite-stimulating drugs.

Notes: Your local chapter of The American Cancer Society is an excellent resource for information on cancer prevention and treatment. See also cancer - support group for other resources.

A registered dietitian is a trained health professional in the area of nutrition and can assist in nutritional planning for people with cancer.

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