Cancer

Nutrition During Chemotherapy and/or Radiation Treatment

Throughout cancer treatment, your goal will be weight maintenance and good nutrition. Eating well during treatment can help you:

Feel better
Keep up your strength and energy
Maintain your weight and your body's store of nutrients
Better tolerate side effects of treatment
Decrease your risk of infection
Heal and recover quickly

Maintain Your Weight

Try to keep your weight stable during treatment. Your health care team will monitor you for rapid weight loss or weight gain. In general, your protein needs will be higher due to both the cancer and treatment. Your calorie needs may also increase with cancer and treatment. Even though you may not be as active during treatment, you may need to eat more to keep from losing weight. We recommend that you do not take a general multivitamin that contains more than 100% of the Daily Value (DV).

Eat a Healthy Diet

Good nutrition during treatment may differ among individuals. If your appetite is good and your weight is steady, try to eat a balanced, healthy diet:

Fruits and Vegetables - Eat a variety of fruits and vegetables by focusing on different colors each week. Choose 7 to 9 servings, or greater than 4 cups, per day.

Grains - Eat at least 6 servings of grain products per day with at least 3 of those servings being whole grain products. Examples include: ½ cup of oatmeal; ½ cup of brown rice; 1 slice of whole grain bread; and ½ cup of whole wheat pasta.

Meat and Poultry - Choose moderate amounts of low fat meat, poultry and fish, about 6 ounces per day. Examples include: lean beef trimmed of fat, such as round, sirloin, flank, tenderloin, and ground beef which is 90% lean or greater; cuts of pork trimmed of all visible fat; and skinless chicken breast.

Dairy - Choose moderate amounts of low fat dairy foods, about 3 serving per day. Examples include: 1 cup of low fat milk; 1 cup of low fat yogurt; 2 cups of low fat cottage cheese; and 1/3 cup of low fat shredded cheese (3 grams of fat or less per ounce).

Cut back on fat, sugar, alcohol and salt.

Fluids - You need 6 to 8 servings of non-caffeinated liquids per day. Each serving should be 8 ounces. Beverages that contain caffeine cannot be counted as part of your fluid intake. Foods that are liquid at room temperature, however, can be counted. Some examples are: ice cream, sherbet, gelatin, cream soups, and popsicles. Keep some type of fluid with you at all times so you can sip continually throughout the day. If you are not eating well, choose fluids that contain calories, such as fruit juices, milk, smoothies, sports drinks, and liquid supplements or meal replacements.

Handy Snacks to Help with a Low Appetite

Applesauce

Bean Dip

Butter

Buttered popcorn

Cereal

Cheese

Cheese Dip

Chocolate milk

Cookies

Cottage cheese

Crackers

Frozen yogurt

Fruit (fresh, dried, canned)

Nuts

Gelatin

Granola

Hot dogs

Ice cream

Instant breakfast

Juice

Milkshake

Peanut

Pizza

Popsicles

Pretzels

Pudding

Quesadilla

Sandwich

Smoothie

Soup

Trail mix

Vegetables

Yogurt

Increase Calories When Needed

Eating a healthy diet during treatment may be challenging. You may not feel hungry and foods may not taste right to you. Even small amounts of food may make you feel full. If you have trouble eating, choose high calorie and high protein foods as listed in the table below. Push yourself to eat even when you are not hungry. Try taking small, frequent meals and using liquid supplements, such as Boost™, Carnation Instant Breakfast Drink™ or Ensure™ to help add calories and protein daily.

More Ideas for Increasing Calories

Add . . .

Amount

Additional Calories

To

Butter, Margarine

Sour Cream

1 tablespoon

1 tablespoon

120

26

Soups, Potatoes, Hot Cereal, Grits, Rice, Noodles, Cooked Vegetables, Gravies and Sauces

Whipped Cream

2 tablespoons

25

Hot Chocolate, Desserts, Gelatin, Pudding, Fruit, Pancakes and Waffles

Whole Milk

Half and Half

1 cup

1 cup

150

315

Soups, Sauces, Scrambled Eggs, Pudding, Hot Cereals, Mashed Potatoes, Hot Chocolate, Meatloaf and Hamburgers

Cream Cheese

1 tablespoon

51

Breads, Muffins, Fruit and Crackers

Honey, Jam, Sugar (white or brown)

1 tablespoon

1 tablespoon

64

30

Breads, Cereals, Shakes, Fruit, Yogurt and Meats

Granola

2/3 cup

223

Cookies, Muffins or Bread Mixes, Yogurt, Fruit and Ice Cream

Dried Fruits

1 mini box of raisins or 2 dried apricots

40

Muffins, Cookies, Breads, Cakes, Cereals and Puddings

Foods That Help Increase Protein

Dairy

Melt cheese on sandwiches, breads, muffins, tortillas, hamburgers, hot dogs, meats, fish, vegetables, eggs, soups, casseroles, chili, mashed potatoes, rice, and pasta.
Use milk (instead of water) while preparing hot cereals, soups, cocoa, and pudding.
Add ice cream, frozen yogurt, or yogurt to carbonated beverages (ginger ale), shakes, cereals, fruit, gelatin, and pie. Sandwich between cookies, cake, and graham crackers.

Eggs

Add powdered milk or egg white powder to shakes, milk, casseroles, meatloaf, breads, muffins, sauces, soups, mashed potatoes, puddings, hot cereals, and scrambled eggs.
Add extra egg whites to scrambled eggs, French toast batter, and casseroles.

Nuts and Legumes

Use nuts or seeds in casseroles, breads, muffins, pancakes, cookies, vegetables, ice cream, or as a simple snack.
Spread peanut butter on sandwiches, toast, muffins, crackers, fruit, waffles, pancakes, and vegetables. Blend in to shake or ice cream.

More Ideas for Increasing Protein

Add . . .

Amount

Extra Calories

Extra Protein

To…

Cheese

1 ounce

114

7 g

Sandwiches, Breads, Muffins, Tortillas, Chili, Hamburgers, Hot Dogs, Vegetables, Eggs, Soup, Casseroles, Potatoes, Rice and Pasta

Whole Milk (instead of water)

1 cup

150

8 g

Hot Cereals, Soups and Hot Chocolate

Powdered Milk

¼ cup

60

6 g

Shakes, Milk, Casseroles, Meatloaf, Bread, Muffins, Sauces, Soups, Mashed Potatoes, Puddings, Hot Cereals and Scrambled Eggs

Ice Cream or Frozen Yogurt

½ cup

200

4 g

Carbonated Drinks (Root Beer Float), Shakes, Fruit and "a la mode" with Cakes, Cookies, Brownies, Pies, etc . . .

Eggs (hard cooked)

1 egg

75

7 g

Salads, Casseroles, Soups and Vegetables

Nuts, Seeds

Wheat Germ

¼ cup

¼ cup

200

100

6-9 g

8 g

Casseroles, Breads, Muffins, Pancakes, Cookies and Waffles.Sprinkle on Fruit, Cereal, Ice Cream, Yogurt, Vegetables, Salads and Toast as a crunchy topping.Use in place of Bread Crumbs. Blend with Parsley or Spinach, Herbs and Cream for a Noodle, Pasta or Vegetable Sauce. Roll a Banana in chopped Nuts.

Peanut Butter

2 T

200

8 g

Sandwiches, Toast, Crackers, Muffins, Fruit, Waffles, Pancakes, Vegetables and Shakes

Beans or Legumes

¼ cup

50

8 g

Soups, Casseroles, Pastas, Grains and Vegetables

Meat and Fish
1 ounce 75 7 g Add chopped, cooked Meat or Fish to Vegetables, Salads, Casseroles, Soups, Sauces, and Biscuit Dough. Use in Omelets, Soufflés, Quiches, Sandwich Fillings and Chicken and Turkey Stuffing. Wrap in Pie Crust or Biscuit Dough as turnovers. Add to stuffed Baked Potatoes.

This information originally appeared in the Journey Guide Patient Handbook developed by the Ireland Cancer Center at University Hospitals, and was adapted for use on NetWellness with permission, 2009.

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Last Reviewed: Nov 16, 2009

Kimberly Ortega, MS, RD, LD
Dietician, Oncology Specialist
Ireland Cancer Center
University Hospitals
School of Medicine
Case Western Reserve University

Joanna M Brell, MD
Assistant Professor
Division of Hematology/Oncology
Ireland Cancer Center
University Hospitals
School of Medicine
Case Western Reserve University

Add . . .	Amount	Additional Calories	To
Butter, Margarine Sour Cream	1 tablespoon 1 tablespoon	120 26	Soups, Potatoes, Hot Cereal, Grits, Rice, Noodles, Cooked Vegetables, Gravies and Sauces
Whipped Cream	2 tablespoons	25	Hot Chocolate, Desserts, Gelatin, Pudding, Fruit, Pancakes and Waffles
Whole Milk Half and Half	1 cup 1 cup	150 315	Soups, Sauces, Scrambled Eggs, Pudding, Hot Cereals, Mashed Potatoes, Hot Chocolate, Meatloaf and Hamburgers
Cream Cheese	1 tablespoon	51	Breads, Muffins, Fruit and Crackers
Honey, Jam, Sugar (white or brown)	1 tablespoon 1 tablespoon	64 30	Breads, Cereals, Shakes, Fruit, Yogurt and Meats
Granola	2/3 cup	223	Cookies, Muffins or Bread Mixes, Yogurt, Fruit and Ice Cream
Dried Fruits	1 mini box of raisins or 2 dried apricots	40	Muffins, Cookies, Breads, Cakes, Cereals and Puddings

Add . . .	Amount	Extra Calories	Extra Protein	To…
Cheese	1 ounce	114	7 g	Sandwiches, Breads, Muffins, Tortillas, Chili, Hamburgers, Hot Dogs, Vegetables, Eggs, Soup, Casseroles, Potatoes, Rice and Pasta
Whole Milk (instead of water)	1 cup	150	8 g	Hot Cereals, Soups and Hot Chocolate
Powdered Milk	¼ cup	60	6 g	Shakes, Milk, Casseroles, Meatloaf, Bread, Muffins, Sauces, Soups, Mashed Potatoes, Puddings, Hot Cereals and Scrambled Eggs
Ice Cream or Frozen Yogurt	½ cup	200	4 g	Carbonated Drinks (Root Beer Float), Shakes, Fruit and "a la mode" with Cakes, Cookies, Brownies, Pies, etc . . .
Eggs (hard cooked)	1 egg	75	7 g	Salads, Casseroles, Soups and Vegetables
Nuts, Seeds Wheat Germ	¼ cup ¼ cup	200 100	6-9 g 8 g	Casseroles, Breads, Muffins, Pancakes, Cookies and Waffles.Sprinkle on Fruit, Cereal, Ice Cream, Yogurt, Vegetables, Salads and Toast as a crunchy topping.Use in place of Bread Crumbs. Blend with Parsley or Spinach, Herbs and Cream for a Noodle, Pasta or Vegetable Sauce. Roll a Banana in chopped Nuts.
Peanut Butter	2 T	200	8 g	Sandwiches, Toast, Crackers, Muffins, Fruit, Waffles, Pancakes, Vegetables and Shakes
Beans or Legumes	¼ cup	50	8 g	Soups, Casseroles, Pastas, Grains and Vegetables
Meat and Fish	1 ounce	75	7 g	Add chopped, cooked Meat or Fish to Vegetables, Salads, Casseroles, Soups, Sauces, and Biscuit Dough. Use in Omelets, Soufflés, Quiches, Sandwich Fillings and Chicken and Turkey Stuffing. Wrap in Pie Crust or Biscuit Dough as turnovers. Add to stuffed Baked Potatoes.