Cancer - during illness: Treatment, symptoms, advice and help

Why is it necessary?

Nutrition is important during all stages of cancer. Many changes occur which can affect appetite and the way nutrients are used. In addition, treatment can itself cause problems with food; it may make the appetite worse by causing nausea, diarrhoea, constipation or taste changes. Weight loss, caused by depression and loss of appetite, is common even with just the knowledge of a cancer diagnosis.

Who would require the diet?

Any person who has a diagnosis or feels they might have cancer may be at 'nutritional' risk. Nutritional risk means weight loss through simple lack of appetite, or an early feeling of fullness. It may also be due to other problems such as swallowing difficulties, constipation or diarrhoea.

More seriously, in advanced cancer, there is an increased metabolic rate (this is the rate at which the body burns energy for normal activities) and so there is a greater requirement for energy from food. It is in this group of people that food intake is at its lowest, possibly caused by pain and the cancer treatment itself.

What is the diet and how does it work?

The main aim of dietary treatment is to provide adequate nutrition from food to prevent weight loss and eventual starvation. It can also help to relieve symptoms and to improve eating experiences. There is no one specific diet that will do this and it is a combination of different tactics that will help.

Problem	Solutions
Poor appetite	Serve small portions, but have more frequent meal breaks, provide encouragement, make the eating experience pleasurable, eg, music, flowers, a change of scenery, a short walk if possible.
Weight loss	Provide high calorie foods, have snacks between meals, try special food supplements such as Build Up or Complan or those which can be specially prescribed by the doctor to have in addition to the food that you eat.
Taste changes	Try using more herbs and spices, but beware some people may prefer flavours without herbs and spices; try mouthwashes to refresh the mouth. Ice cubes and fruit drink flavoured ice cubes may also help. Avoid foods that cause particular problems.
Nausea & vomiting	Ginger-containing products may help, such as biscuits and drinks. Dry foods, cold foods, and small frequent meals will help, as well as eating and cooking in a well-ventilated room, as this reduces the smell of food. Try to get someone else to cook. Fizzy drinks may help.
Diarrhoea