Nutrition During Chemotherapy

Quick Answer

Good nutrition during chemotherapy helps tolerate treatment better, maintains strength, and speeds recovery. Focus on protein (meat, eggs, legumes), adequate calories, plenty of fluids. Manage nausea with small frequent meals, cold or room temperature foods, and avoid strong odors. Avoid raw and uncooked foods to protect immunity. Every case is unique - consult a specialized dietitian.

Introduction: Why Is Nutrition So Important During Chemo?

Chemotherapy fights cancer, but also affects healthy fast-dividing cells (digestive system, mouth, hair, immunity). The result: difficult side effects that affect appetite and ability to eat.

Good nutrition is not a luxury - it's an essential part of treatment:

• Maintains weight and muscles: Severe weight loss weakens the body and delays treatment
• Supports immunity: Reduces risk of serious infection
• Speeds healing: Between chemo sessions
• Improves quality of life: Better energy, milder symptoms
• Helps complete treatment: Without delay or dose reduction

Common Nutritional Challenges and Solutions

1. Nausea and Vomiting

Most common and bothersome.

Coping strategies:

• Small frequent meals: 5-6 meals instead of 3 large
• Cold or room temperature foods: Less smell
• Dry starchy foods: Saltine crackers, toast, white rice
• Avoid heavy fats: Slow digestion and increase nausea
• Avoid strong odors: Cooking, perfumes, pungent smells
• Don't drink with food: Fills stomach - drink between meals
• Ginger: Ginger tea, ginger cookies (naturally effective)
• Inhale mint or lemon: Calms nausea

Good foods when nauseated:

• Saltine crackers
• White toast
• Banana
• Peeled apple
• Boiled white rice
• Clear chicken broth
• Vanilla ice cream
• Boiled potatoes

2. Loss of Appetite

Very common - food seems unappealing or tasteless.

Solutions:

• Boost calories: Add olive oil, butter, honey, nuts to foods
• Make food attractive: Colors, beautiful presentation
• Eat favorites: Now is not the time for strict diet
• Calorie-rich drinks: Juices, milkshakes, nutritional drinks
• Light activity before eating: Short walk opens appetite
• Share meals with others: Social eating is more enjoyable
• Don't feel guilty: Do what you can - any food is better than none

3. Change in Taste and Smell

Food may taste metallic, bitter, or tasteless.

Adaptation:

• Use non-metallic cookware: Wood, plastic
• Try strong flavors: Lemon, herbs, spices
• Eat cold foods: Taste is less intense
• Rinse mouth before eating: Water with baking soda (quarter teaspoon in cup)
• Chew sugar-free gum: Stimulates saliva
• Try protein alternatives: If meat tastes metallic, try chicken, fish, legumes

4. Mouth and Throat Inflammation (Mucositis)

Painful sores make eating difficult.

Soft soothing foods:

• Pudding, custard
• Yogurt, labneh
• Creamy soups (slightly cooled)
• Mashed avocado
• Mashed potatoes with milk
• Ripe banana
• Smoothies (not acidic)
• Ice cream (numbs pain)

Avoid:

• Citrus fruits and juices
• Crunchy or rough foods
• Spicy seasonings
• Very salty foods
• Hot drinks

5. Diarrhea

Some types of chemo cause it.

BRAT diet and derivatives:

• Bananas
• Rice - white rice
• Applesauce
• Toast

Other good foods:

• Boiled potatoes
• Boiled chicken
• Cooked carrots
• Yogurt (natural probiotic)

Avoid:

• High fats
• High fiber (whole grains, raw vegetables)
• Dairy products (except yogurt)
• Caffeine and alcohol
• Gas-causing foods (onions, cabbage)

Very important: Drink plenty of fluids - water, broth, diluted juices - to replace lost fluids.

6. Constipation

Some chemo drugs and anti-nausea medications cause it.

Solution:

• Fiber gradually: cooked vegetables, peeled fruits, whole grains (if tolerated)
• Plenty of fluids: 8-10 cups water daily
• Prune or fig juice: natural laxative
• Daily walking: stimulates intestines
• Warm fluids in morning: stimulate movement

7. Severe Fatigue

Chemo drains energy.

Nutrition for energy:

• Don't skip meals: Even if small
• Ready snacks: Nuts, yogurt, cheese, dried fruits
• Ask for help: Let others cook for you
• Healthy ready meals: Acceptable at this stage
• Prepare on energy days: Cook in bulk and freeze

Essential Nutrients

Protein: Top Priority

Protein repairs tissues, maintains muscles, and supports immunity.

Goal: 1.2-2 grams per kg of body weight daily (higher than normal)

High-quality protein sources:

• Animal: chicken, turkey, fish, beef, eggs, dairy products
• Plant: lentils, beans, chickpeas, tofu, nuts, seeds
• Supplements: protein powder (whey, plant-based) if can't eat enough

Easy ways to increase protein:

• Add milk powder to soups and drinks
• Scrambled or boiled eggs - easy to digest
• Greek yogurt - double the protein of regular yogurt
• Peanut butter on bread or fruits
• Cottage cheese with fruits

Adequate Calories

The body needs more energy to fight cancer and heal.

If losing weight: Boost calories in healthy ways:

• Add olive oil to salads and vegetables
• Nuts and seeds as snacks
• Avocado rich in healthy calories
• Smoothies with banana, nut butter, whole milk
• Honey on yogurt or bread

Fluids: More Than You Think

Dehydration is dangerous - increases fatigue, constipation, and kidney problems.

Goal: 8-12 cups daily (more if diarrhea or vomiting)

Fluid options:

• Water (best)
• Coconut water (replaces electrolytes)
• Chicken or vegetable broth
• Light herbal tea
• Diluted juices
• Soup
• Ice cream and jelly (count as fluids)

Vitamins and Minerals

Food first, but may need supplements:

• Vitamin D: Often low, supports immunity and bones
• B vitamins: For energy and nerve health
• Iron: If there's anemia

Important warning: Don't take any supplement without oncologist approval! Some supplements (especially high-dose antioxidants) may interact with chemo.

Food Safety: Iron Rules

Chemo weakens immunity - infection risk very high.

Avoid completely:

• Raw or undercooked meats, poultry, and fish: sushi, rare steak, pink chicken
• Raw eggs: homemade mayonnaise, raw dough, runny boiled eggs
• Unpasteurized dairy products: fresh milk, soft cheeses from raw milk
• Raw sprouts: alfalfa, bean sprouts
• Unpasteurized juices: fresh apple juice, farmers market juices
• Old foods: leftovers more than one day, foods past expiration date

Safe preparation rules:

1. Wash hands: Before and after preparing food
2. Wash fruits and vegetables: Even peeled ones, under running water
3. Cook well: Meats to 75°C, poultry to 80°C, eggs until fully cooked
4. Separate foods: Separate cutting board for raw meats
5. Refrigerate quickly: Don't leave food out more than two hours
6. Heat well: Leftovers to high temperature

Practical Meal Plan

On Severe Nausea Days

Morning:

• Saltine crackers bedside before getting up
• Lukewarm ginger tea

Breakfast:

• White toast
• Half banana

Lunch:

• Boiled white rice
• Boiled chicken (small pieces)
• Cooked carrots

Snack:

• Vanilla ice cream

Dinner:

• Clear chicken soup
• Boiled potatoes

On Better Appetite Days

Breakfast:

• Scrambled eggs (2)
• Whole wheat bread
• Avocado
• Apple juice

Lunch:

• Grilled salmon (150g)
• Brown rice
• Cooked vegetables
• Greek yogurt

Snack:

• Smoothie (banana, almond butter, milk, honey)

Dinner:

• Lentil soup
• Bread
• Cooked green salad
• Cut fruits

Special Important Questions

Does fasting or ketogenic diet help against cancer?

No strong scientific evidence currently. May actually harm:

• Dangerous weight loss
• Lack of important nutrients
• Weakness and low energy

Medical opinion: Most oncologists don't recommend them during active treatment.

Does sugar "feed cancer"?

All cells (healthy and cancerous) need glucose. Avoiding sugar completely:

• Won't stop cancer
• May cause dangerous weight loss

Balance: Reduce added sugars (sweets, soft drinks), but complex carbohydrates (rice, bread, fruits) are necessary for energy.

Organic foods: necessary?

Beneficial but not absolutely necessary:

• If your budget allows, great
• If not, wash vegetables and fruits well
• Priority is fresh well-cooked foods

Advice from the Heart

1. Don't compare yourself to others: Every body reacts differently
2. Bad days are normal: Tomorrow may be better
3. Any food is better than none: Don't feel guilty
4. Ask for help: Family, friends, dietitian
5. Listen to your body: Trust its signals
6. Celebrate small victories: Ate a full meal? Achievement!

Conclusion: You're Stronger Than You Think

The chemo journey is difficult, but good nutrition is a powerful weapon in your hands. You don't need perfection - just do what you can. Every bite that nourishes your body is a step toward healing.

Remember: you're not alone. A medical team, dietitians, and an entire community support you.

Frequently Asked QuestionsWhat do I do if I can't eat for several days?

Call your doctor immediately. Rapid weight loss is dangerous. You may need: stronger anti-nausea medications, IV fluids, or temporary tube feeding. Don't wait - early intervention is better.Are nutritional drinks (Ensure, Fortisip) good?

Yes, excellent when eating is difficult. Rich in protein and calories. But natural food is better when you can. Use them as addition not complete replacement.Are multivitamins safe?

A regular multivitamin (100% of daily need) is usually safe. But avoid high doses of antioxidants (C, E, beta carotene) - may interact with chemo. Always consult your doctor.When should I stop eating before chemo session?

Don't go hungry! Have light meal 1-2 hours before (not heavy). Empty stomach may increase nausea. Bring light snacks (crackers, fruits) to clinic.Is alcohol completely forbidden?

Preferably avoid it: interacts with some chemo drugs, dehydrates body, weakens immunity, and harms liver (which processes drugs). If your doctor permits very small amount, drink with extreme caution.How long do side effects last?

Varies by chemo type. Usually worst days 2-3 after session, then gradually improve within a week. Some symptoms (taste change) may continue throughout treatment and disappear weeks after ending.Can I eat restaurant food?

Avoid during severe low immunity period (days after session). If necessary: choose reputable restaurants, order very well-cooked food, avoid raw salads and seafood. Home food is safer.

Medical Disclaimer

This article is for educational purposes only and does not replace specialized medical follow-up. Every cancer type and chemo protocol has special nutritional needs. The information here is general - always consult your oncologist and oncology dietitian before applying any advice. Some foods or supplements may interact with your medications or be dangerous in your specific case. Do not stop any medication or start any diet without your medical team's approval.

Need Specialized Nutritional Support During Your Treatment Journey?

Dr. Mai Obeid - Clinical Dietitian

For appointments and inquiries: +961 81 337 132