Diet

Eating can become a vicious cycle for someone with advanced cancer. You know you need a balanced diet to stay well and strong enough to control symptoms, but those symptoms may have stolen your appetite and made eating unpleasant.

Depending on your treatment, the right kinds of food can improve your strength, fight infection and help you recover more quickly. You may also need to adapt your diet to cope with symptoms such as pain, constipation or diarrhoea.

If you are losing weight due to treatment, or because you are struggling to eat, you may need to increase your protein and calories. If you are overweight, or if treatment or a lack of mobility is causing you to put on weight, you may need a diet that is rich in nutrients but lower in energy.

The guidelines for a balanced diet when you have advanced cancer resemble those for healthy eating in general: eat fruit and vegetables, whole grains, legumes, small amounts of meat or fish and a smattering of good fats. All this should be done, as far as your illness will allow and in consultation with your health care team.

When appropriate, the Cancer Council Australia recommends the following for people with advanced cancer:

  • Eat plenty of vegetables, legumes and fruit – five or more servings of vegetables and two or more servings of fruit per day.
  • Have cereals (preferably wholegrain) – between three and twelve servings each day, depending on age and gender.
  • Eat meat in moderation – no more than three to four servings of lean red meat each week and avoid processed meats.
  • Select lower fat foods like lean meat and reduced-fat dairy products, and try using low-fat cooking methods like grilling instead of frying.
  • Choose low-salt products – flavour foods instead with herbs and spices.


Tips
  • 1 serving of vegetables: 1/2 cup cooked vegetables or legumes, 1 medium potato or 1 cup salad vegetables.
  • 1 serving of fruit: 1 medium piece, 2 small pieces, 1 cup chopped or canned fruit.
  • 1 serving of cereals: 1 slice of bread, 1/2 pita bread or 1/2 cup cooked pasta, rice or couscous.
The ideal, for an optimum quality of life, is to get the nutrients you need in food that you can both stomach and enjoy, and to be able to dine with your family and friends.

What may help

Talk to your Doctor

Your doctor may be able to treat some of the symptoms – such as nausea or mouth ulcers – that hinder eating. They can also advise you on weight management and eating or refer you to a dietician.

Talk to a dietician

A dietician can provide you with a dietary plan that meets your nutritional needs while taking into account the factors affecting your eating.

Q&A

Q: I love to have a drink with my friends, but should I be avoiding alcohol?

A: Despite convincing evidence that alcohol is a risk factor for some types of cancer, there is no evidence to say that drinking if you have cancer is a concern.

The Cancer Council recommends cancer survivors limit (no more than two standard drinks a day for men and one for women) or avoid alcohol, and this is probably a good guideline for someone with advanced cancer too – if only to help your body remain as strong as possible to fight symptoms. Talk to your Doctor about it and ask about how alcohol may mix with your treatment and medications.

Talk to your Friends

Your friends and family may be happy to accommodate your dietary needs so you can enjoy eating with them. You may prefer to go out for breakfast or lunch, for instance, rather than go to dinner when you may be tired and the food may be too heavy and the portions too big. If friends or family want to cook for you, brief them on what you can eat.

Tips

If you have no appetite but need to maintain or increase your weight try:

  • Eating small meals more often
  • Eating as soon as you feel hungry, rather than waiting for meal times
  • Using supplements, such as Sustagen or Fortisip
  • Adding cream or butter to meals
  • Snacking on yoghurt, cheese and crackers, or milkshakes
  • Adding lentils or split peas to soups and casseroles.

If you need to control your weight but maintain your nutrients, try:

  • Eating regularly - don't skip meals, but keep meals small
  • Replacing energy-dense foods with vegetables and salad
  • Filling up on soup
  • Making your carbohydrates wholegrain, where possible
  • Using reduced-fat dairy products
  • Using high-density foods such as lollies, chocolate, pastries and biscuits as occasional treats only
  • Watching out for 'sneaky' calories in sof drinks and alcohol.

For more information

Life, Hope & Reality was developed and written by Afaf Girgis, Claire Johnson, and Sylvie Lambert with funding from the NHMRC and Cancer Council NSW.

Last updated 30 August 2015