Caring4Cancer

Hello, my name is Amanda. I posted about my ovarian cancer already, and, Im wondwering, what should I eat now that Im in treatment? Do I need to change, my habits? I try to eat healthy, with asald, fruit, fish.)

Hello Amanda,

You mentioned that you are in treatment and that you are trying to eat healthfully by including salad, fruit, and fish in your diet. These are great foods and this is a healthy way to eat, as long as you are not losing weight or having trouble eating normally. During treatment, there are two important nutrition goals to keep in mind, which are to maintain your weight and to eat healthfully. Sometimes these two goals can be accomplished together. Other times, simply eating enough to maintain your weight is the best you can do. Plenty of research tells us that losing weight makes it harder for your body to heal and recover during treatment. This is why the most important thing you can do for yourself nutritionally is to eat enough to keep your weight up.

If you are feeling reasonably well, you are not losing weight, and you are not experiencing symptoms that interfere with your ability to eat normally, then you should focus on the healthiest diet possible. This means eating plenty of vegetables; fruit; whole grains; and legumes or starchy beans, peas, and lentils. An easy approach for healthy eating is to follow the 75% - 25% principle. Every time you eat, make sure that 75% (three-fourths) of your plate is covered by healthy plant food, including vegetables, fruit, whole grains, and legumes. The remaining 25% (one-fourth) should be covered by lean protein, such as fish, chicken, or lean beef. If you prefer to eat a more vegetarian diet, use legumes as your lean protein source. Following the 75% - 25% principle will help you eat plenty of healthy food without getting bogged down in counting servings or tracking exactly what goes into your mouth.

As I mentioned, this is an ideal way to eat, as long as you are not losing weight. If you are going through treatment and you are losing weight, the most important thing you can do is to eat enough to stop, or at least minimize, the weight loss. Losing weight makes it harder for your body to heal and rebuild itself, which is why it is so important to avoid this. Even if you are overweight, losing weight during treatment generally is not helpful or healthy.

If you are losing weight, ask your doctor or nurse about medical options for better managing your symptoms. In addition to this, you will need to focus on eating the right type of food and eating more frequently. For many people in cancer treatment, eating large meals is not an option. It is common to feel full more quickly and you may not have much of an appetite. If this is the case, you will need to eat small frequent meals and snacks of calorie- and protein-rich food. You can try granola bars; fruit; nuts; yogurt; single-serving sizes of canned fruit, tuna, or chicken; trail mix; power bars; oatmeal; hard-boiled eggs; and smoothies, shakes, or other quick and easy blender meals and snacks. You should not wait until you are hungry to eat, but instead nibble on little bits of food as often as you can. As well, you can add nuts, seeds, olive oil, or canola oil to most recipes for extra calories.

There are many other steps you can take to make sure you eat enough during cancer treatment, but the bottom line is that the most important goal is to prevent weight loss. Secondly, eat as healthfully as you can.

For more information on both healthy eating and eating to manage side effects and to prevent weight loss, go to the Nutrition area of the Daily Management section and check out information in Recipes and Nutrition Tips and Symptom Support.

If I may jump in here - I've just started chemotherapy yesterday for lymphoma and I was hoping to be able to continue to lose weight throughout all this.  A little background - last November 1 I started a "lifestyle change" (hate the word diet!).  My goal was to lose weight, but more importantly to get healthy.  I track all my food using an online food journal - including vitamins, protein, fiber, calories - the whole lot.  I also started exercising and even started a "couch to 5K" program to learn to run (believe me, this is HUGE for me).  To date I have lost 60 pounds, but am still about 50 pounds overweight. 

I realize I need to feed my body what it needs to fight this cancer and I eat very healthy foods - I eat lots of protein, good fats, etc.  I've lost about 1 to 1.5 pounds on average per week.  I know what's healthy and I guess I'm just wondering why I shouldn't continue this during treatment?  (Assuming of course I escape the major nausea stuff).  As long as I am eating enough protein and calories should I be okay to continue to lose slowly as I have been?

I've tried to find a nutritionist to talk to but haven't had much luck so I would really like to hear more from you.

Thanks so much!

Pam

Hi Pam,

Congratulations on your success with making healthful diet and exercise changes. You said that the "couch to 5K" program is huge for you and you are absolutely right! Making lasting changes to improve diet and to exercise regularly is A LOT of work. Anybody who's tried to do this can attest to that. And you're very smart to look at your nutrition and exercise choices as a lifestyle change rather than a diet. You should be very proud of yourself for your success!

First, before I answer your question, I want to stress that you should always discuss any issues that can affect your health, including your weight loss efforts, with your health care team. It's important that your team knows how and what you are doing throughout treatment so they can address any health issues that arise quickly, before they become more serious.

Regarding weight loss during treatment, there is one issue that you need to consider when you decide whether or not you should continue to lose weight during treatment. That issue is how the body uses energy to fuel itself during cancer treatment. Under normal circumstances, when a person puts him or herself into a calorie deficit, the body will lose both muscle and fat for the first couple of days. In other words, if you eat fewer calories than you are burning, right off the bat, your body will begin to lose fat and muscle.
 
Fortunately, very quickly, within just a couple of days, your body responds to this weight loss by shifting the weight loss primarily to fat. The body quickly realizes it is getting fewer calories than it is burning and when this happens, it turns on the ability to dip into your fat reserves for energy more easily and efficiently. Due to this shift toward using mostly fat for energy, you preserve your muscle and lose mostly fat. Obviously, this is a desirable effect, because when we lose weight, we want to lose fat, not muscle.

With this basic understanding of how the body responds to weight loss under normal circumstances, we can talk about the potential problem with losing weight during treatment. So we know that the body quickly shifts to burning mostly fat when a person eats fewer calories than he or she is burning. However, when you add in the stresses of cancer and its treatment, sometimes, this shift from burning muscle and fat, to burning mostly fat, never occurs. In other words, because of the stress that cancer, medications, chemotherapy, radiation therapy, surgery, or any other type of cancer treatment place on the body, the body can't respond normally to a calorie deficit. Instead of shifting to burning mostly fat, the body just keeps right on burning up muscle tissue. Obviously, this is not a good thing. Losing muscle can worsen fatigue and make it harder for your body to heal.

So, here's what you need to keep in mind. If you generally feel good, if you are not losing weight without trying, and if you still feel like you have the energy to exercise, you absolutely should continue to do those things. Research even shows that people who are more active during treatment have less fatigue and feel better. If your weight loss continues at the same slow steady pace as before you started chemotherapy, this is a good sign that you are continuing to lose mostly fat, not muscle.

However, if you start to lose weight without trying, if you begin losing more than about 1 pound per week, or if you find that you have several days after each chemotherapy treatment during which you cannot eat much at all, you need to focus on getting in the calories and protein that your body needs to heal. If any of these things occur, this is a sign that your body is burning up muscle tissue for energy, and that is not healthy.

There are a couple of things you can do to help give your body the tools is needs to preserve muscle mass. First, be sure you get plenty of protein. To learn more about how much protein you need, you can read my article on this topic. Just go to the nutrition section on caring4cancer.com, click on "Your Nutrition Questions Answered", and then click on "How Much Protein Do I Need?" In general, you should aim for 0.65 to 0.80 grams of protein per pound of body weight each day. So, you can take your weight, multiply it by 0.65 to 0.80 and this will give you the range of protein, in grams, that you should eat each day.

Second, after talking to your doctor to make sure it is safe to do so, you can add in some resistance training to your exercise plan. The most common form of resistance training is lifting weights, but anything that challenges your muscles, such as push ups, sit ups, and leg lunges is resistance training. You don't need a gym or fancy weights. Be sure you discuss this with your doctor before you begin resistance training to make sure it is ok.

The great thing about resistance training is that it's proven to help preserve muscle mass during cancer treatment. Research out of Duke University has shown that regular, moderate resistance training (it doesn't have to be heavy weights) helps women who are in treatment for breast cancer to maintain strength and muscle mass. It is likely that these findings are applicable to other cancers as well.

I hope this information is helpful to you!

C4C Cancer Nutritionist Suzanne

hi suzanne, i am taking radiation after surgery for prostate cancer and changed my diet to fruits, vegetables, fish, and soy.i still have my appetite but i seem to be losing weight a litttle at a time. i believe i was 198 lbs. before surgery in march and now i'm around 186. i still eat alot just salads and fruits mostly and fish twice a week. as far as exercise i walk about 2 miles a day and i do work 8 hours a day at a labor intensive job. am i ok then or should i be eating differently? i do crave some pizza or a burger now and then, but i just eat more rice and move on. i read about a macrobiotic diet that has helped cancer patients, is that not good?

thanks, john

Hello John,

There are some aspects of the macrobiotic diet that are healthy, including the focus on eating more whole grains and green vegetables. However, this diet may not be right for you. Individual needs vary and there is no one perfect diet for everyone. Also of concern is that the macrobiotic diet tends to be low in protein, low in calories, and may not provide enough of certain nutrients, such as vitamin B12, vitamin D, and calcium, for good health.

You did not mention whether you were trying to lose weight. From your comments, it sounds as if you are not trying to lose weight. Assuming this is the case, it is clear that a strict macrobiotic diet is not providing enough calories and protein to keep your body weight where you want it.

Weight loss occurs when we eat less energy (calories) than we burn through our daily activities. Your weight loss is telling you that you are burning more calories than you are eating while following the macrobiotic diet.

As I mentioned, some features of the macrobiotic diet are positive, but there are no good, well-controlled studies that demonstrate that a macrobiotic diet is effective for treating or curing cancer. A few reports have compared the experience of cancer patients who have tried a macrobiotic diet with expected survival rates for their type and stage of cancer. Other studies, called case series, have discussed potential benefits in patients who’ve tried this diet.

These reports have suggested that a macrobiotic diet may have some health advantages, but again, it is important to note that these are not well-controlled studies. They cannot tell us conclusively if macrobiotics will improve cancer survival rates. Also, it’s good to be aware that all cancers are different and what diet is good for one type may not be the best choice for other types of cancer.

If you like the general idea of the macrobiotic diet, you can use that as the base of your eating pattern and modify it to better meet your calorie and protein needs. A typical macrobiotic diet usually is based around the following general guidelines:

50% to 60% Whole Grains
25% to 30% Vegetables (non-starchy)
5% to 10% Soup (broth-based)
5% to 10% Beans Sea Vegetables (such as sea weed)

One way to change this diet so that you get more protein and calories would be to decrease the amount of whole grains and increase the amount of beans. For example, you could aim to have 25% of your diet coming from whole grains and 25% coming from beans. This will increase protein plus give you a couple hundred additional calories each day.

You can make up the remaining calories and protein by adding in additional sources of lean protein, such as fish (wild caught if possible) and whole food soy products such as tofu, tempeh, and edamame, which are steamed soy beans, often served in the pod in Japanese restaurants. They can be purchased frozen in most grocery stores. You might try adding in some of the healthier, starchy vegetables, such as sweet potatoes, for additional calories.

I suggest adding in some healthy fat, such as nuts, seeds, and nut butters to round out and improve the macrobiotic diet for you. This will increase the calorie content and help halt your weight loss as well.

And don’t forget that you need to get plenty of calcium, vitamin B12, and vitamin D from other sources if you are going to cut out all animal products such as meat and dairy. Good sources of calcium include fortified soy milk; dark green leafy vegetables such as kale, chard, and collard greens; and beans. Good sources of vitamins B12 and D include fortified foods such as fortified soy milk and fortified cereals, breads, and other whole grains. For people who eat no animal products, taking a vitamin B12 supplement can fill in the gaps too.

If you are not taking a vitamin D supplement, you may want to add this in. I have a blog on this topic. In my blog, I discuss the relationship between vitamin D and cancer risk and survival; safe and appropriate levels of vitamin D to supplement; and who should NOT take extra vitamin D. Please read this carefully and talk to your doctor to let him or her know that you plan to take vitamin D.

In fact, you should let your doctor know about all supplements, herbs, and other over-the-counter products you are taking. This can help prevent dangerous interactions between your cancer treatments and these products.

To read my vitamin D blog, you can go to:

http://www.caring4cancer.com/suzannedixon/blogs/archive/2007/07/05/vitamin-d-wonder-nutrient.aspx.

Last but not least, be sure you enjoy eating and give yourself permission to enjoy “treat” foods. If your diet is very healthy most of the time, having an occasional piece of pizza or a piece of pie is not going to negatively impact your health. The most important thing is to keep your overall diet healthy and based around high quality food like fruit, vegetables, whole grains, and legumes.

Those occasional treats will give you a few extra calories which your body seems to need and will keep you sane. Remember, eating healthfully is a gift, not a punishment!

Nutritionist Suzanne

Suzanne,

I am so glad I found this sight....you are the person I've been searching for....A nutritionist......my husband 60 years old......is a physicac education and drivier's ed teacher and coachs football......he is 5'9" 210....discovered renal cell cancer of the kidney.......removed bleeding tumor in brain May 18th,then kamma knife......the kidney removed.....then 28 days of radiation........1 week off then back to teaching and coaching.......when he told the doc he thought about giving up football one year the doc said"coach, you get out there and do what you LOVE doing and thats to coach......the community of Greeley, Nebr has been wonderful......great support!!

my question to you is.........how do i get him to eat????? he had radiation to the brain.....and it wiped out his taste buds........he's lost 20 lbs but he was heavy to begin with.......the fatique and energy level is what is the hardest for him.....my heart just aches when i see him cry........cuz he's so so tired......the only thing i can get him to eat is pancakes.......morning noon and nite!!!!

also will eat instant oatmeal.......i bought a deal of soy protein and mix that with gatoraid......can u give me any more ideas?? he was low on potsiim and his blood sugar was up because of the steriod they put him on to keep the swelling down......also dalinten.....he won't eat any meat..........just those darn pancakes!! and he craves strawberries.......i got a bunch of it and he nibbles on it........i hope i hear from u soon......thank u sooooooooo much........kj

I also have ovarian stage 111 c diagnosed in nov 03. I have been on and off chemo since then. I always had irritable bowel syndrom and now on chemo am always constipated. I drink lots of water and juice. Eat high fiber and lots of fruits and try to eat lots of veggies. I take a stool sofner but never seem to completely eliminate. This is frustrating as I am  bloated. I exercise alot also. I have tryed to eliminate sugar also and eat organic.

Janet