Before treatment

During the initial diagnosis, your doctor will recommend a treatment plan. This plan may involve, surgery, radiation therapy, chemotherapy, hormone therapy, and biological therapy.

These treatment methods are meant to kill cancer cells, but can sometimes also damage healthy cells. As a result, side effects can occur, some of these side effects can have a negative effect on your ability to eat:

  • loss of appetite
  • changes in weight
  • sore mouth or throat
  • dry mouth
  • dental and gum problems
  • changes in sense of taste or smell
  • nausea/vomiting
  • diarrhea
  • lactose intolerance
  • constipation
  • fatigue and/or depression

Not everyone will develop these side effects, not every individual will react the same to the treatment.

When it comes to dieting during the treatment stage, recommendations may seem very different from usual suggestions for healthful eating. Dieticians usually recommend eating lots of fruits, vegetables, and whole grain breads and cereals; and cutting back on fat, sugar, alcohol, and salt.

However, breast cancer patients are recommend to focus on eating high calorie foods with lots of protein, this may include drinking more milk, cream, cheese and cooked eggs. Other suggestions are to use more sauces and gravies, or changing your cooking methods to use more butter, margarine, or oil. Dietitians do suggest that breast cancer patients refrain from eating too much high-fiber foods because these can aggravate problems such as diarrhoea or a sore mouth. The reason for the difference in suggested diets, is because breast cancer patients need to build up their strength which helps withstand the effects of the cancer and treatment.

What you should keep in mind before you go into treatment, is that many people have few or no eating related side effects. In the cases that side effect do occur, they are mild, and most go away after treatment is completed. Also, if you’ve been eating healthy before your treatment starts, you go into it with reserves that can help you keep up your strength, prevent breakdown of tissue, rebuild tissue, and enforce your natural defense system against infection.

During the treatment

As a result of your breast cancer treatment, you may experience eating-related side effects. This may not be the case for everyone, some might have their normal appetite during the treatment, while others will not be able to touch food for days. During your treatment there is the possibility for the following eating-related side effects:

  • Loss of appetite
  • Weight loss
  • Weight gain
  • Sore mouth or throat
  • Dry mouth
  • Change in sense of taste or smell
  • Nausea

Loss of Appetite
This is one of the most common side effects. It is not certain whether the loss of appetite is a direct cause of the cancer or the treatment. But it can also be a result of the emotions that arise during treatment (fear or depression). If you are experiencing emotions that you feel are affecting you ability to eat, consult a nurse, or doctor on ways to lessen these difficulties. A loss of appetite can also be caused by a combination of other side effects, such as nausea, vomiting, or change in taste and smell. If you think that this might be causing your loss of appetite, consult your doctor, there are medications available that can limit the side effects.

For some woman, the loss of appetite is only temporary, lasting a few days, while other woman struggle with it during their entire treatment. Either way, here are some suggestions that might help:

  • Try liquid or powdered meal replacements during times it is hard to eat food.
  • Try to eat frequent, small, meals throughout the day, rather than a few big ones.
  • Keep snacks within reach, so you can have something to eat when you feel like it. Examples of snacks might be: cheese and crackers, muffins, ice cream, fruit, or pudding.
  • If you don’t feel like eating solid foods, try fluids during the day. Juice, soup, and other fluid foods can give you important calories and nutrients that help with your fight against cancer.
  • Try eating before going to bed, this won’t affect your appetite for your next meal.
  • Try eating good meals when you feel well, this is often in the morning.
  • During meals, try drinking small amounts, because it may make you feel full.
  • If your doctor allows it, can have small glass of beer or wine during diner, this may help stimulate your appetite.

Weight Loss
Many patients experience weight loss during cancer treatment, this is particularly due to the cancer itself. But it can also be caused by emotional issues that arise during breast cancer treatment, such as fear, anxiety, or depression. If you do experience weight loss, try eating high protein foods, this might be able to slow your weight loss, and maybe even help you gain a little weight. It may be useful to look at the tips given above, under “loss of appetite”.

You might also want to try some recipes suggested by the National Cancer Institute (download the booklet):

  • Fortified Milk
  • High-Protein Milkshake
  • Peanut Butter Snack Spread

Weight Gain
While some breast cancer patients might experience weight loss, others might experience weight gain. This is particularly true for breast cancer patients taking certain medications, or on hormone therapy or chemotherapy. If you do experience weight gain during your treatment, it is important that you do not go on a diet right away, but consult your doctor on what may be causing it. In some cases it might just be anticancer drugs causing your body to hold on to excess fluids, called edema. If this is the case, your doctor might suggest a dietitian, who will be able to put you on a low salt diet. This is important, because salt causes your body to keep extra water.

Over half of the women diagnosed with breast cancer may actually gain weight during their treatment. Because of this, doctors often recommend low fat diets, similar to the diets recommended after treatment is finished.

Here are some tips on slowing, or eliminating the weight gain:

  • Emphasize fruits, vegetables, and breads and cereals.
  • Choose lean meats, and low fat dairy products
  • Cut back on butter, mayonnaise, sweets and other extras.
  • Choose low-fat and low-calorie cooking methods (boiling, steaming).
  • Avoid eating high-calorie snacks between meals.
  • If you are able to, try to exercise more.

Sore mouth and/or throat
Radiation therapy, chemotherapy, or infections may cause mouth sores, tender gums, or a soar throat. This can decrease your appetite, and discourage eating. You should check with your doctor that the soreness is a side effect, and not a separate dental problem. If it is a side effect, your doctor might be able to subscribe medicine that can help treat the side effects. It is also important that if you experience these problems you check with your dentist, he/she will be able to recommend a special product to clean your mouth. You should also rinse your mouth with water after eating, removing any left over foods rests and bacteria.

It is important that you choose your foods correctly if you are experiencing these side effects, because the wrong foods can cause more irritation. It is recommended that you try to eat soft foods, which are easy to chew and swallow, such as:

  • milkshakes
  • bananas, applesauce, and other soft fruits
  • peach, pear, and apricot nectars
  • watermelon
  • cottage cheese, yogurt
  • mashed potatoes, noodles
  • macaroni and cheese
  • custards, puddings, and gelatin
  • scrambled eggs
  • oatmeal or other cooked cereals
  • pureed or mashed vegetables, such as peas and carrots
  • pureed meats

You can also try this recipe for fruit and cream, recommended by the National Cancer Institute.

As said, you should try to refrain from eating foods and liquids that can cause irritation to your mouth and throat:

  • oranges, grapefruits, lemons, or other citrus fruit or juice
  • tomato sauces or juices
  • spicy or salty foods
  • raw vegetables, granola, toast, crackers, or other rough, dry foods
  • commercial mouthwashes that contain alcohol

Dry mouth
Radiation and chemotherapy for breast cancer can sometimes reduce the flow of saliva, which can cause dry mouth. When this happens, food becomes harder to chew and swallow, but it can also change the way that food tastes. Some suggestions on how to deal with dry mouth:

  • Try to have a sip of water every few minutes, it might even be good to carry a bottle of water around with you.
  • Try eating very sweet or tart foods and beverages, such as lemonade. These may help your mouth make more saliva.
  • Chewing gum, sucking on hard candy or popsicles can also help increase the production of saliva.
  • Eat soft, pureed foods, these may be easier to swallow.
  • Try to keep your lips moist with lip salves.
  • Moisten foods with sauces, gravies, and salad dressings to make it easier to swallow.

If your dry mouth is persistent, and becomes severe, you can ask your doctor for medicine that coats, protects, and moistens your mouth and throat (known as artificial saliva).

Change in smell or taste
The smell and taste of certain foods may change during treatment, especially meat or other high-protein foods, which can start to taste bitter or metallic (some foods may even have less taste). Chemotherapy, radiation therapy, or breast cancer itself may be the cause, but the changes will go away after the treatment is finished.

There is no way of predicting who will be affected by cancer and the treatment, there is also no way to prevent side effects from occurring. What you should do, if the side effect continues to persist, is visit your dentist or doctor to make sure that it is actually a side effect of the treatment that is causing these changes. There are choices you can make that can help you if the taste of certain foods start to change:

  • Choose and prepare foods that look and smell good for you
  • If beef, or other red meat, starts to taste or smell strange, try eating chicken, turkey, eggs, dairy products, or fish instead
  • Try marinating the meat, chicken, or fish with sweet fruit juices, sweet wine, Italian dressing, or sweet-and-sour sauce
  • Try using seasonings, such as basil, oregano, or rosemary
  • Try tart foods, such as oranges or lemonade
  • If the smell of food starts to bother you, try serving them at room temperature, or turning on a fan, or cover the food while cooking, cooking outdoors might also be a good option
  • Try using bacon, ham, or onion to add flavor to vegetables

A common side effect of surgery, chemotherapy, radiation therapy, and biological therapy, is nausea (with or without vomiting). Cancer itself, other medications, or even unrelated conditions can also cause nausea. Like all other side effects, not all breast cancer patients experience nausea, and those that do don’t experience it at the same time (some may have it right after therapy, others not till a few days afterwards). If you develop nausea after therapy or surgery, try asking your doctor about medications that can control this side effect, these are called antiemetics.

A few suggestions to help reduce nausea are:

  • To try foods that are easy on your stomach:
    • Toast, crackers, and pretzels
    • Yogurt
    • Sherbet
    • Angel food cake
    • Cream of wheat, rice, or oatmeal
    • Boiled potatoes, rice, or noodles
    • Skinned chicken that is baked or broiled, not fried
    • Canned peaches or other soft, bland fruits and vegetables
    • Carbonated drinks
  • Avoid foods that are:
    • Fatty, greasy, or fried
    • Very sweet
    • Spicy or hot
    • Have strong odors
    • Eat small amounts, often and slowly.
    • Don’t wait till you’re hungry to eat, feelings of hunger can make nausea stronger
    • Drink less fluids with meals
    • Rest after meals, because activity may slow digestion
    • Wear loose-fitting clothes
    • If you experience nausea during or immediately after chemotherapy, try not to eat 1 to 2 hrs before treatment starts


After treatment

Having a healthy and balanced diet is an important aspect of recovery from breast cancer. Your body needs all the help it can get to recover from the surgery and therapy you underwent. A registered dietitian is your best source of information about your diet, but we have provided a few tips to help you on your way. If you want to get in touch with a dietitian, ask your doctor for a referral.

The majority of eating-related side effects caused by radiation, chemotherapy, or other treatments will start to go away after you finish you treatment. If you experience side effects, you will notice that they will gradually go away, and you will start to get your appetite back. In some cases, the side effects persist, in particular weight loss. If this happens to you, you should contact your doctor or dietitian, with whom you will be able to set up a plan to beat the problem. After the cancer treatment ends, and the side effects start to wear off, you will want to start eating normally again. However, it is important that you eat right at such an important time in your life.

Your body will not regain its strength from a high fat diet, but starving yourself won’t help either. In order to regain your strength, rebuild tissue, and help you feel better you need to eat well balanced meals on a daily basis. There is no scientific proof that a well balanced diet will prevent cancer from recurring, but it will help you recover. A few tips:

  • It is important that you eat a variety of foods daily, no one food contains all the nutrients you need to recover.
  • It is important to eat lots of fruits and vegetables. Raw, or cooked, vegetables, fruit, and fruit juices provide the minerals, vitamins, and fiber you need.
  • Breads and cereals are also important, especially whole grain varieties. These types of food provide carbohydrates, vitamins and minerals, and fiber.
  • Try to eat as little fat, salt, sugar, alcohol, and smoked or pickled foods. When buying milk products, choose the low fat varieties. You should also try to keep you portions of lean meat and poultry (without skin) small, no more than 6-7 oz. a day. You should also try to use lower-fat cooking methods, such as broiling, steaming, and poaching.

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