Chemotherapy changes how food tastes, how much you want to eat, and how your body handles what you swallow. That is normal, and it is one of the parts of treatment you have the most control over. Below are the twelve questions patients ask us most often.
Medical disclaimer
This article is general health information, not medical advice. It cannot take the place of a conversation with your own oncology team. Do not start, stop, or change any treatment, supplement, or diet based on what you read here. Always talk to your oncologist, pharmacist, or registered dietitian first, because their advice is based on your diagnosis, your medicines, and your lab results.
Eating well during treatment: the short version
Major clinical nutrition guidelines for people with cancer agree on a few basics: watch for weight loss early, keep protein intake up, and involve a dietitian rather than guessing.[1] Structured dietary counselling during treatment has been shown in controlled research to improve how patients eat and how they feel.[2] Nutrition is supportive care, not an alternative treatment.
Frequently asked questions
1. Do I need a special cancer diet?
No. There is no diet that has been shown to treat cancer. The goal during chemotherapy is different and more practical: keep your weight stable, get enough protein, and stay hydrated so you can complete treatment on schedule.
2. I have no appetite. What should I do?
Stop thinking in terms of three meals. Eat small amounts every two to three hours, and treat food as part of your treatment plan rather than waiting to feel hungry. Keep easy, ready-to-eat options within reach so a low-appetite day does not become a no-food day.
3. How much protein do I need?
More than you did before treatment. Current guidelines suggest people with cancer generally need above one gram of protein per kilogram of body weight per day, and often more.[1] Eggs, dairy, fish, poultry, beans, lentils, tofu, and nut butters all count. Your dietitian can give you a number that fits your body and your kidney function.
4. Nothing tastes right. Is that permanent?
Usually not. Taste changes are common during chemotherapy and typically improve in the weeks after treatment ends. In the meantime, plastic utensils can help with a metallic taste, cold or room-temperature foods often taste better than hot ones, and marinades, herbs, lemon, and mild spices can bring flavour back.
5. What helps with nausea?
Anti-sickness medicine comes first. Modern guideline-based regimens prevent nausea far better than treating it after it starts, so take what is prescribed on schedule rather than only when you feel sick.[3] Alongside that, dry and bland foods, small frequent portions, sipping fluids between meals rather than with them, and avoiding strong cooking smells all help.
6. Are there foods I should avoid?
If your white blood cell count is low, your team may advise avoiding raw or undercooked meat, fish, and eggs, unpasteurised dairy, and unwashed produce. Grapefruit and grapefruit juice can interfere with certain medicines. Ask your pharmacist about your specific drug list rather than relying on general lists online.
7. Can I drink alcohol?
Ask your oncologist. Alcohol can irritate a sore mouth, interact with several medicines, and add strain to a liver that is already processing chemotherapy. Many patients are advised to avoid it entirely during treatment.
8. Should I take supplements or antioxidants?
Tell your team about everything you take, including vitamins and herbal products. Some supplements interact with chemotherapy, and high-dose antioxidants during treatment are debated because of the theoretical possibility of blunting the treatment’s effect. Nutrients from food are not the concern; high-dose pills are.
9. I have mouth sores. What can I eat?
Choose soft, moist, mild foods: smoothies, yoghurt, scrambled eggs, porridge, soups that are warm rather than hot. Avoid acidic, salty, crunchy, and spicy foods. A gentle salt-and-baking-soda rinse several times a day can be soothing, and your team can prescribe a mouthwash if the sores are painful.
10. What should I do about diarrhoea or constipation?
Report both, because they are managed differently and because severe diarrhoea can become dangerous quickly.[4] For diarrhoea, prioritise fluids with some salt and sugar, and simple low-fibre foods until it settles. For constipation, increase fluids and fibre gradually and ask about a stool softener, as many anti-sickness and pain medicines slow the bowel.
11. Should I use nutrition drinks?
They can be useful when you cannot eat enough ordinary food. Reviews of oral nutritional supplements in patients with cancer show they help increase intake, particularly for people who are already losing weight.[5] They work best as an addition to meals rather than a replacement for them.
12. When should I call my care team?
Call promptly if you cannot keep fluids down for more than a day, if you have lost more than about two kilograms without trying, if you have several loose stools a day, if you have not passed stool in three days, or if you have a fever. Weight loss and dehydration are easier to fix early than late.
A simple plan for a hard week
- Keep a protein source at every eating occasion, even small ones.
- Sip fluid steadily through the day rather than in large amounts at once.
- Eat the most on the days you feel best; expect the days after infusion to be lighter.
- Keep a short food and symptom note to bring to your next appointment.
- Ask for a referral to an oncology dietitian. You do not need to be losing weight to qualify.
References
- Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. PMID: 27637832.
- Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME. Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. J Clin Oncol. 2005;23(7):1431-1438. PMID: 15684319.
- Roila F, Molassiotis A, Herrstedt J, et al. 2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol. 2016;27(suppl 5):v119-v133. PMID: 27664248.
- Bossi P, Antonuzzo A, Cherny NI, et al. Diarrhoea in adult cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2018;29(Suppl 4):iv126-iv142. PMID: 29767689.
- Baldwin C, Spiro A, Ahern R, Emery PW. Oral nutritional interventions in malnourished patients with cancer: a systematic review and meta-analysis. J Natl Cancer Inst. 2012;104(5):371-385. PMID: 22345712.
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