A diagnosis of cancer makes people understandably fearful and, say specialists, they often experience a loss of independence.
This encourages them to want to take a more active involvement in one area of life that they can influence — what they eat.
When asked, doctors are quite likely to tell a patient to “eat what you like”. They are not, says Kellie Anderson, a health educator at the Maggie’s Cancer Caring Centre in Edinburgh, being as flippant as this may sound.
“Everyone’s physical response to cancer treatment is unique, so it is impossible to give blanket advice on how to eat and which foods will suit you,” Anderson says. “The digestive system gets knocked for six because treatments affect rapidly dividing cells in our bodies and the mouth and digestive tract are lined with such cells.”
Taste can be affected; some people’s perception of sweetness increases and others find salty foods less salty. Some people experience “mouth blindness” and so detect little or no flavour.
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“It can also cause people to experience anything from mouth ulcers to diarrhoea or constipation,” Anderson says. “Suddenly, ‘textbook’ healthy eating becomes inappropriate. Hence a doctor’s standard advice is to eat what and when you fancy.”
This can leave patients rather at sea, as many want to make healthy changes. “I do juicing demonstrations because while foods like broccoli and cabbage, beetroot and carrots may not appeal or be digestible in their whole form during treatment, they may become so when juiced.”
There are also times when foods such as cakes, biscuits and puddings may be useful. About 40 per cent of people lose significant weight at the time of diagnosis, which can pose treatment challenges. Eating what you fancy and having higher-calorie snacks between meals is the best way forward.
As Richard Wilson, director of nutrition and dietetics at King’s College Hospital, London, explains: “Every mouthful of food has to pack a calorie punch. You need an energy-based diet with plenty of protein and calories, so fortifying food with melted butter, grated cheese or cream; choosing high-fat options such as pastry and full-fat milk; and eating six small meals a day instead of three large ones may be helpful.”
Of course, eating nutritious foods can bolster your immune system and help to avoid infections during treatment. Jane Freeman, a specialist cancer dietician at the London Oncology Clinic, says: “This means having fruit, vegetables and lean protein foods that include dairy, which are important for healing and repair. It’s good to include wholegrain cereals for antioxidants, energy and digestive health, plus nuts and seeds and omega-3 rich oils.” But Freeman says that sometimes the body craves and does better with something like home-made chicken soup, shepherd’s pie or rice pudding.While many people lose weight during treatment, weight gain can be an issue, especially for those who have had breast cancer. Many women who receive follow-up treatment after surgery for breast cancer gain 2lb-14lb in the first year. “This can be put down to fatigue, hormonal treatments, steroids, emotional issues and reduced activity,” Freeman says.
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Diet advice changes after treatment. In a booklet called Eating Well and Being Active after Treatment, the World Cancer Research Fund advises people to be as lean as possible without being underweight and to follow a nutritious, balanced diet. Avoid sugary drinks, cakes, biscuits and puddings.
It also says processed meats (bacon, salami, ham), should be banned and red meat limited. Alcohol should not exceed two drinks a day for men and one for women.