Cancer has undoubtedly affected almost every person in some or other way. Globally it has contributed to an estimated 14.1 million cancer cases, 8.2 million cancer deaths and 32.6 million people living with cancer in 2012, according to the GLOBOCAN 2012 project.
In South Africa specifically there were 57 000 known cases in 2009 of which the top 5 most common cancers for men and women, according to the National Cancer Registry (2009) are shown below:
- Prostate cancer
- Cancer of unknown primary (CUP)
- Kaposi sarcoma
- Lung cancer
- Colorectal cancer
- Breast cancer
- Cervical cancer
- Cancer of unknown primary (CUP)
- Kaposi sarcoma
- Colorectal cancer
HOW DOES CANCER AFFECT YOU IN TERMS OF NUTRITION?
The dietary needs of a person with cancer as well as those undergoing treatment may differ from those of a healthy person. A healthy person can quite easily follow healthy eating guidelines and eat enough food to maintain their weight. A cancer patient may not find that task as easy due to the various possible side-effects that may come about from treatment or the cancer itself. In such cases it may be extremely challenging to consume enough energy and protein to meet dietary needs and this may mean that you need to consume foods that are not normally recommended. For example, you may need to eat high fat, energy-dense food in order to maintain your weight. The dietary needs of people with cancer however differ from person to person so it is important to discuss this with a registered dietitian who is part of your cancer treatment team.
Maintaining a good nutritional status during cancer and cancer treatment is absolutely essential because it plays such a pivotal role in your recovery. Eating well will enable you to feel better, stronger, support your immune system, help you to maintain your body weight which in itself also assists recovery and it is also allows you to tolerate the side-effects of treatment better.
GET PREPARED BEFORE TREATMENTS STARTS
It is important to understand what lies ahead of you and to prepare yourself as best possible to give yourself the best chance at dealing with the challenges of cancer treatment. So learn, read and ask as many questions as you can about your cancer and the treatment you are taking. Being prepared and taking action beforehand will also reduce anxiety.
Here are a few steps you can take to prepare yourself:
- Start eating well in advance, before you start treatment so that you are in a habit of it.
- Speak to your friends and family about ways they can help you such as cooking, cleaning or shopping.
- Speak to your cancer treatment team about any concerns you may have regarding your diet and allow them to help you make the right changes.
- Keep your kitchen cupboard well stocked with all of the healthy foods you normally enjoy and those that you know you can eat when feeling sick.
- Keep the cupboard also stocked with foods you can eat when struggling with a side-effect that may be common for your type of treatment. For example, mouth sores are common with radiation therapy of the mouth and throat so you’ll need to stock cold foods such as ice cream or milkshake.
- Cook in advance and freeze single meals and stock foods which need little preparation or cooking.
TIPS TO EAT WELL ONCE TREATMENT STARTS
There are many benefits of eating well during cancer treatment. The most important one is that you ensure that your body has enough reserves and nutrients in order to support the immune system in defending against infection, preventing body tissue breakdown and assisting with rebuilding and repairing.
Below are a few tips to follow to ensure you eat well amidst difficult circumstances (remember that each person’s requirements may differ so it is also important to individualise these tips, which your registered dietitian will be able to do):
- Although weight changes are normal, try to stay at a healthy weight.
- Be physically active because it will help you to maintain your muscle mass, strength and bone mass. It can also reduce depression, anxiety, fatigue and constipation. If your doctor approves it, start slowly and aim for 150 minutes per week.
- Eat when you have the biggest appetite which is in the morning for most people.
- Drink plenty of liquids and aim for 8-12 glasses per day. If you cannot eat then try to drink something such as milk instead.
- Eat 5-6 portions of fruit and vegetables per day. ½ a glass (125ml) of fruit/veggie juice is the equivalent of 1 serving.
- Avoid alcohol.
- Increase energy and protein if losing weight or are at risk of losing weight:
- Make a high energy and protein FUTURELIFE® smoothie such as the recipe below.
- Buy other high energy and protein shakes.
- Enjoy high protein bars such as FUTURELIFE® High Protein SmartBar, FUTURELIFE® High Protein LITE SmartBar and FUTURELIFE® Crunch Bar.
- Use sugar, oil, peanut butter, butter, milk powder, FUTURELIFE® powdered range or cheese to add to foods to increase the energy and protein content. Add to porridge, stews, soups etc.
- Snack more and try to eat or drink something every 2 -3 hours
- Dairy products such as FUTURELIFE® Smart Drink™ are excellent sources of protein. In cases where these are not well tolerated, you can consume cultured dairy such as yogurt which will be easier to digest.
- When unable to eat then rather drink something that provides energy, protein and nutrients such as a meal replacement, energy/protein supplement such as FUTURELIFE® Smart food™, FUTURELIFE® HIGH PROTEIN Smart food™, milk, juice, soup, milkshake etc.
- Eat 5-6 smaller meals instead of 3 big meals.
- Always keep snacks nearby for when you do feel like eating.
- Eat when your appetite is most normal.
- Exercise with approval of your doctor which will increase appetite.
- Try a bedtime snack.
- Add extra protein and energy to your diet by following the steps given earlier.
- Avoid drinking liquids with meals which will fill you up quicker.
- Increase physical activity which increases gastrointestinal activity and will help to alleviate symptoms of constipation.
- Drink at least 8 glasses of fluid per day and replace lost fluids if vomiting.
- Drink hot liquids such as coffee or tea.
- Eat high fibre foods if you are allowed to, as with some cancers you need to avoid fibre.
- Replace all fluids and electrolytes lost.
- Eat foods that contain electrolytes such as bananas, potatoes and FUTURELIFE® High Energy SmartBar.
- Avoid high fibre foods that may worsen diarrhoea.
- Eat grated apple which has been left to go slightly brown which is high in “soluble fibre”. This helps to prevent diarrhoea by soaking up liquid and creating a gel thus thickening stools.
- Avoid foods which worsen diarrhoea (fatty food, very high sugar drinks and food, alcohol, sugar-free products containing xylitol or sorbitol, including apple juice).
- Try easily digestible foods (yogurt, clear liquids, carbonated drinks, canned bland fruit and vegetables).
- Avoid foods that are fatty, very sweet, spicy or have a strong smell.
- Eat small but regular meals.
- Eat before getting hungry.
- Drink liquids in between meals but not with meals.
- Eat dry crackers or toast .
- Avoid drinking if vomiting, wait until vomiting is under control and then drink small amounts of clear liquids.
Smell & taste changes
- Avoid foods which smell and taste bothers you. You can reduce the small by using a straw, drinking through a travel mug, put a fan on when cooking or serve foods at room temperature.
- Focus on foods which smell and taste good to you.
- Try tart foods such as citrus fruit, sherbet or lemon custard.
- Add sweetness to foods if they have a salty, bitter taste to you.
- Marinate food to enhance flavour.
Swallowing difficulty & mouth or throat sores
- Choose foods that are easy to chew and swallow (custard, yogurt, milkshake, scrambled eggs, soup, FUTURELIFE® Smart Food™, FUTURELIFE® HIGH PROTEIN Smart food™ and FUTURELIFE® Smart Oats®).
- Cook food very well, cut into small pieces and you can even liquidize foods.
- Drink through a straw.
- Suck on ice chips to soothe painful sores and inflammation.
- Eat food that is cold or at room temperature.
- Avoid foods that cause pain (spicy, hot, raw, salty or acidic foods).
GOOD FOOD HANDLING PRACTICES
It is important to ensure that you use hygienic food handling practices to ensure that you do not get sick because often cancer patients on treatment have weakened immune systems and will therefore struggle to fight off food-borne infections.
Below are hygienic food-handling practices:
- Wash your hands thoroughly before and after cooking and before eating.
- Keep hot foods hot (>60˚C) and cold foods cold (<4˚C) so refrigerate leftovers as soon as possible.
- Do not defrost food at room temperature but rather allow them to defrost in the refrigerator or in the microwave. Once defrosted, use straight away and do not re-freeze.
- Wash fruit and vegetables well before peeling or cutting.
- Look at the expiry date of foods and consume within that date.
- Do not lick a utensil and then put it back in the dish.
- Avoid cross-contamination of foods by using a clean knife to cut different foods and use a separate cutting board for raw meat, chicken and fish. Also do not use the same plates or utensils for raw and cooked meat.
- Avoid eggs with cracked shells.
- Ensure food is well packaged and that cans aren’t dented, swollen or rusted.
Remember that you’re not alone. Don’t be afraid to seek help from your cancer management team, family and friends. Things may be overwhelming at first but there’s always a way to manage the possible side effects.
WHERE DOES FUTURELIFE® FIT IN?
The FUTURELIFE® powdered range makes the perfect base for any smoothie. We would recommend using FUTURELIFE® HIGH PROTEIN Smart food™ as it is:
- High in energy- thereby assisting you in meeting your daily calorie requirements.
- High in protein- thereby assisting you in meeting your protein requirements.
- High in dietary fibre- thereby assisting you in meeting your fibre requirements and prevention constipation.
- Contains inulin- a prebiotic fibre which assists in the digestion and absorption of nutrients.
- Meets 100% RDA per 100g for most vitamins and minerals.
- High in omega-3- this may be lacking in your diet if you are unable consume sufficient amount of food sources of omega-3.
- It is price competitive (if not cheaper) compared to other powdered “supplements” most cancer patients rely on if they are experiencing weight loss and loss of appetite.
- Comes in 2 flavours- vanilla and chocolate so you can choose your flavour preference.
- It is versatile- it can be enjoyed as a meal, shake or smoothie at breakfast, lunch, dinner or as a snack.
It can be mixed instantly with just water or milk and requires no cooking- saving you time and energy.
- University of Stellenbosch. Dietary treatment of cancer patients. Http://sun025.sun.ac.za/portal/page/portal/Health_Sciences/English/Centres%20and%20Institutions/Nicus/Nutrition_Facts_sheets/Cancer%20-%20Treatment.pdf
- LK Mahan, S Escott-Stump. Krauses’s Food and nutrition therapy. 12th Saunders, 2008.