We all know nutrition is of utmost importance to cancer patients. Poor nutrition may keep patients from starting or continuing treatment, which is something none of us want to see happen. I have been noticing more and more lately how much nutrition, chemotherapy, and radiation are all interrelated.
Cancer and cancer treatment can cause taste changes, which in turn causes poor nutrition and weight loss. With radiation in particular, taste changes can last for upwards of a year, so this is something that is very important to address.
The biggest complaint from patients is that food and beverages have a metallic taste. Surprisingly, elemental zinc can help to combat this complaint. The doctor must give the "OK" to add this to their medication regimen as this is considered a medication -- but a simple and fairly cheap remedy. An over-the-counter bottle can be purchased at the pharmacy for a mere $5 for 100 tablets. Here are a few other tips to help those patients experiencing taste changes:
- Use plastic utensils (no metallic taste).
- Promote good oral hygiene, especially before eating.
- Patients with mucositis should avoid certain seasonings -- they may need to experiment.
- A piece of advice I offered a patient recently was to not eat her favorite foods again until other foods were starting to taste better.
- Eat meat and other foods at a cooler temperature.
- Add fresh lemon juice to supplemental drinks to help lessen the sweetness of them and/or diminish the bitter aftertaste.
- Add a pinch of salt to decrease the sweetness of foods.
Some common side effects of cancer treatment can cause decreased nutrition. Contributors to poor nutrition include fatigue, nausea, vomiting, and anorexia. Like taste changes, these side effects have simple fixes, which we can encourage our patients to abide by.
An example of this would be to encourage patients to eat in the morning. Generally speaking, fatigue and anorexia are most minimal in the morning, so encourage patients to eat a high-protein, high-calorie, nutrient-dense breakfast. Also, inform patients to eat small, frequent meals. This can help to increase appetite as well as decrease nausea. High-carbohydrate, low-fat foods help to decrease nausea and vomiting, as they help to decrease acidity in the stomach.
When it comes to fluid intake, oral fluids help with fatigue and nausea; however, they can contribute to anorexia. Teach patients to avoid carbonated beverages as these are empty calories and can contribute to the feeling of fullness too early on. If patients are suffering with fatigue, nausea, or vomiting, encourage adequate oral hydration as dehydration can contribute to these side effects of treatment. Also, if patients are suffering anorexia, oral hydration is still important, but encourage drinking between meals or after meals so that patients can fill up on nutrient-rich foods.
If patients are too tired to eat or simply donít have an appetite, encourage liquid supplements such as Ensure, Carnation Instant Breakfast, Glucerna, etc. These drinks are formulated to support nutrition, do not require as much energy expenditure to consume, and do not have a strong odor to them -- all things that combat nausea, vomiting, anorexia, and fatigue.
Lastly, multidisciplinary support is often required to combat side effects that contribute to poor nutrition. When patientsí pain and nausea are controlled, they often are more adept to eat. Depression due to treatment or diagnosis can contribute to poor eating habits; advocate for patients and make sure this is addressed if it is an issue. Dieticians can assist in food choices for patients who have comorbidities. Physical activity can oftentimes help to combat fatigue and increase appetite, so get patients moving early and keep them moving throughout treatment.
The better educated a patient is on how physical activity and nutrition contributes to the outcome of treatment, the more likely they are to participate in their care.
The recipe below may be a helpful option for cancer patients suffering with poor nutrition.
Peach Yogurt Frost:
- 1 envelope vanilla instant breakfast mix
- 1 cup low-fat milk
- 1 (6-ounce) container low-fat peach yogurt
- 1 cup frozen peaches (or other fruit) or 6-10 crushed ice cubes
- Add 1-2 tablespoons of powdered milk to increase protein intake (optional)
Combine all ingredients in a blender and blend until smooth. This recipe makes three servings (155 calories and 7 grams of protein per serving).
What have you found helpful for cancer patients experiencing taste changes and/or poor nutrition?