Nutrition and Cancer

The staff at your doctor’s office wishes to support your nutritional needs during your treatment.  Your personal dietary goals will vary based on the type of treatment you receive, the duration of your treatment, and your nutritional status at the beginning of your treatment.

Some patients do not experience any nutritional problems during their treatments, some experience only a few minor issues and a small group will require significant nutritional support or guidance.  Depending on your needs, dietary recommendations will be made that best ensure your nutritional health.

Special Diets

If you were eating well and maintaining your normal weight before you start treatment, you do not need a special diet. However, dietary changes designed to maintain your pretreatment weight might be necessary if you lost weight before you were diagnosed or if you lose a significant amount of weight during treatment, or if you experience difficulty eating. If you do develop diet related issues, talk to your physician or call our triage nurse.

We do not want you to lose weight even if you were overweight before you started treatment.  Cancer, and the methods used to treat cancer, can be debilitating, and weight loss under these conditions can result in a patient’s feeling weak, tired, or “just not right.” Therefore, weight loss is not advised during cancer treatment.

What is a Healthy Diet?

A healthy diet supplies all of the calories, protein, vitamins, minerals, and fluid you need to maintain a healthy weight, and ensure proper function of your gastrointestinal tract.

Of all nutrients, water is the most important. Water makes up over half of our body weight, allows for the transport of nutrients to our cells, allows for the excretion of waste products from our bodies, and ensures the smooth function of all of our organ systems. The U.S Dietary Guidelines recommend that Americans drink between 64 ounces and 80 ounces of fluid each day. It may sound like a daunting task, but we can all achieve this by drinking 4 ounces of liquid for every hour that we are awake.

Then there is the question of fueling our bodies. Our body prefers to run on a type of sugar called glucose, which our intestinal systems supply by breaking down the sugars and starches we eat. Sugar is found in fruit, table sugar and sweets, milk and milk products, and many baked or processed foods. Starches include foods like bread, cereal, rice, pasta, other grain products, potatoes, and winter squashes.

Your body does not know the difference between glucose that comes from starch and glucose that comes from sugar, so you should eat whatever types of these foods that appeal to you. Your body breaks down all starches to sugar and it is not necessary to avoid simple sugars like candy. Feel free to try the candy that has been set out for patients in various locations throughout the cancer center. It is a myth that eating sweets will make some cancers grow faster.

The structural parts of our bodies are based on protein. Some protein can be found in starches and vegetables, but complete protein sources include animal products like meat, poultry, fish, eggs, milk, and milk products. You should try to eat at least two servings of protein per day. A serving size of meat, fish, or poultry is 3 ounces, which is roughly the size of one deck of cards.  A serving of milk is one cup, and a serving of eggs is two large eggs.

Vitamins and minerals needed to repair, replace, and fuel our cells are found in many different foods, but some are more abundant in certain types of food.  In general, the foods that are unprocessed contain the most nutrients. Examples include fresh meat, chicken, fish, milk, vegetables, fruit, and whole grains. During the 1930, there were many persons who developed nutrient deficiencies in the U.S as a result of the depression. In order to help prevent nutrient deficiencies, the US began the enrichment and fortification of food during the 1940s. At that time, the US began fortifying all grain products with the B-vitamins, thiamin, riboflavin and niacin as well as iron. These nutrients are often lost during processing. Since this time, the grain enrichments laws ensure that most rice, pasta, cooked cereals in the have been enriched. Then in 1996, a lack of folic acid was linked to neural tube defects in newborns, folate was also added to grains. The grain enrichment laws ensure that most rice, pasta, cooked cereals, and breads sold in the U.S. have been enriched. The Food Guide Pyramid guidelines recommended that all persons eat a minimum of six servings from the grain group daily. However, whole grains are recommended over refined and enriched products because of their link to a reduction in cancer, cardiovascular disease and overall health.

Fiber is also much more abundant in whole grain foods than processed grain foods, so whole grains are preferable for healthy individuals. However, depending on your illness, and its treatment, you may actually be advised to avoid whole grains while under our care.

Iron, although added to most grain products, is not well absorbed from these foods and will probably need to be supplied by other foods in your diet. Meat, fish, or poultry are the best sources of dietary iron. If you do not wish to eat these foods, and you are found to be iron deficient, you should ask your physician if an iron supplement might be appropriate during your treatment.

Fresh, frozen, or dried fruits and vegetables offer plentiful levels of vitamins and minerals, while canned fruits and vegetables are less abundant sources of these nutrients because of the high temperatures used in the canning process. The adult goals for fruits and vegetables are at least three servings of vegetables per day, and at least two servings of fruit per day.  One-half-cup of most vegetables equals one serving size. One cup of fruit equals one serving for most fruits.

Milk is such a good source of protein, sugar, vitamins, and minerals, that it has its own food group. If you are able to drink milk, or eat milk products, they are important nutrient sources in your diet. if you cannot drink milk, or eat milk products, the dietitian can suggest other foods, or supplements, that supply these valuable nutrients.

Just Plain Calories

The most concentrated form of calories available in your diet comes from fat. Good sources include butter, margarine, oils, whole milk, meat, and poultry. You should not avoid these foods unless advised to do so by your physician. In addition to being an excellent source of calories, fats also supply us with the fat-soluble vitamins A, D, E, and K.

Some patients need more fat in their diets during cancer treatment in order to maintain their pre-illness weights. Consider this a plus! The New Mexico Cancer Center may be the only doctor’s office you ever visit where you will not be criticized for eating a hot fudge sundae!

Nutrition and Cancer Research

According to the National Cancer Institute, nutrition guidelines for cancer prevention may help cancer survivors prevent the development of a second cancer. The relationship between diet and cancer continues to be studied, but the strongest link between diet and cancer prevention is the relationship between a diet high in fruits and vegetables and whole grains and a reduced risk of lung, prostate, breast, and gastro-intestinal cancers. For this reason, the National Cancer Institute is a primary supporter of the Eat 5 to 9 a Day Program to promote increased intake of fruits and vegetables among Americans.

Frequently asked questions

What if I am already on a physician recommended diet?
You should discuss this with your physician and the dietician here at New Mexico Cancer Center. He or she may wish you to continue on this diet while you are being treated; or prefer that you stop while you are a patient here. The patients who most often need to continue on their previous diets are diabetics, and patients with pre-existing digestive problems.

Can I continue to take the vitamin, mineral and herbal supplements that I took before treatment?
Nutritional supplements are another matter that you should cover with your doctor. Some supplements, particularly herbal supplements, can interfere with the treatments that you receive in our facility.

What are the most common diet related problems of cancer therapy?
The most common problems are constipation or diarrhea, while patients taking certain medications and/or receiving chemotherapy sometimes experience nausea or vomiting.    Patients who receive head and neck radiation, or radiation to part of the intestinal tract, have other issues that can lead to difficulty tolerating certain foods.

Should any of these problems affect you, they need to be addressed individually. You should inform your treatment nurse, or the center’s telephone nurses, if you experience any of the intestinal problems mentioned above. The nurses may be able to help you immediately, or they may refer the problem to someone else. Either way, telling a staff nurse about your side effects is the quickest way to find the right solution to your problem.

Keeping track of the foods you eat

The food pyramid is an excellent guide to the number of servings of each food group needed by adults.  If you have no digestive problems, try to select unprocessed foods to ensure that you receive adequate amounts of fiber, and recently discovered compounds called phyto-nutrients, which are not found in processed foods.

What foods are in the grain group?
Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain product.  Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples of grain products.  Grains are divided into 2 subgroups, whole grains and refined grains.
Whole grains contain the entire grain kernel — the bran, germ, and endosperm.

Examples include:

• whole-wheat flour
• bulgur (cracked wheat)
• oatmeal
• whole cornmeal
• brown rice

Refined grains have been milled, a process that removes the bran and germ. This is done to give grains a finer texture and improve their shelf life, but it also removes dietary fiber, iron, and many B vitamins.

Some examples of refined grain products are:

• white flour
• degermed cornmeal
• white bread
• white rice

Most refined grains are enriched. This means certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron are added back after processing. Fiber is not added back to enriched grains. Check the ingredient list on refined grain products to make sure that the word “enriched” is included in the grain name. Some food products are made from mixtures of whole grains and refined grains.

What foods are in the vegetable group?
Any vegetable or 100% vegetable juice counts as a member of the vegetable group. Vegetables may be raw or cooked; fresh, frozen, canned, or dried/dehydrated; and may be whole, cut-up, or mashed. Vegetables are organized into 5 subgroups, based on their nutrient content.

What foods are in the fruit group?
Any fruit or 100% fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed.

What foods are included in the milk, yogurt, and cheese group?
All fluid milk products and many foods made from milk are considered part of this food group. Foods made from milk that retain their calcium content are part of the group, while foods made from milk that have little to no calcium, such as cream cheese, cream, and butter, are not. The US Department of Agriculture normally recommends that milk group choices should be fat-free or low-fat. This does not hold true for cancer patients, who may need the extra calories provided by high fat foods.  You should not limit your fat intake unless you weight rises above you pre-illness weight.

What foods are included in the meat, poultry, fish, dry beans, eggs, and nuts (meat & beans) group?
All foods made from meat, poultry, fish, dry beans or peas, eggs, nuts, and seeds are considered part of this group. Dry beans and peas are part of this group as well as the vegetable group.

As with milk products, the USDA recommends that most meat and poultry choices should be lean or low-fat. Fish, nuts, and seeds contain healthy oils.  However, we do not recommend that you avoid high fat foods unless your weight rises above your pre-illness weight.

What are “oils”?
Oils are fats that are liquid at room temperature, like the vegetable oils used in cooking. Oils come from many different plants and from fish.

Some common oils are:

• canola oil
• corn oil
• cottonseed oil
• olive oil
• safflower oil
• soybean oil
• sunflower oil

Most oils are high in monounsaturated or polyunsaturated fats, and low in saturated fats. Oils from plant sources (vegetable and nut oils) do not contain any cholesterol. In fact, no foods from plants sources contain cholesterol.

A few plant oils, however, including coconut oil and palm kernel oil, are high in saturated fats and for nutritional purposes should be considered solid fats.

Solid fats are fats that are solid at room temperature, like butter and shortening. Solid fats come from many animal foods and can be made from vegetable oils through a process called hydrogenation.

Some common solid fats are:

• butter
• beef fat (tallow, suet)
• chicken fat
• pork fat (lard)
• stick margarine
• shortening

*Information on the Food Pyramid is from the USDA website: www.foodpyramid.com/mypyramid/