What to eat during cancer

Try

• Bland, dry, starchy foods: toast, plain rice and crackers.
• Cold foods that do not smell much, such as yogurt, pudding and popsicles.
• Ginger in tea or food, if you like it. It does not replace anti-nausea medicine.
• Small sips of clear fluids through the day: water, broth, ginger ale, tea or sports drinks. If you are losing weight, choose drinks with calories.
• Do not skip meals. An empty stomach often makes nausea worse. Eat 5 or 6 small meals.
• Keep crackers by the bed and eat a few before getting up.
• After vomiting, wait until it stops, then take small sips of clear liquids, then soft bland food.
• Take anti-nausea medicine on time, as prescribed.
• Nausea can start 1 to 7 days after treatment (delayed nausea). Tell your team, because medicines can be changed.

Avoid

• Greasy, fried, very sweet or spicy food if it upsets you.
• Strong smells, such as cooking fumes, fish, onion, garlic and coffee.
• Your favorite foods on sick days, so you do not link them with feeling ill.

Call your doctor if: You cannot keep fluids or your medicines down.; Signs of dehydration: dizziness, weakness, confusion, or very little or dark urine.; Nausea is stopping you from eating, or you are losing weight..

Try

• High-protein foods first in the meal: eggs, cottage cheese, Greek yogurt, fish, chicken, beans.
• Energy boosters: butter or oil on food, whole milk, cheese, nut butters.
• Milkshakes, smoothies and soups when solid food feels like too much.
• A bedtime snack.
• Nutrition supplement drinks between meals if prescribed.
• Eat small meals every 2 to 3 hours, 5 or 6 times a day. Set an alarm if you forget.
• Eat within 1 hour of waking, and have your biggest meal when your appetite is best.
• Light activity can help appetite.
• Make meals pleasant: eat with family, in a relaxed place.
• If poor appetite lasts, ask your doctor about medicines that can help.

Avoid

• Filling up on water, tea or thin soup just before or during meals. Drink mostly between meals.

Call your doctor if: You are losing weight without trying.; Pain, nausea, mouth sores, constipation or low mood are stopping you from eating..

Try

• If meat tastes bitter or like metal: try chicken, fish, eggs, beans, tofu or yogurt instead.
• If food tastes bland: add lemon, herbs or marinades, if your mouth is not sore.
• Cold or room-temperature foods, which smell less.
• Rinse your mouth or brush your teeth before meals.
• Try new foods on days you feel well.
• Taste usually returns a few months after chemotherapy.

Avoid

• Metal forks and spoons if you notice a metal taste. Use plastic ones.
• Cooking smells. Keep food covered and stay out of the kitchen while food is cooking.

Call your doctor if: You are eating much less because of taste changes, or losing weight.; White patches or soreness in your mouth (this can be thrush, a fungal infection)..

Try

• Soft, moist foods: oatmeal, mashed potatoes, scrambled eggs, pudding, yogurt, soft pasta and milkshakes.
• Cold or room-temperature food. Ice chips can numb pain.
• Food cut very small or blended.
• Drink through a straw and use a small spoon for small bites.
• Rinse your mouth often with a mix of salt and baking soda in warm water, as NCI suggests.
• Check your mouth every day for sores, white patches, or red, puffy areas.
• Brush gently with a soft toothbrush and fluoride toothpaste. Guidelines (MASCC/ISOO) find that regular mouth care helps prevent mouth sores.
• Ask your doctor about numbing medicine to use before meals.
• For head and neck radiation, ask about a benzydamine mouthwash, which MASCC/ISOO recommends to help prevent mouth sores.

Avoid

• Spicy food.
• Sour and citrus foods: lemon, orange, tomato and pineapple.
• Salty foods such as pickles and chips.
• Hard or crunchy foods such as dry toast and nuts.
• Raw vegetables.
• Hot food and drinks.
• Alcohol, tobacco in any form, and mouthwash that contains alcohol.

Call your doctor if: Mouth or throat pain makes it hard to eat, drink or sleep.; Fever of 100.4°F (38°C) or higher.; White coating or patches in the mouth or on the tongue..

Try

• Moist foods with gravy, sauces, broth or soup.
• Sips of water all day, 8 or more cups unless your doctor has limited fluids.
• Sugar-free lozenges or sugar-free, non-acidic chewing gum to help make saliva. International guidelines (ISOO/MASCC/ASCO) support these.
• Ice chips or sugar-free popsicles to suck on.
• Rinse your mouth every 1 to 2 hours.
• Keep your lips moist with lip balm.
• Brush with fluoride toothpaste and floss every day. Use fluoride gel at bedtime if your dentist prescribes it.
• Ask your doctor or dentist about saliva substitutes (gels or sprays that wet the mouth). Guidelines support them, and pilocarpine tablets after head and neck radiation.

Avoid

• Alcohol, tobacco and mouthwash that contains alcohol.
• Dry, hard, spicy, sour or salty foods that hurt your mouth.
• Sugary foods and drinks between meals. A dry mouth raises the risk of tooth decay.

Call your doctor if: You cannot swallow food, or you are losing weight.; Mouth pain, sores or white patches..

Try

• Soft, smooth, moist foods: scrambled eggs, yogurt, oatmeal, mashed potatoes, mashed vegetables, pudding and milkshakes.
• Food softened with gravy, sauces, yogurt or broth.
• High-protein, high-calorie drinks if solids are hard.
• Sit upright with your head tipped slightly forward when eating or drinking. Stay upright for 30 minutes after. Take small mouthfuls and eat slowly.
• Eat 5 or 6 small meals a day.
• Ask for a swallowing assessment from a speech-language pathologist.
• If you cannot eat enough, tube feeding can keep you strong. Ask about it early.

Avoid

• Hot food and drinks.
• Spicy food.
• Acidic foods and juices such as citrus, tomato and pineapple.
• Sharp or crunchy foods.
• Alcohol and fizzy drinks.

Call your doctor if: Coughing or choking when you swallow, or a fever with cough (food or drink may be going into the lungs).; Pain or burning when swallowing that stops you eating or drinking.; You cannot drink enough, or you are losing weight..

Try

• Plenty of fluids at room temperature: water, clear broth, and drinks with salts such as sports drinks or oral rehydration solution.
• Low-fiber foods: white rice, white bread, plain pasta, applesauce and peeled boiled potato.
• Foods with salt and potassium: bananas, boiled potato and clear soups.
• Yogurt is often easier than milk.
• Eat small meals often.
• Keep a daily record of how many stools you pass and show it to your team.
• Keep the anal area clean and dry. A warm, shallow bath can soothe soreness.
• Only take anti-diarrhea medicine your doctor recommends. If you are on immunotherapy, call before taking any.

Avoid

• Milk, unless it is lactose-free.
• Fried, fatty and spicy food.
• Raw vegetables, beans, and fruit skins and seeds.
• Very hot or very cold drinks, caffeine, alcohol and fruit juice.
• Sugar-free sweets and gum (they contain sweeteners that loosen stools).

Call your doctor if: Seven or more stools a day above your usual number. This can be dangerous and may need hospital care.; On immunotherapy: any new loose or more frequent stools, belly pain, or blood or mucus in the stool. Call the same day.; Fever, blood or mucus in the stool, stomach cramps, dizziness or weakness.; Signs of dehydration: very little or dark urine, dizziness, fast heartbeat or confusion..

Try

• Plenty of fluids, about 8 cups a day unless told otherwise. Warm drinks such as tea, coffee or warm water can help.
• If your doctor agrees, more fiber: oatmeal, fruit, vegetables, stewed apple and prunes.
• Prune juice, which is a mild natural laxative.
• Fiber helps many people. But if constipation comes from opioid painkillers, or you cannot drink much, extra fiber can make it worse. Ask your doctor first.
• Be active every day. A short walk counts.
• Eat at the same times each day.
• Use only laxatives your doctor recommends. Do not use enemas or suppositories unless told to.
• Opioid painkillers and some anti-nausea medicines often cause constipation. ESMO advises a laxative for everyone who starts opioids, so ask for one.

Avoid

• Adding a lot of fiber without also drinking more.
• Gas-forming foods if you feel bloated.

Call your doctor if: Fewer than 3 bowel movements in a week.; Severe belly pain, vomiting or a swollen belly (this can mean the bowel is blocked).; Bleeding or soreness from the rectum..

Try

• Small, regular meals and snacks with protein.
• Enough fluids through the day.
• If you have anemia (low red blood cells), ask your team which iron-rich foods suit you, such as beans, eggs and lean meat.
• Do the most important tasks when you have the most energy. Keep naps under an hour.
• Light exercise such as walking can improve energy.
• Let family help with shopping and cooking. Cook and freeze small portions on good days.
• Ask your team to check for causes they can treat, such as anemia, pain, poor sleep, low mood, infection or dehydration.

Avoid

• Too much caffeine, and alcohol.
• Iron tablets or tonics unless prescribed.

Call your doctor if: Fever of 100.4°F (38°C) or higher with tiredness (this can mean infection).; Dizziness, confusion or very little urine (this can mean dehydration).; Tiredness that stops you eating, drinking or managing daily tasks..

Try

• Extra protein and energy in every meal: stir milk powder into soups or oatmeal; add butter or oil to rice and potatoes; add cheese, eggs or nut butter to dishes.
• Oral nutrition supplements if your team prescribes them.
• When you are losing weight, starchy and sweet foods such as bananas, rice and bread are a useful source of extra energy.
• Weigh yourself regularly and write it down.
• Weight loss makes side effects worse and treatment harder to complete, so act early.
• If eating by mouth is not enough, ask about tube feeding. Many people still eat by mouth alongside it.

Avoid

• Diets that cut calories, fasting, or cutting out whole food groups.
• Protein powders bought on your own, especially if you have kidney disease. Use what your team prescribes.

Call your doctor if: You are losing weight without trying.; You cannot eat for a week, or you are eating much less than usual..

Try

• Freshly cooked food served hot.
• Pasteurized milk and dairy, such as yogurt, cottage cheese and milkshakes made from it.
• Eggs cooked until the white and yolk are firm. Meat, fish and chicken cooked well.
• Fruit and vegetables you wash well, scrubbing firm skins.
• Wash hands with soap before cooking and eating. Ask family to do the same.
• Use separate cutting boards and utensils for raw meat and for produce. Keep raw and cooked food apart.
• Keep foods at safe temperatures and refrigerate leftovers promptly.
• Rules differ between hospitals. NCI notes that studies of a strict 'neutropenic diet' (a very restricted low-germ diet) found no clear benefit over a regular diet with careful food safety. Follow your own hospital's list.

Avoid

• Raw sprouts and food that has been sitting out.
• Raw (unpasteurized) milk and cheeses made from it.
• Runny eggs, and raw or undercooked meat, fish or tofu.
• Wheatgrass juice and home-made raw herbal juices.

Call your doctor if: Fever of 100.4°F (38°C) or higher, or chills. Call at once: infection during treatment can be life-threatening.; Do not take acetaminophen (Tylenol), aspirin or ibuprofen for a fever before talking to your team. They can hide signs of a serious infection.; Diarrhea, cough, sore throat, burning when passing urine, or redness or swelling where a line or port enters the skin..

Try

• Regular meals at fixed times, each with some protein, fiber and healthy fat.
• Whole grains, beans and vegetables, in measured portions.
• Whole fruit spread through the day, rather than juice.
• Water as your main drink.
• Steroids such as dexamethasone and prednisone can raise blood sugar even in people who have never had diabetes. After a morning dose, sugar usually rises by late morning and stays high into the evening.
• If you are asked to check at home, test 2 hours after lunch or just before dinner.
• If you have diabetes, tell your diabetes doctor when steroids or chemotherapy start, change or stop. Your medicines may need adjusting.
• Take steroids with or after food. Never stop or reduce them on your own.
• If you are losing weight, do not cut food to control sugar. Ask for your diabetes medicine to be adjusted instead.

Avoid

• Sugary drinks, fruit juice, sweets and sugar in coffee or tea.
• Skipping meals or cutting out carbohydrates completely. This is unsafe and often does not lower sugar.

Call your doctor if: Feeling very thirsty, passing a lot of urine, blurred vision, or feeling very tired or drowsy.; Blood sugar above 200 mg/dL for more than 2 days, or still rising.; Go to emergency if blood sugar is above 400 mg/dL, or if you have vomiting, fast breathing, fruity-smelling breath or confusion.; Blood sugar below 70 mg/dL if you take insulin or diabetes tablets..

The claim. Fights cancer and inflammation, and protects the body during treatment.

The evidence. Not proven to help any health condition, including cancer. Early research suggests curcumin mouthwash may ease mouth sores from treatment. Turmeric in normal cooking is generally considered safe, though MSK suggests mentioning it to your team during chemotherapy.

Is it safe? Supplements, especially 'high-absorption' curcumin products (for example with black pepper extract), have been linked with liver injury. Turmeric may increase bleeding with blood thinners, and in lab studies it blocked some chemotherapy drugs. It can raise side effects of tacrolimus, a transplant drug, and NCCN lists curcumin among supplements you may be asked to stop because of drug interactions. Stop and see a doctor if you get tiredness, dark urine or yellow eyes.

The claim. Builds strength, reduces stress and boosts immunity.

The evidence. Some preparations may help sleep and stress. Lab studies suggest effects on cancer cells, but this has not been seen in people.

Is it safe? Rare but serious liver injury has been reported, and it should be avoided with cirrhosis. It is not recommended before surgery, with thyroid or autoimmune disease, or in pregnancy. It may interact with diabetes, blood pressure, sedative, anti-seizure and thyroid medicines and immunosuppressants. It may raise testosterone, so people with hormone-sensitive prostate cancer should avoid it.

The claim. 'Green blood' that cures cancer, cleans toxins and raises blood counts.

The evidence. There is no scientific evidence that wheatgrass prevents or treats cancer. A few small studies suggest fewer infections or smaller drops in white cells during chemotherapy, but they are too small to rely on.

Is it safe? It can cause nausea. It is drunk raw, and wheatgrass is grown from sprouts, so germs are a concern. Avoid it when your blood counts are low or after a transplant, when raw sprouts and raw vegetables are on the avoid list.

The claim. Makes the body less acidic so cancer cannot grow.

The evidence. A systematic review (a study that pools all research on a question) found no evidence for or against alkaline water or diets for preventing or treating cancer. The body keeps its acidity stable whatever you eat.

Is it safe? Not harmful in itself, but it costs money and offers no cancer benefit. Do not let it replace treatment or normal meals.

The claim. Protect healthy cells from chemotherapy and radiation therapy.

The evidence. There is no proven benefit. In a large breast cancer trial, taking antioxidant supplements before and during chemotherapy was linked with a higher chance of cancer coming back, and vitamin B12 and iron pills were also linked with worse results. A standard multivitamin was not.

Is it safe? Guidelines advise against high-dose vitamins unless a test shows a shortage, and NCCN advises avoiding antioxidant supplements during chemotherapy and radiation therapy. Some supplements can make radiation therapy and chemotherapy work less well. High-dose beta-carotene pills raised lung cancer risk in smokers.

The claim. Build muscle and strength.

The evidence. For healthy people, a varied diet usually gives enough protein and extra powder does not build more muscle. For people with cancer who cannot eat enough, prescribed oral nutrition supplements do help.

Is it safe? High protein can worsen kidney function in people who already have kidney disease. Use the supplement your team prescribes rather than buying one on your own.

The claim. Improve gut health and prevent diarrhea.

The evidence. Mixed, and guidelines disagree. MASCC/ISOO and ESMO suggest probiotics containing Lactobacillus may help prevent diarrhea from radiation therapy to the pelvis. ESPEN found the data not strong enough to recommend them routinely. In people on immunotherapy, one observational study linked probiotic use with poorer results.

Is it safe? Ask your oncologist before starting, especially during immunotherapy or when your immunity is very low. ESMO notes that probiotics rarely cause serious infection in people with weak immunity.

The claim. Stops weight loss and muscle wasting.

The evidence. Mixed. ESPEN gives a weak suggestion for it in advanced cancer during chemotherapy with weight loss, and ESMO says supplement drinks enriched with omega-3 may be offered during treatment. A review of 38 studies found no benefit for cancer-related wasting, and UK guidance (NICE) says not to offer it for weight loss in pancreatic cancer that cannot be removed.

Is it safe? Ask your team before taking it.

The claim. Prevents mouth sores and diarrhea from treatment.

The evidence. Mixed. MASCC/ISOO suggests glutamine by mouth may help prevent mouth sores during chemoradiation for head and neck cancer, but advises against glutamine through an IV for transplant patients. ESPEN found the data not consistent enough to recommend it.

Is it safe? Do not start it on your own. Ask your team.

The claim. Natural, so safe, and they strengthen the body during treatment.

The evidence. There is no evidence that natural remedies stop cancer coming back or improve survival. Most herbs have never been tested together with chemotherapy.

Is it safe? Herbal products can interfere with how drugs are broken down, making them weaker or more toxic. Many supplements are not tested the way medicines are, and NCCN notes that many do not contain what the label says or contain unlisted ingredients. Show every product, with its bottle or package, to your oncologist.

The claim. Prevents or treats cancer.

The evidence. There is no strong evidence that vitamin D affects cancer growth. It does matter for bones, especially with hormone therapy for breast or prostate cancer. Your body makes vitamin D when your skin is in sunlight, and WCRF says to stay safe in the sun.

Is it safe? Get a blood test first. Take the dose your doctor advises, as too much calcium or vitamin D is harmful.