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Nutritional Counseling

Good nutrition is vital for cancer patients because they can have unique nutritional needs. Their nutritional status should be assessed throughout all stages of their cancer care from pre-treatment, to during treatment, after treatment and into survivorship.

With proper nutrition, cancer patients can take control of their life and well-being and give themselves the best chance to win the fight against cancer. Good nutrition is especially important for children and adults because both the cancer and its treatment can affect appetite and the body’s ability to tolerate food and use nutrients.

Cancer treatments like chemotherapy, radiation therapy and surgery, or a combination of treatments kill cancer cells but may also damage healthy cells in the process. This causes various side effects of cancer treatment and can affect the patient’s desire or ability to eat or drink. Side effects can include loss of appetite, weight loss, sore mouth or throat, dry mouth, dental and gum problems, changes in taste or smell, nausea, and vomiting.

Our Registered Dietitian in the Upstate Cancer Center is available to counsel patients and advise them on how best to maintain good nutrition before, during and after their treatments. To schedule an appointment, call 315-464-HOPE (4673) or ask your doctor to place a referral for nutritional counseling. There is a consultation fee, but some insurance plans reimburse for the service.

There is a grant available for cancer patients to receive nutrition counseling free of charge if the service is not covered by their insurance plan, or if a co-pay is required.

Symptom Management

Cancer treatments can cause side effects that may impact your ability to taste or smell, decrease your appetite, or impede your ability to eat, resulting in malnutrition. If left untreated, malnutrition can cause patients to be weak and unable to fight cancer and finish cancer treatments effectively. Common side effects may include fatigue, diarrhea, nausea and vomiting, and taste changes.

Fatigue

One of the most commonly reported side effects of cancer and cancer treatments is fatigue. Fatigue can include various symptoms such as weakness, tiredness, lack of energy, and dizziness. If you are experiencing fatigue-like symptoms that inhibit your day-to-day activities and your ability to continue a healthy diet, please speak with your health care team about ways to reduce your fatigue.

Tips for dealing with fatigue:

Nap periodically throughout the day.
Exercise when and where you can. Studies show that regular exercise reduces fatigue in patients currently undergoing cancer treatment and can also help maintain weight, muscle mass, elevate mood, and improve cardiac function. Always consult your doctor before beginning a new workout regimen.
Ask for help from family and friends with grocery shopping and meal preparation.
Eat frequent meals throughout the day instead of 3 large meals.
Quick snacks that can help combat fatigue include: apples & peanut butter, hard-boiled eggs, trail mix, fruit & yogurt, pretzels & hummus or cheese & crackers.
Choose foods that are easy to prepare and high in calories, protein, and fiber.
Drink plenty of water throughout the day. The average adult needs approximately 8 cups of water a day.
Limit diuretics such as tea, coffee, energy drinks, and soda to less than 2 cups a day. Consume these drinks in the morning to prevent them from affecting your sleep at night.

Diarrhea

Diarrhea is the passing of three or more loose stools a day. If left untreated, it can lead to severe symptoms such as weight loss, dehydration, and malnutrition. Many factors can cause diarrhea, but the most common is the type of cancer treatment a patient is currently receiving. Treatments such as radiation, immunotherapy, and chemotherapy specifically to the pelvic area or abdominal area can cause diarrhea. Other causes of diarrhea could be diet, cancer location, stress, infection, or recent surgery.

Tips for dealing with diarrhea:

Keep a food and symptoms journal. This will help to identify food patterns that may be contributing to diarrhea.
Eat small frequent meals throughout the day. Eat all meals slowly to allow time for food to digest.
Include foods that are high in probiotics into your diet. Foods like yogurt, kefir, and buttermilk help keep your gut healthy by restoring the bacteria's balance in your stomach.
Limit consumption of spicy food, fatty foods, caffeine and alcohol, and foods that can produce a high amount of gas.
Consume low fiber foods. Good examples include:
- Oatmeal, grits, or cream of wheat
- White bread, pasta, bagels, or English muffins
- Lean meat, fish, and eggs
- Nut butter
- Less than 2 cups of dairy a day including milk, ice cream, yogurt, and cottage cheese
- Cooked vegetables such as carrots, wax beans, mushrooms, beets, and squash
- Potatoes with skins removed

Nausea and Vomiting

Nausea and vomiting are common side effects of cancer and cancer treatments. It is the body's most effective way of eliminating offensive substances from the stomach. While many people perceive these to be lesser side effects to cancer and cancer treatments, nausea and vomiting can prevent patients from receiving the proper nutrition they need. Left untreated, they can cause more harmful side effects such as dehydration, slow wound healing, weight loss, and malnutrition.

Tips for dealing with nausea:

Avoid foods that emit strong odors. Choose cold or room temperature foods as these will have less of a smell that could exacerbate nausea.
When consuming beverages and soups, place them in a container with a fitted lid and straw. This will help reduce odors produced by drinks or soups.
Avoid sweet, greasy, or spicy foods.
Always keep something in your stomach by eating small snacks throughout the day, such as crackers, toast, or dry cereal.
Have crackers next to your bed for a quick bite to eat when you wake up.
Continue to drink lots of fluids. This will help with nausea and keep you hydrated.
Don't drink a lot of fluids all at once. Take a few sips at a time. Cold and hot beverages may upset an already nauseous stomach; try room temperature beverages instead.

Taste Changes

Patients undergoing cancer treatments often report that they have changes in their taste. These changes can range from food tasting differently, everything tasting the same, certain foods having a metallic or chemical taste, or nutrition having no taste at all. While it is found that cancer patients regain their taste after stopping treatments, changes in taste can have severe effects on patients while they are undergoing treatment. Taste changes may lead to loss of appetite, weight loss, and malnutrition.

Tips for dealing with changes in taste:

Recognize what tastes good to you. Some patients can only taste sweetness, bitterness, acidity, or saltiness. Flavor foods with these flavor profiles through herbs, spices, sugar, maple syrup, or citrus juices.
Marinate meats in fruit juices, salad dressings, or flavorful sauces.
Eat cold foods; these tend to taste better than hot foods.
Red meats may have a metallic taste to them. Swap them out for other protein choices such as chicken, fish, eggs, or beans.
Use plastic or glass cutlery and plates.
Rinse mouth frequently with baking soda solution. 1 teaspoon baking soda to 1 quart of room temperature water. This will help remove any bad tastes that may linger in your mouth and allow your taste buds to detect different flavors.
Try different textures such as crunchy, creamy, or crispy foods.
Don't give up on your favorite foods! Just because they don't taste good now doesn't mean that they won't taste better in a few weeks. Keep trying new things each week.

Cancer Treatment & Nutrition

Before, during, and after cancer treatments, it is essential to maintain a healthy diet full of the five primary food groups:

Whole-Grain
Protein
Fruits and Vegetables
Dairy
Healthy Fats

Cancer treatments will require an increase in daily calories and protein. Added nutrition can help you keep up your strength and energy, maintain a healthy weight, tolerate treatment side effects, and heal and recover faster.

Staff & Services

Katie Krawczyk, MA, CDN, CNSC

Food & Nutritional Services

Katie Krawczyk, MA, CDN, CNSC, is a registered dietician and certified nutrition support clinician who is available to meet with you to provide individualized counseling based on sound science. During her appointment, she will work with individuals to:

manage side effects related to treatment such as taste alterations, diarrhea, poor appetite, weight loss, dehydration, nausea and fatigue
answer questions regarding the vast amount of conflicting nutrition information available on the internet
prescribe alternate therapy such as oral supplements and tube feeding
educate on diet and lifestyle to reduce risk of recurrence

Tell your care team if you are interested in learning more about how to optimize your nutrition status to help with your cancer treatment. Your provider can place a referral to Katie.