How to - and what - to eat during chemo.

Eating during chemotherapy was sometimes a battle!

This isn’t a sermon about nutrition or a lecture on fasting during chemotherapy. But here’s what worked for me. I hope it helps!

Firstly, everyone’s chemo experience is different. And secondly there are hundreds of different combinations of chemotherapy drugs, each with their own - long! - list of side effects. So what worked for me may not be right for you.

Based on advice I was given by an oncology nutritionist, I evolved a way of eating during chemo that kept me feeling nearly normal. It helped stave off fatigue, nausea and kept my energy up. It was especially useful during the famous red devil chemo, when food can become a battleground.

I’m not a clinical nutritionist but what I did worked. It showed in my blood. The first thing the oncology nutritionist said to me each round was “Wow, what’s your secret?”

Before and during chemo

Before each infusion, I packed a box of chemo snacks, which I kept within easy reach. Some healthy, some not so much. Some savoury, some sweet. I found my taste buds changed. One round, I craved toast and marmite. Another, the only thing that made me feel better was chocolate. I just went with it for the first few days.

On the morning of chemo, I had a normal breakfast. I read up about chemo fasting and while there may be some evidence that it helps with nausea and improves chemo efficacy. But I decided it wasn’t for me. I’m rubbish when I’m hungry!

During the infusion, I would make sure I drank loads. And ate snacks rather than a meal. I was told not to take anything you really, really love to the chemo ward. Wise words! There are a few things I will never, ever eat again. Favourite foods can easily become repulsive when you associate them with chemotherapy.

All dressed up and out for dinner, in the good weeks

When you feel really sick

For me, the worst side effect in the first few days was nausea and vomiting. In spite of fistfuls of anti nausea meds, I still managed to have breakthrough puking. Which was fun. And made it hard to get food in. And hard to know what to try and eat.

The priority during this phase was keeping up fluids. I would sip slowly at anything I could. Fizzy water, electrolyte drinks and Orangina were hits. It was a win when a quarter of a glass of something stayed in for more than half an hour! I avoided anything caffeinated and didn’t want anything milky.

The second aim during this acute phase was just to get something in my stomach. Anything. Even though you feel awful, it’s actually better when there’s a bit of food in your tummy. The advice I received was ‘Don’t worry about what. Just think calories’.

I was told that if I could only manage a few teaspoonfuls, go for high calorie foods that go down without thinking or chewing. Yoghurt, soggy breakfast cereal, ice cream, peanut butter, soup. I sipped a lot of smoothies. Very slowly.

During this phase, the smell of cooking made me vomit. So I only ate cold food. And kept away from the kitchen.

At this point, it’s important not to stress about what you’ve eaten. Or not eaten. If you only eat peanut butter and yoghurt for 2 days, it’s better than nothing. And you have the ‘good weeks’ to make up for it with balanced nutrition.

When you feel better but still nauseous

After about day 3, I started to be able to face food again. My favourite recovery meal was tomato soup with rice in it. Weird but it worked. Sort of solid, sort of liquid, salty and sugary. It went down without any chewing and filled me up. My chemo was on a Thursday. Tomato soup and rice was my Sunday night dinner.

I will never eat tomato soup and rice again. But it served a purpose!

From this point on, I could start eating normally again. Ish.

My taste buds were different during chemo. And I battled sometimes with mouth sores and breakthrough nausea. I couldn’t eat big portions. And if I let myself get hungry, I’d feel sick and then struggle to get back to eating. In many ways, this phase was a lot like being pregnant.

A bit of a battle. A bit queazy. Not sure what you fancy. But when you do eat, you feel better. I focused on eating small portions and 6 meals a day. Most of which were healthy. Or at least not too unhealthy. And I made sure I added protein to everything.

Here’s an example day.

My portions were probably half my normal size but I was eating 6 times a day.

Breakfast - cereal with fruit
Snack - protein shake with fruit
Lunch - wrap with salad and protein
Snack - protein bar, smoothie
Dinner - small portion of family meal with plenty of veg and protein
Snack - nuts and chocolate

Avoiding weight gain during chemo

Many - most? - people gain weight during chemo. Why? Partly inactivity. Partly steroids, which cause water retention and increased appetite. And partly a tendency to snack more and make poor food choices. No blame here, it’s very easy to do! But best avoided, or limited, if you can.

Avoiding weight loss during chemo

For me, I lost a little weight each round. The first few days, when I was vomiting, I would lose a couple of kilos. And then I’d struggle to put it back on as my appetite was lower than normal. For those who lose weight, it’s mostly muscle. And the best ways to combat this are increasing dietary protein. And exercising.

Supplements

I was advised not to take any supplements and to avoid certain foods - grapefruit, turmeric and st johns wort were on the banned list - during chemo. So please make sure you check in with your medical team if there’s something you want to take. Some supplements can interfere with how chemo drugs work or make side effects worse.

Eating during chemo wasn’t all bad! I felt mostly normal 75% of the time.

How can I help you?

If you’re in the thick of chemo and would like to talk to someone about how to manage your food better and make better choices, I’m here to help.

And if, like me, you’re through the other side and have a different experience or other tips for how to eat through chemo, I’d love to hear from you.

What worked for you?

Drop me a line!

ps.

Food and cancer is a huge topic and there are many schools of thought around fasting. sugar, meat, dairy etc. My choices are personal, well researched and what I have decided is right for me. And my family. I’m not here to tell you what to do.

What you choose to eat and what you believe is right is entirely up to you :)