Like steroids, progesterone antagonists are effective in improving appetite and weight in patients with AIDS-related cachexia and CAS. No definitive conclusions about other outcomes related to lean body mass, quality of life, or fatigue could be drawn. No improvement in survival was found. A placebo-controlled study looked at megestrol acetate at a dose of 7.

The megestrol group had a mean weight gain of Interest in the use of cannabinoids in CAS is ongoing because of their effects on appetite and potential benefit in HIV-related cachexia.

Cyproheptadine is a serotonin and histamine antagonist developed as an antihistamine. Side effects include increased appetite and weight gain. Patients also showed a significant increase in serum leptin levels. An increase in serum leptin has been correlated with an increase in body mass index.

Increases in cytokines associated with cancer—including tumor necrosis factor-alpha TNF-alpha , interleukin-6 IL-6 , and interleukin-1—have been shown to be important in the etiology of this disorder.

Specific targeted agents have also been studied. These include agents targeting TNF-alpha, such as etanercept, infliximab, and pentoxifylline, which, in small trials, have not had a significant impact. Several studies using thalidomide, a nonspecific antagonist to TNF, have been performed.

Patients who took thalidomide had a statistically significant reduction in weight loss compared with those who took a placebo. Olanzapine is an antipsychotic that blocks multiple neurotransmitters, including dopamine, serotonin, catecholamines, acetylcholine, and histamine.

A single-center dose escalation trial evaluated the effect of olanzapine 2. In contrast, a retrospective review evaluated food intake 3 days before and after initiation of olanzapine in 80 cancer patients hospitalized due to anorexia. A prospective trial randomly assigned patients starting chemotherapy for untreated, locally advanced, or metastatic gastric, hepatopancreaticobiliary, and lung cancers to receive olanzapine 2.

Given the multifactorial etiology of and multiple mechanisms involved in the development of CAS, it is possible that combining agents with different mechanisms of action might result in greater efficacy. In this study, the combination arm was found to be superior.

Another trial used megestrol alone versus megestrol plus L-carnitine, celecoxib, and antioxidants to treat women with gynecologic malignancies. Conversely, a randomized placebo-controlled trial of megestrol acetate and placebo versus megestrol acetate and celecoxib found no significant difference in weight gain, quality of life, appetite score, or grip strength between the two groups.

However, both groups showed improvements, suggesting a benefit of the single-agent use of megestrol acetate. Researchers also looked at the combination of formoterol, an anabolic beta-2 adrenergic agonist, and megestrol acetate in 13 patients.

Six of seven evaluable patients achieved a major response, with increases in muscle mass. For these reasons, there is no recommended combination at this time. In addition, combining drug therapy with nutrition support and increased physical activity may have even greater efficacy.

CAS is a complex, multifactorial complication of cancer and its therapy, resulting in weight loss and decreased lean body mass. As understanding of the mechanisms of CAS improves and new agents that selectively target proposed pathways become available, more efficacious treatments are expected to become available.

Trials of new agents must be able to compare similar groups of patients. In addition, treating preventively in high-risk patients, as opposed to treating patients already experiencing CAS, may have better outcomes.

Further clinical trials are essential to determine the best possible therapies. Patients with advanced disease often develop new or worsening nutrition-related side effects associated with disease progression, treatment, or both.

In a large systematic review of symptom prevalence in patients with incurable cancer, the most common nutrition impact symptoms were the following:[ 1 ]. These symptoms were present in a large subset of patients receiving care in various settings and in a small subset of patients in their last 2 weeks of life.

Other symptoms among advanced-cancer patients receiving care in inpatient palliative care units,[ 2 , 3 ] cancer cachexia specialty clinics,[ 4 ] hospice, or nonhospice settings [ 3 ] included the following:[ 1 - 4 ].

In addition, advanced-cancer patients with pain and opioid-induced constipation OIC reported both physical and psychological distress related to the OIC. Clinically refractory cachexia develops as a result of very advanced cancer or rapidly progressive disease that is unresponsive to antineoplastic therapy.

It is associated with active catabolism and weight loss that is unresponsive to nutrition therapy. At the end of life, patients often have severely restricted oral intake of food and fluids as part of the normal dying process.

The primary objective of nutrition intervention in patients with advanced cancer is to conserve or restore the best possible quality of life and control any nutrition-related symptoms that cause distress. Nutrition goals for a patient with advanced cancer may depend on the overall plan of care.

These patients may be receiving anticancer therapy with or without concurrent palliative care , may be receiving palliative care alone, or may be enrolled in hospice.

Regardless of the care setting, patients are screened to determine the need for nutrition intervention. The Patient-Generated Subjective Global Assessment PG-SGA has been validated in cancer patients and addresses body weight history, food intake, symptoms, and functional status.

As the focus of care shifts from cancer-modifying therapy to hospice or end-of-life care, nutrition goals may become less aggressive, with a shift toward comfort. Continued assessment and adjustment of nutrition goals and interventions is required throughout this continuum to meet the changing needs of the patient receiving palliative or hospice care services.

Ethical issues may arise when patients, families, or caregivers request artificial nutrition and hydration when there is no prospect of recovering from the underlying illness or benefiting appreciably from the intervention. When there is uncertainty about whether a patient will benefit from artificial nutrition, hydration, or both, a time-limited trial with clear, measurable endpoints may be useful.

The caregiving team will explain that, as with other medical therapies, artificial nutrition and hydration can be stopped if the desired nutrition effects do not occur. Randomized controlled trials of enteral or parenteral nutrition in cancer patients receiving formal palliative care are lacking.

If patients are to benefit from parenteral nutrition, they must be physically and emotionally capable of participating in their own care and have the following:[ 13 ]. Patients with a life expectancy shorter than 40 days may be palliated with home intravenous IV fluid therapy, although this practice is controversial.

Patients and caregivers often consider the provision of food and fluids to be basic care. However, the use of artificial nutrition and hydration at the end of life is a complex and controversial intervention that is influenced by clinical, cultural, religious, ethical, and legal factors.

Patients and families often believe these interventions will improve quality and length of life, but evidence of clear benefit is lacking.

In addition, agitated or confused patients receiving artificial nutrition and hydration may need to be physically restrained to prevent them from removing a gastrostomy tube, nasogastric tube, or central IV line.

Patients at the end of life who have increased difficulty with swallowing have less risk of aspiration with thick liquids than with thin liquids. For patients at the end of life, the goal of nutrition therapy is to alleviate symptoms rather than reverse nutrition deficits. The pleasure of tasting food and the social benefits of participating in meals with family and friends can be emphasized over increasing caloric intake.

Other studies found no effect on terminal delirium, thirst, chronic nausea, or fluid overload. The American Academy of Hospice and Palliative Medicine suggests that providers facilitate respectful and informed discussions about the effects of artificial nutrition and hydration near the end of life among physicians, other health care professionals, patients, and families.

Ideally, patients will make their own decisions on the basis of a careful assessment of potential benefits and burdens, consistent with legal and ethical norms that permit patients to accept or forgo specific medical interventions.

Decisions about whether to provide artificial nutrition and hydration to patients in the late stages of life are complex and influenced by ethical, cultural, and religious issues, as well as by legal issues, clinical considerations, and patient and family preferences.

A number of organizations have published guidelines on the ethical considerations about whether to forgo or discontinue hydration and nutrition support, including the following:. These guidelines reflect judicial decisions that have supported the authority and liberty of the competent individual to refuse life-saving hydration and nutrition, the role of medical expertise, and respect for the dignity and values of the patient and family.

For more information, see the sections on Artificial Hydration and Artificial Nutrition in Last Days of Life. Religion and religious traditions provide a set of core beliefs about life events and an ethical foundation for clinical decision-making. To provide an optimal and inclusive healing environment, all palliative team members need to be aware of their own spirituality and how it may differ from that of fellow team members and the patients and families they serve.

Another group [ 32 ] has provided an extensive analysis of how world religions formulate ethical decisions related to withdrawing treatment and determining when death has occurred.

Religious beliefs are often closely related to cultural views. Individuals living in the midst of a particular tradition can continue to be influenced by it, even if they have stopped believing in or practicing it.

Patients may rely on religion and spirituality as important means to interpret and cope with illness. The wide range of practices related to neutropenic diets reflects the lack of evidence regarding the efficacy of dietary restrictions in preventing infectious complications in cancer patients.

Studies evaluating various approaches to diet restrictions have not shown clear benefit. A meta-analysis and a systematic review of articles evaluating the effect of a neutropenic diet on infection and mortality rates in cancer patients found no superiority or advantage in using a neutropenic diet over a regular diet in neutropenic cancer patients.

Even after the observational study was omitted from the analysis, the results persisted. The review concluded that these individual studies provided no evidence showing that the use of a low-bacterial diet prevents infections.

Other studies have demonstrated potential adverse effects of neutropenic diets. One group of investigators [ 6 ] conducted a retrospective review of patients who had undergone hematopoietic cell transplantation HCT.

The patients who received the neutropenic diet experienced significantly more documented infections than did the patients receiving the general hospital diet, which permitted black pepper and well-washed fruits and vegetables and excluded raw tomatoes, seeds, and nuts.

The neutropenic diet group had a significantly higher rate of infections that could be attributed to a gastrointestinal source, as well as a trend toward a higher rate of vancomycin-resistant enterococci infections.

Without clinical evidence to define the dietary restrictions required to prevent foodborne infection in immunocompromised cancer patients, recommendations for food safety are based on general food safety guidelines and the avoidance of foods most likely to contain pathogenic organisms.

The effectiveness of these guidelines depends on patient and caregiver knowledge about, and adherence to, safe food handling practices and avoidance of higher-risk foods. Leading cancer centers provide guidelines for HCT patients and information about food safety practices related to food purchase, storage, and preparation e.

Patients can be referred to FoodSafety. gov for up-to-date information about food recalls and alerts. Recommendations support the use of safe food-handling procedures and avoiding consumption of foods that pose a high risk of infection, as noted in Table 7.

Maintaining adequate nutrition while undergoing treatment for cancer is imperative because it can reduce treatment-related side effects, prevent delays in treatment, and help maintain quality of life. Patients are likely to search the internet and other lay sources of information for dietary approaches to manage cancer risk and to improve prognosis.

Unfortunately, much of this information is not supported by a sufficient evidence base. The sections below summarize the state of the science on some of the most popular diets and dietary supplements. A vegetarian diet is popular, is easy to implement, and, if followed carefully, does not result in nutritional deficiencies.

There is strong evidence that a vegetarian diet reduces the incidence of many types of cancer, especially cancers of the gastrointestinal GI tract. There are no published clinical trials, pilot studies, or case reports on the effectiveness of a vegetarian diet for the management of cancer therapy and symptoms.

There is no evidence suggesting a benefit of adopting a vegetarian or vegan diet upon diagnosis or while undergoing cancer therapy. On the other hand, there is no evidence that an individual who follows a vegetarian or vegan diet before cancer therapy should abandon it upon starting treatment.

It compared participants who were managed with active surveillance and behavioral counseling with a control group who received no counseling. However, time to cancer progression did not differ between the two groups. It is a high-carbohydrate, low-fat, plant-based diet stemming from philosophical principles promoting a healthy way of living.

Although there are anecdotal reports of the effectiveness of a macrobiotic diet as an alternative cancer therapy, none has been published in peer-reviewed, scientific journals.

No clinical trials, observational studies, or pilot studies have examined the diet as a complementary or alternative therapy for cancer. In fact, two reviews of the diet concluded that there is no scientific evidence for the use of a macrobiotic diet in cancer treatment. No current clinical trials are studying the role of the macrobiotic diet in cancer therapy.

A ketogenic diet has been well established as an effective alternative treatment for some cases of epilepsy and has gained popularity for use in conjunction with standard treatments for glioblastoma. The ketogenic diet can be difficult to follow and relies more on exact proportions of macronutrients typically a ratio of fat to carbohydrates and protein than other complementary and alternative medicine CAM diets.

Therefore, it is safe for a patient diagnosed with glioblastoma to start a ketogenic diet if implemented properly and under the guidance of a registered dietitian. Similarly, findings from a study that compared the acceptability and adverse effects of a ketogenic diet to the American Cancer Society's high-fiber, low-fat diet among women with ovarian or endometrial cancer found no differences between groups over 12 weeks.

Further, the findings indicated that the ketogenic diet was both safe and acceptable. For information about the use of intravenous vitamin C as a treatment for people with cancer, see Intravenous Vitamin C. The use of probiotics has become prevalent within and outside of cancer therapy.

Strong research has shown that probiotic supplementation during radiation therapy, chemotherapy, or both is well tolerated and can help prevent radiation- and chemotherapy-induced diarrhea, especially in those receiving radiation to the abdomen.

Evidence is also emerging for possible benefits of probiotics for immunotherapy-induced toxicities, particularly in the colon. Melatonin is a hormone produced endogenously that has been used as a CAM supplement along with chemotherapy or radiation therapy for targeting tumor activity and for reducing treatment-related symptoms, primarily for solid tumors.

Several studies have shown tumor response to, or disease control with, chemotherapy alongside oral melatonin, as opposed to chemotherapy alone. One study has shown tumor response with melatonin in conjunction with radiation therapy. However, another study did not demonstrate increased survival with melatonin, but did demonstrate improved quality of life.

Melatonin taken in conjunction with chemotherapy may help reduce or prevent some treatment-related side effects and toxicities that can delay treatment, reduce doses, and negatively affect quality of life.

Melatonin supplementation has been associated with significant reductions in neuropathy and neurotoxicity, myelosuppression, thrombocytopenia, cardiotoxicity, stomatitis, asthenia, and malaise. Overall, several small studies show some evidence supporting melatonin supplementation alongside chemotherapy, radiation therapy, or both for solid tumor treatment, aiding tumor response, and reducing toxicities.

Negative side effects for melatonin supplementation have not been found. Therefore, it may be appropriate to provide oral melatonin in conjunction with chemotherapy or radiation therapy to a patient with an advanced solid tumor. Glutamine is an amino acid that is especially important for GI mucosal cells and their replication.

Chemotherapy and radiation therapy often damage these cells, causing mucositis and diarrhea, which can lead to treatment delays and dose reductions and severely affect quality of life. Some evidence suggests that oral glutamine can reduce both of those toxicities by aiding in faster healing of the mucosal cells and entire GI tract.

For patients receiving chemotherapy who are at high risk of developing mucositis, either because of previous mucositis or having received known mucositis-causing chemotherapy, oral glutamine may reduce the severity and incidence of mucositis.

For patients receiving radiation therapy to the abdomen, oral glutamine may reduce the severity of diarrhea and can lead to fewer treatment delays. In addition to reducing GI toxicities, oral glutamine may also reduce peripheral neuropathy in patients receiving the chemotherapy agent paclitaxel.

Oral glutamine is a safe, simple, and relatively low-cost supplement that may reduce severe chemotherapy- and radiation-induced toxicities.

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above. Nutrition Therapy. Added text about a Cochrane review of 38 trials involving 4, patients that reported on the use of megestrol at doses of to mg per day for treatment of cachexia-anorexia syndrome CAS cited Ruiz-Garcia et al.

as reference Added Olanzapine as a new subsection. Revised Table 6 to add information about whether commonly prescribed medications for CAS affect appetite, cachexia, or both. This summary is written and maintained by the PDQ Supportive and Palliative Care Editorial Board , which is editorially independent of NCI.

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This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about nutrition before, during, and after cancer treatment. It is intended as a resource to inform and assist clinicians in the care of their patients.

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Home About Cancer Cancer Treatment Side Effects of Cancer Treatment Appetite Loss Nutrition in Cancer Care PDQ® —Health Professional Version. Starvation-related malnutrition: pure chronic starvation e. Chronic disease—related malnutrition e.

Acute disease—related or injury-related malnutrition e. Insufficient energy intake. Weight loss. Loss of muscle mass. Loss of subcutaneous fat. Localized or generalized fluid accumulation that may sometimes mask weight loss. Diminished functional status as measured by hand grip strength.

Maintain weight. Maintain the ability to stay on the intended treatment regimen with fewer changes. Improve quality of life. Produce better surgical outcomes. In This Section Tumor-Induced Effects on Nutrition Status Disease site Tumor metabolism Treatment-Induced Effects on Nutrition Status Chemotherapy and hormone therapy Radiation therapy Surgery Biotherapy Hemopoietic cell transplantation HCT Influences on nutrition status and risk of malnutrition include the following:[ 1 ] Baseline nutrition status.

Disease site. Stage of disease. Treatment approach. Alterations in taste and smell. Precachexia: early signs clinical and metabolic that precede substantial weight loss.

Cachexia: the presence of significant weight loss or sarcopenia in the absence of simple starvation. Loss of appetite. Taste changes. Early satiety. Changes in taste or ability to swallow.

Changes in bowel movements usually diarrhea. GI symptoms such as gas. In This Section Screening MST PG-SGA Assessment Optimizing nutrition for patients with cancer involves early detection of malnutrition or risk of malnutrition so that intervention may be initiated in the early stages of disease or treatment.

Screening Early recognition of nutrition-related issues is necessary for appropriate nutrition management of cancer patients. The Malnutrition Universal Screening Tool. The Malnutrition Screening Tool MST.

The Patient-Generated Subjective Global Assessment PG-SGA. Food intake. No intervention. Education by registered dietitian or other clinician. Intervention by registered dietitian. Critical need for improved symptom management. Food- and nutrition-related history.

Anthropometric measurements. Biochemical data, medical tests, and procedures. Nutrition-focused physical assessment. Medical history. Treatment plan. Subcutaneous fat loss Orbit. Upper arm. Thoracic and lumbar regions. Subcutaneous muscle loss Temple. Clavicle and acromion. Dorsal hand.

Anterior thigh. Posterior calf. Localized or generalized fluid accumulation. Diminished functional status e. Tumor location current or anticipated mechanical function impairment.

Anticipated duration of symptoms. Intent of treatment. In This Section Goals of Nutrition Therapy Methods of Nutrition Therapy Counseling by a registered dietitian Behavioral strategies for symptom management Oral nutrition supplements Nutrition support Pharmaceutical management of cancer-associated cachexia and weight loss Goals of Nutrition Therapy The goals of medical nutrition therapy are to do the following:[ 1 ] Address current cancer- and treatment-related issues.

Minimize treatment-related side effects. Nutrition status. Type and stage of disease. Comorbid conditions. Overall medical treatment plan.

Provides individualized care to each patient with nutrition- and diet-related needs. Incorporates current research and utilizes evidence-based nutrition practice.

Collaborates with the medical team to ensure integration of care with the overall treatment plan during active treatment and into survivorship.

Taste and smell changes. Loss of Appetite and Weight Loss Eat small, frequent meals and healthy snacks throughout the day. Eat foods that are high in protein and calories.

Eat high-protein foods first in your meal while your appetite is strongest—foods such as beans, chicken, fish, meat, yogurt, and eggs. Add extra protein and calories to food.

Cook with protein-fortified milk. Drink milkshakes, smoothies, juices, or soups if you do not feel like eating solid foods. Prepare and store small portions of favorite foods. This can help to reduce your risk of cancer, cancer recurrence and other diseases.

The World Cancer Research Fund and the American Institute for Cancer Research recommends that you:. Sugar does not directly cause cancer or cause cancer to grow faster. Glucose, a simple sugar, found in most carbohydrate foods including added sugar, grains, cereals, beans, fruits, vegetables, and dairy is the main energy source for all cells, including cancer cells.

Just like healthy cells, cancer cells need a blood supply, oxygen and energy to grow. Limiting all sources of carbohydrate will not starve cancer cells and may negatively affect your healthy cells. Your body needs energy and may use your muscle and fat tissue for energy, which is not recommended.

Many healthy foods such as whole grains, cereals, beans, fruits, naturally contain sugar along with vitamins, minerals, fibre and phytonutrients. Eat a variety of foods and limit table sugar white or brown , soft drinks, sweet baked goods cookies, cakes and processed foods that contain large amounts of added sugar.

For more information, see the " Sugar and Cancer " PDF handout. You can read more about the sugar-cancer connection on the American Institute for Cancer Research website. The Academy of Nutrition and Dietetics also addresses the question " does sugar feed cancer " PDF.

We don't yet know if either a true ketogenic or modified ketogenic diet helps people with cancer. Currently, no major health organization, including BC Cancer, recommends the ketogenic diet for cancer patients. A true ketogenic diet is a very high fat, low carbohydrate diet.

This diet can be high in foods such as red and processed meats, as well as saturated fats. It can also be low in some nutrients the body needs along with most healthy plant foods. A modified ketogenic diet has less extreme carbohydrate restrictions.

If you are interested in trying a ketogenic diet it is recommended that you seek individual nutrition advice from a registered dietitian with experience in ketogenic diet.

A diet rich in vegetables, fruits, whole grains and legumes is recommended for most cancer patients. For more details please see the common question "What do I eat after a cancer diagnosis? Visit the American Institute for Cancer Research AICR blog if you are interested in reading more about ketogenic diet and cancer.

The acid-alkaline level in the body is very tightly controlled. Eating more alkaline foods will not make your blood more alkaline, but it can change your urine alkalinity. Extra acidic or alkaline substances don't build up in the blood because they are removed in the urine to keep the blood within a narrow and slightly alkaline range.

Choose foods for their nutritional content and taste and not how they claim to change the acid or alkaline level in your body. Visit the American Institute for Cancer Research AICR blog if you are interested in reading more about alkaline diet and cancer.

Pesticides used in farming have the potential to build up in the body, which has caused concern for the risk of developing cancer. Current evidence suggests there may be a possible association between pesticides and some cancers.

There is evidence both for and against a link between pesticides and the risk of developing cancer and more research is needed. To reduce your risk of pesticide exposure, buy foods that are locally grown, in season and be sure to peel and wash vegetables and fruits well.

Buying organic food is an individual choice based on personal values, availability and cost. Overall, it is believed that the potential risks associated with pesticides are not as great as the nutritional value of plant foods and their role in cancer prevention and promoting good health.

Therefore whether you choose organic or not it is important to eat a diet rich in fruits and vegetables and obtain the recommended servings each day.

Having cancer does not mean you need to take supplements. It is best to get your vitamins and mineral from food sources if you can. Large doses of vitamins and minerals have not been shown to boost the immune system in well-nourished people or be beneficial for other reasons, and could cause harm.

A once a day multivitamin and mineral supplement may be needed if you are not able to eat a variety of foods or if your diet has changed. If you have questions about taking single nutrient supplements ex.

Calcium, Iron, vitamin D talk to your health care team. It is not recommended to take large amounts of antioxidants, including Vitamin A, C, E and selenium, in supplement forms during cancer treatment.

Many but not all chemotherapy drugs and radiation work by causing oxidative stress to kill cancer cells. Taking antioxidant supplements can counteract this.

The amount found in foods, such as fruits and vegetables, and a once-a-day multivitamin and mineral supplement is safe during cancer treatment.

If you decide to take large doses of antioxidants, or other vitamins or minerals during treatment, speak to your health care team.

They are often thought to be safe because they are labelled as "natural". This is not necessarily true. Even though plants are natural, they are not always safe and their effect is not always known.

Many of these products can increase risk of drug interactions, cause less cancer cells to be destroyed by treatment and affect test results. If you would like to use herbal products during your cancer treatment, please discuss the safest way to do this with your health care team.

Growth hormones are not approved for use in Canada in chickens or pigs or added to their feed. However, hormones may be used in beef cattle. One of the growth hormones used is a form of estrogen that occurs naturally in animals and humans.

Any residues of these hormones in meat are very small when compared to the amount of estrogen a woman produces daily. Yes, red meat in moderation can be part of a healthy diet.

Red meat includes beef, pork, goat, and lamb. These foods provide many nutrients including iron, protein, vitamin B12, and zinc.

See the " The Importance of Eating Protein " PDF handout during treatment and recovery for more about this nutrient. It is recommended to limit red meat in your diet to grams 18 ounces cooked or less per week.

Eating processed meat and too much red meat can increase the risk of colorectal cancer. Processed meat may also increase the risk for cancer of the stomach, nasopharynx, esophagus, lung and pancreas. Processed meat is often made from red meat, but poultry, or other meats that have been commercially preserved by smoking, curing, or with additives like nitrates are also considered processed meat.

Examples of processed meats include ham, bacon, sausage, salami, hot dogs, pepperoni, many deli meats, and bologna. Products that are preserved with naturally-occurring nitrites such as celery extract are still considered processed meats and may also increase risk of cancer.

If you choose to eat processed meat, eat it in small amounts and less often, like ham at a holiday dinner or a hot dog at a hockey game.

The Canadian Cancer Society has more information about red and processed meat and cancer prevention on their website. Receiving cancer treatment does not necessarily mean you need to avoid any foods.

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You might need to be checked for vitamin or mineral deficiencies. Some people with cancer take large amounts of vitamins, minerals, and other dietary supplements to try to boost their immune system or even destroy cancer cells.

But some of these substances can be harmful, especially when taken in large doses. In fact, large doses of some vitamins and minerals may make chemotherapy and radiation therapy less effective. Antioxidants include vitamins A, C, and E; selenium and zinc; and some enzymes that absorb and attach to free radicals destructive molecules , preventing them from attacking normal cells.

If you want to take in more antioxidants, health experts recommend eating a variety of fruits and vegetables, which are good sources of antioxidants. Taking large doses of antioxidant supplements or vitamin-enhanced foods or liquids is usually not recommended while getting chemo or radiation therapy.

Talk with your doctor to find out the best time to take antioxidant supplements. Phytonutrients or phytochemicals are plant compounds like carotenoids, lycopene, resveratrol, and phytosterols that are thought to have health-protecting qualities.

Phytochemicals are best taken in by eating the foods that contain them rather than taking supplements or pills.

Herbs have been used to treat disease for hundreds of years, with mixed results. Today, herbs are found in many products, like pills, liquid extracts, teas, and ointments.

Many of these products are harmless and safe to use, but others can cause harmful side effects. Some may even interfere with cancer treatments and recovery from surgery. Many people believe that a pill or supplement they find in stores, is safe and it works.

The FDA does not make manufacturers of these products print possible side effects on their labels. Take the bottle s to your doctor to talk about the dose and be sure that the ingredients do not interfere with your health or cancer treatments.

Some other safety tips:. The American Cancer Society medical and editorial content team. Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

National Cancer Institute. Nutrition in Cancer Care PDQ - Health Professional Version. March 3, Rock CL, Thomson CA, Sullivan KR, et al. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin. United States Department of Agriculture.

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Understanding Cancer What Is Cancer? Cancer Glossary Anatomy Gallery. Cancer Care Finding Care Making Treatment Decisions Treatment Side Effects Palliative Care Advanced Cancer. Patient Navigation. End of Life Care. For Health Professionals. Cancer News. Explore All About Cancer. Connect with Survivors Breast Cancer Support Cancer Survivors Network Reach To Recovery Survivor Stories.

Resource Search. Volunteer Be an Advocate Volunteer Opportunities for Organizations. Fundraising Events Relay For Life Making Strides Against Breast Cancer Walk Endurance Events Galas, Balls, and Parties Golf Tournaments.

Featured: Making Strides Against Breast Cancer. Explore Get Involved. Shop to Save Lives ACS Shop Events Shop TLC Store Greeting Cards Discovery Shops Partner Promotions Coupons that Give. Protein is good for your health in many ways. It helps your body grow cells, heal tissue and maintain a healthy immune system.

And it can help you avoid infection and recover more quickly. The key is to know where to find it. Good sources of protein include fish, poultry, lean red meat, eggs, nuts and nut butters, dried beans, peas and lentils, dairy products and soy foods.

Yet every cell in your body needs water. They can provide much-needed calories and keep you from becoming dehydrated. Do your best to drink plenty of water and other fluids each day. Your dietitian can give you specific guidelines on how much is right for you. Alcohol can interfere with some cancer treatments and medicines.

It can make side effects like a sore mouth and throat worse. And we now know that drinking any type of alcohol increases your risk of developing some types of cancer.

The best way to get vitamins or minerals is to eat a well-balanced diet. If you do that, you usually get what you need to stay healthy. Taking a regular-strength multivitamin and mineral supplement for your age group every day is often OK, but check with your healthcare team just to be sure.

There is no evidence that taking more than the recommended amounts of vitamins and minerals or that taking large amounts megadoses of any vitamin or mineral will improve your health or help to prevent or cure cancer.

In fact, taking too much of some types of vitamins or minerals can be harmful to your health — and it may even make cancer treatment less effective. Many people wonder whether eating specific foods will boost their immune system and help them fight cancer.

No single diet, food or supplement can boost your immune system. The best thing you can do for your immune system is to follow an overall healthy lifestyle, which includes eating a balanced, healthy diet with a variety of foods.

There is no scientific evidence that any specific food or diet for example, the alkaline diet, a macrobiotic diet or the Gerson therapy diet can cure cancer.

Because these diets often restrict food choices like meat, milk, eggs and even vegetables and fruit , they may not provide enough calories, protein, vitamins and minerals. This can lead to weight loss and poor nutrition. Eating-related side effects are common during cancer treatment.

But most of the time you may not eat well because cancer treatments can damage healthy cells along with cancer cells, causing side effects. And when you have them, it can take some time to figure out what will help.

You may find that your ability to eat well varies from one day to the next. This can all be pretty frustrating. The good news is that most of the time, side effects related to eating are temporary. Once treatment ends, many people gradually get back to eating normally again. Find out more about these eating-related side effects: constipation diarrhea difficulty swallowing dry mouth dumping syndrome fatigue loss of appetite nausea and vomiting osteoporosis sore mouth and throat taste changes trismus weight gain.

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. Patients experiencing difficulty eating may also benefit from our other integrative care services. One experiencing difficulty eating because of pain may benefit from pain management services or oncology rehabilitation.

A speech therapist may help a patient experiencing difficulty swallowing. Some reputable cancer nonprofits also offer nutrition consultations for cancer patients. For example, the Leukemia and Lymphoma Society offers free, one-on-one nutrition consultations to patients and caregivers for all cancer types.

Check with nonprofits that are specific to your particular cancer type to see whether they offer similar services. Many cancer nonprofits also provide nutritional resources and recommendations for coping with specific eating-related side effects.

A few you many want to explore include:. Patients themselves may not know what kind of help they need. Here are a few things for your family and friends to keep in mind:. Managing nutrition during cancer treatment can be challenging, but it may provide you with some control over how you feel during treatment.

It may be beneficial to have a team equipped to approach the different challenges or barriers to getting the nutrition you need, like we do at CTCA.

Maintaining your weight and nutritional status and staying active is worth the effort to improve your treatment outcome and to prepare for survivorship. Call us anytime. Nutrition for cancer patients: How to fuel your body for the fight February 17, by Carolyn Lammersfeld, MBA, MS, RD, CSO, LD This page adheres to our medical and editorial policy and guidelines.

Patients often come to us with questions, like: Should I eat only organic or non-GMO foods? What about a ketogenic diet? Would that help? Should I go vegan?

Are there dietary supplements I should take? Does sugar feed cancer? Why is good nutrition during cancer treatment important? Energy for physical activity If you lose weight during treatment, you may be losing strength and muscle mass rather than stored fat.

The American Society of Clinical Oncology provides guidelines on how to exercise safely during treatment and lists many other possible benefits of exercise during and after treatment, including: Lowering your risk of treatment-related side effects Reducing the risk of depression and anxiety Improving sleep quality Reducing the risk of developing other chronic diseases, including other cancers If possible, try to include some aerobic exercise and resistance training among your activities.

Support for the immune system Cancer treatment may compromise the immune system. Preparation for survivorship The benefits of developing a healthier diet and exercise habits during treatment may carry over into survivorship.

What should you eat during cancer treatment? Try to include: Whole grains like whole-wheat, brown rice, quinoa and buckwheat Two to three cups of vegetables daily One to two cups of fruits daily Skinless poultry and cold water ocean fish like salmon, tuna and cod a couple of times per week Dried beans, peas, lentils and legumes for additional protein Healthy fats like olive oil, avocado, nuts and seeds Low-fat dairy or a dairy substitute for calcium Clean water Try to reduce your consumption of red meat, processed meats , refined carbohydrates and added sugar.

Check with your care team about your specific dietary needs Ask your care team about dietary recommendations that may be associated with your specific type of cancer, treatment or treatment side effects.

Pay extra attention to food safety during cancer treatment Depending on your treatment, you may be immunocompromised. Common causes of malnutrition and dehydration in cancer patients Even when patients are actively trying to eat well and stay hydrated, conditions caused by the cancer itself and side effects of treatment may lead to malnutrition and dehydration.

These cancers include: Head and neck cancers Esophageal cancer Stomach cancer Intestinal cancers Pancreatic cancer Colorectal cancer Malnutrition is also common among patients with advanced lung cancer. Treatment side effects that may cause malnutrition and dehydration Side effects of cancer treatment that may lead to malnutrition and dehydration include: Nausea and vomiting are commonly associated with chemotherapy and radiation therapy.

The National Cancer Institute estimates that up to 80 percent of patients undergoing chemotherapy experience these side effects. Loss of appetite may be more common with certain types of cancers, such as stomach, pancreatic, lung and ovarian cancers. Mucositis develops from inflammation of the digestive tract that often results in painful ulcers commonly called mouth sores in the mouth, throat and gastrointestinal tract.

Mucositis may be a side effect of chemotherapy or radiation therapy, especially for head and neck cancer treatment. Some targeted therapies and immunotherapy may also cause this side effect. Dry mouth may result from radiation therapy targeting head and neck cancers and from some medications taken during chemotherapy.

Taste and smell changes may result from damage to the taste buds caused by chemotherapy, radiation therapy and surgical oncology. These changes may contribute to a loss of appetite. Constipation and diarrhea are commonly associated with chemotherapy but may also be consequences of some pain medications, radiation therapy and surgical procedures.

Dehydration in cancer patients The side effects that lead to malnutrition may also result in dehydration in cancer patients. Warning signs of malnutrition and dehydration At CTCA, we regularly monitor our patients for signs of malnutrition and dehydration and work to prevent these issues through our nutritional support services.

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Yogurt Berry Brûlée with Maple Almond Brittle. Apple Pumpkin Shake. The benefits of developing a healthier diet and exercise habits during treatment may carry over into survivorship. According to the National Cancer Institute , research suggests that these healthier behaviors may improve the quality and length of life of some cancer survivors.

The American Institute for Cancer Research advises cancer survivors to implement their 10 Cancer Prevention Recommendations , which include maintaining a healthy body weight, getting enough physical activity and other dietary recommendations. Following these guidelines may also reduce obesity, which has been associated with an increased risk of developing 13 cancer types and a recurrence of some cancers, such as breast cancer.

A healthier lifestyle may also help you manage or prevent other chronic illnesses, such as heart disease or diabetes. At CTCA®, we understand the importance of preparation for survivorship.

We offer diet, exercise and healthy lifestyle guidance to our patients through our survivorship support program after primary treatment is completed.

This program supplements the services we provide during treatment through our integrative care therapies, which include nutritional support, naturopathic support, oncology rehabilitation and pain management, to help reduce and manage the effects of cancer and treatment side effects.

The challenge of nutrition during cancer treatment is balancing the right quantity and quality of food and nutrient intake given your specific cancer type, treatment and side effects you may experience. Guidelines for a healthy diet during cancer treatment are similar to those recommended for the general population: a balanced, plant-forward diet with whole grains, healthy sources of protein, fruits, vegetables and micronutrients.

Try to include:. Try to reduce your consumption of red meat, processed meats , refined carbohydrates and added sugar. Ask your care team about dietary recommendations that may be associated with your specific type of cancer, treatment or treatment side effects.

For example, if you have a bowel obstruction, limiting fiber intake may be important. Because chemotherapy comes with a high risk of nausea and vomiting, patients may be advised to modify what they eat and add some oral nutrition supplements.

Patients often ask about the use of supplements. Some supplements may actually be harmful or cause unexplained symptoms. Depending on your treatment, you may be immunocompromised. Some treatments are likely to affect your white blood cell count or neutrophil counts, which may put you at higher risk for foodborne illness.

During treatment, try to be diligent about following normal kitchen safety precautions , such as heating and storing foods to proper temperatures and being careful to sanitize cutting boards and avoid cross contamination.

Even when patients are actively trying to eat well and stay hydrated, conditions caused by the cancer itself and side effects of treatment may lead to malnutrition and dehydration.

Patients with gastrointestinal cancers are at higher risk of malnutrition because of associated difficulties with eating, swallowing and digestion. These cancers include:. Malnutrition is also common among patients with advanced lung cancer.

Lung cancer patients with this condition may benefit from an appetite stimulant or a feeding tube. The side effects that lead to malnutrition may also result in dehydration in cancer patients. Mild dehydration may cause symptoms such as fatigue, headaches, dry skin and constipation. Severe dehydration may cause low blood pressure, rapid heartbeat, fever, disorientation, confusion and shock.

Frequent dehydration may cause urinary tract infections and kidney stones. Untreated severe dehydration may even be life-threatening. Drinking eight cups of water a day is a standard recommendation, but the amount you need generally depends on your body weight. To calculate that amount, divide your weight by two.

Divide that result by eight to determine how many cups per day you need to drink. At CTCA, we regularly monitor our patients for signs of malnutrition and dehydration and work to prevent these issues through our nutritional support services.

These include:. There may be medications available to help. Working with a health care professional who can anticipate likely side effects and consequences of your treatment may help you prepare for and reduce the chances of experiencing nutritional deficiencies.

Getting access to nutritional support during treatment may not be easy, however. Up to 90 percent of cancer patients are treated in an outpatient facility, where they may not have access to a nutrition professional.

Cancer centers that do have these clinicians on staff may have an insufficient number of registered dietitian nutritionists RDNs to meet the needs of all patients.

Also ask, before treatment if possible, whether anyone will be regularly screening you for malnutrition or other nutrition-related complications during treatment. Health care professionals with nutritional expertise who may provide nutritional support during cancer treatment include:. At CTCA, we understand the benefits of working proactively to prevent nutritional deficiencies.

Our patients have the option of working with a registered dietitian throughout treatment. Our dietitians work with the rest of your care team to monitor your nutritional status and make recommendations to help you manage side effects you may experience during treatment.

Patients experiencing difficulty eating may also benefit from our other integrative care services. One experiencing difficulty eating because of pain may benefit from pain management services or oncology rehabilitation. A speech therapist may help a patient experiencing difficulty swallowing.

Some reputable cancer nonprofits also offer nutrition consultations for cancer patients. For example, the Leukemia and Lymphoma Society offers free, one-on-one nutrition consultations to patients and caregivers for all cancer types. Check with nonprofits that are specific to your particular cancer type to see whether they offer similar services.

Many cancer nonprofits also provide nutritional resources and recommendations for coping with specific eating-related side effects. A few you many want to explore include:.

Patients themselves may not know what kind of help they need. Here are a few things for your family and friends to keep in mind:. Managing nutrition during cancer treatment can be challenging, but it may provide you with some control over how you feel during treatment.

It may be beneficial to have a team equipped to approach the different challenges or barriers to getting the nutrition you need, like we do at CTCA. Maintaining your weight and nutritional status and staying active is worth the effort to improve your treatment outcome and to prepare for survivorship.

Call us anytime. Nutrition for cancer patients: How to fuel your body for the fight February 17, by Carolyn Lammersfeld, MBA, MS, RD, CSO, LD This page adheres to our medical and editorial policy and guidelines. Patients often come to us with questions, like: Should I eat only organic or non-GMO foods?

What about a ketogenic diet? Would that help? Should I go vegan? Are there dietary supplements I should take? Does sugar feed cancer? Why is good nutrition during cancer treatment important?